Periodontal Instrumentation / Edition 2

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Overview

Peridontal Instrumentation, Second Edition, is the perfect "how-to" manual for the dental hygiene student, dental student, and the practitioner seeking an instrumentation manual which covers both basic and advanced periodontal techniques. The authors have maintained the excellent coverage of basic instruments and skills, while adding state-of-the-art techniques that guarantee the most up-to-date coverage of periodontal instrumentation available.

Each module consists of numerous lessons, each of which includes a convenient performance check list. Over 850 photographs illustrate step-by-step procedures, enhancing comprehension and providing a quick, reliable reference.

  • 15 Principles of Scaling
  • Exploring the Periodontal Patient
  • Advanced Root Instrumentation, which describes treatment of furcations, line angles and deep narrow pockets
  • Instruments Modified for Periodontal Patients including After Five curets, Mini Five curets, and Gracey Curvettes
  • Use of Ultrasonic Scaling Devices

Illustrated guide to instrumentation & techniques for exams, scaling & root planing, polishing, advanced treatments.

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Product Details

  • ISBN-13: 9780838578049
  • Publisher: Prentice Hall
  • Publication date: 9/1/1991
  • Edition description: 2nd ed
  • Edition number: 2
  • Pages: 485
  • Product dimensions: 8.33 (w) x 10.73 (h) x 0.63 (d)

Read an Excerpt

This book was written for dental and dental hygiene students as well as practicing general dentists and dental hygienists. It began as a revision of an earlier book, Dental Hygiene: The Detection and Removal of Calculus, written by Anna Matsuishi Pattison and Jacquelyn Behrens for the U.C.L.A. Allied Health Professions Projects. In planning the revision, however, it became evident that a book of much wider scope and depth was needed in dental education, one designed to systematically introduce both dental and dental hygiene students to the basic clinical procedures of periodontics: Hence, a new book with a new title, Periodontal Instrumentation: A Clinical Manual, was published in 1979. The acceptance of the first edition by the educational community has been most rewarding.

Twelve years have gone by since the first edition of Periodontal Instrumentation appeared. Dentistry and Medicine, and indeed society, have been rocked by the emergence of AIDS. Periodontics has seen a vast increase in the understanding of the etiology and pathogenesis of the various forms of periodontal disease. Despite this, the fundamental concepts and techniques of periodontal instrumentation and its role as the foundation of periodontal therapy has changed little. When we sit down next to our patients in the dental chair, we still treat periodontal disease by removing plaque, calculus, and altered cementum. All of these advances have underscored the importance of instrumentation skills in successfully treating periodontal disease. For this reason, the material dealing with basic instrumentation skills has been retained from the first edition. New material has been added on both fundamental and advanced instrumentation skills for this edition, expanding the application of this text from beginning to advanced students and beyond to the experienced private practitioner.

A significant number of patients suffering from periodontal disease could be treated more successfully if general dentists and dental hygienists were better educated in periodontal examination techniques and in scaling and root planing procedures. Much of the periodontal surgery that is performed today most certainly could have been avoided by earlier recognition of periodontal disease, better patient education, and more thorough instrumentation in the early stages of gingivitis and periodontitis.

Proficiency in periodontal instrumentation especially scaling and root planing, is essential to the ultimate success of any course of periodontal therapy. Even the most sophisticated or complex surgical procedure will not be successful if the clinician has not scrupulously debrided the tooth surfaces. Of all clinical periodontal procedures, subgingival scaling and root planing is the most difficult and exacting skill to master. It seems to be only the exceptional clinician who is able to confidently and consistently perform thorough instrumentation of root surfaces. Because this skill is so commonly performed in dental practice, it is unfortunate that relatively little has been written in the major periodontal textbooks about instrumentation. Also, a relatively small portion of the clinical curricula of most dental schools is devoted to the teaching of this skill, which is the cornerstone of periodontal therapy in the general practice of dentistry.

The book is organized in six modules, which appear in the sequence of the steps in initial periodontal therapy. Module I, Examination Procedures, introduces the extraoral and intraoral examination and the periodontal examination. Module II, Detection of Calculus, describes the use of the explorer and compressed air. Module III, Scaling and Root Planing, teaches the fundamentals of scaling and root planing with universal and Gracey curets, sickles, hoes, files, and ultrasonic sealers. Module IV, Instrument Sharpening, discusses principles of sharpening and demonstrates sharpening of curets and sickles. Module V, Polishing, includes fundamentals of polishing and polishing technique. Module VI, The Periodontal Patient, includes advanced root instrumentation, new instruments specially modified for periodontal patients, and adjunctive procedures such as treatment planning, pain and anxiety control, and gingival curettage.

Each module begins with prerequisites, a general objective and directions for use of the module. This is followed by a series of skills lessons. We have long been concerned about education that teaches "how" but does not emphasize "why". Therefore, each procedure is preceded by a discussion of its rationale. The lessons are followed by review questions, an answer key, and a performance check when appropriate. The performance checks are designed for self-evaluation alone or for self- and instructor evaluation.

Acknowledgments

We are deeply grateful to all of those who provided assistance and encouragement in the preparation of this book. Mrs. Peggy Tsutsui spent many hours writing, reviewing, and revising the new lesson "Exploring the Periodontal Patient." The other members of the dental hygiene faculty at USC provided valuable suggestions and comments during the development of the first edition. The exceptional photography was done by Don Harris and Martin Fong. Artists Valerie Almquist, Maureen De Bose, Ian Warpole, and Douglas Yasuda drew the clear and concise illustrations. Bonina Cohen, Martha Barrera, and Sharon Sanders were all cooperative models who appear in the patient photographs. Kelly Banks provided excellent secretarial support. We would like to thank Richard Saslow, Howard Wax, Warner Ratzel, and especially Karen Neiner of the Hu-Friedy Manufacturing Company for providing historical and technical information on the Gracey curets, as well as the instruments that were photographed for the book. Hank Greenberg of G.C. American Corporation and Dr. Murray Schwartz also provided instruments and information for this edition.

Our appreciation extends to Dr. Henry Takei and his wife, June Takei, who on several occasions inspired us to go on writing because of their enthusiasm and concern for the periodontal education of dental and dental hygiene students. Likewise, we are sincerely indebted to Dr. Esther Wilkins, colleague and good friend, who has been a constant source of inspiration, encouragement, advice, and professional expertise through both the first and second editions.

We would like to express our gratitude to William Schmitt, Jolene Vezzetti, and Charles Evans of Appleton & Lange for their support and patience in the preparation of this manuscript.

Finally, we would like to say to our parents, family, and friends and especially our children, Geoffrey and Andrew, thank you for bearing with us. We sincerely appreciate your understanding and faithful endurance in support of our endeavor.

Anna Matsuishi Pattison Gordon L. Pattison
Los Angeles, California June 1991

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Table of Contents

I. EXAMINATOIN PROCEDURES.

A. Extraoral and Intraoral Examination.

B. Introduction to Instrumentation: Use of the Periodontal Probe.

C. Periodontal Examination.

D. Interpretation of Probing.

II. DETECTION OF CALCULUS.

A. Use of the Explorer.

B. Use of the Compressed Air.

III. SCALING AND ROOT PLANING.

A. Fundamentals of Scaling and Root Planing.

B. Scaling and Root Planing Procedure.

C. Use of Universal Curets.

D. Use of the Gracey Curets.

E. Instrumentation of Different Areas of the Mouth.

F. The Fifteen Principles of Instrumentation.

G. Use of Sickles.

H. Use of Hoes an Files.

I. Use of Ultrasonic and Sonic Scaling Devices.

IV. INSTRUMENTATION SHARPENING.

A. Principles of Sharpening.

B. Sharpening Curets.

C. Sharpening Sickles.

V. POLISHING.

A. Fundamentals of Polishing.

B. Pain and Anxiety Control.

C. Exploring the Periodontal Patient.

D. Advanced Root Instrumentation.

E. Instruments Modified for Periodontal Patients.

F. Gingival Curettage.

G. Periodontal Dressings and Suture Removal.

H. Postoperative Instructions.

I. Desensitizing Root Surfaces.

Index.

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Preface

This book was written for dental and dental hygiene students as well as practicing general dentists and dental hygienists. It began as a revision of an earlier book, Dental Hygiene: The Detection and Removal of Calculus, written by Anna Matsuishi Pattison and Jacquelyn Behrens for the U.C.L.A. Allied Health Professions Projects. In planning the revision, however, it became evident that a book of much wider scope and depth was needed in dental education, one designed to systematically introduce both dental and dental hygiene students to the basic clinical procedures of periodontics: Hence, a new book with a new title, Periodontal Instrumentation: A Clinical Manual, was published in 1979. The acceptance of the first edition by the educational community has been most rewarding.

Twelve years have gone by since the first edition of Periodontal Instrumentation appeared. Dentistry and Medicine, and indeed society, have been rocked by the emergence of AIDS. Periodontics has seen a vast increase in the understanding of the etiology and pathogenesis of the various forms of periodontal disease. Despite this, the fundamental concepts and techniques of periodontal instrumentation and its role as the foundation of periodontal therapy has changed little. When we sit down next to our patients in the dental chair, we still treat periodontal disease by removing plaque, calculus, and altered cementum. All of these advances have underscored the importance of instrumentation skills in successfully treating periodontal disease. For this reason, the material dealing with basic instrumentation skills has been retained from the first edition. New material has been added on both fundamental and advanced instrumentation skills for this edition, expanding the application of this text from beginning to advanced students and beyond to the experienced private practitioner.

A significant number of patients suffering from periodontal disease could be treated more successfully if general dentists and dental hygienists were better educated in periodontal examination techniques and in scaling and root planing procedures. Much of the periodontal surgery that is performed today most certainly could have been avoided by earlier recognition of periodontal disease, better patient education, and more thorough instrumentation in the early stages of gingivitis and periodontitis.

Proficiency in periodontal instrumentation especially scaling and root planing, is essential to the ultimate success of any course of periodontal therapy. Even the most sophisticated or complex surgical procedure will not be successful if the clinician has not scrupulously debrided the tooth surfaces. Of all clinical periodontal procedures, subgingival scaling and root planing is the most difficult and exacting skill to master. It seems to be only the exceptional clinician who is able to confidently and consistently perform thorough instrumentation of root surfaces. Because this skill is so commonly performed in dental practice, it is unfortunate that relatively little has been written in the major periodontal textbooks about instrumentation. Also, a relatively small portion of the clinical curricula of most dental schools is devoted to the teaching of this skill, which is the cornerstone of periodontal therapy in the general practice of dentistry.

The book is organized in six modules, which appear in the sequence of the steps in initial periodontal therapy. Module I, Examination Procedures, introduces the extraoral and intraoral examination and the periodontal examination. Module II, Detection of Calculus, describes the use of the explorer and compressed air. Module III, Scaling and Root Planing, teaches the fundamentals of scaling and root planing with universal and Gracey curets, sickles, hoes, files, and ultrasonic sealers. Module IV, Instrument Sharpening, discusses principles of sharpening and demonstrates sharpening of curets and sickles. Module V, Polishing, includes fundamentals of polishing and polishing technique. Module VI, The Periodontal Patient, includes advanced root instrumentation, new instruments specially modified for periodontal patients, and adjunctive procedures such as treatment planning, pain and anxiety control, and gingival curettage.

Each module begins with prerequisites, a general objective and directions for use of the module. This is followed by a series of skills lessons. We have long been concerned about education that teaches "how" but does not emphasize "why". Therefore, each procedure is preceded by a discussion of its rationale. The lessons are followed by review questions, an answer key, and a performance check when appropriate. The performance checks are designed for self-evaluation alone or for self- and instructor evaluation.

Acknowledgments

We are deeply grateful to all of those who provided assistance and encouragement in the preparation of this book. Mrs. Peggy Tsutsui spent many hours writing, reviewing, and revising the new lesson "Exploring the Periodontal Patient." The other members of the dental hygiene faculty at USC provided valuable suggestions and comments during the development of the first edition. The exceptional photography was done by Don Harris and Martin Fong. Artists Valerie Almquist, Maureen De Bose, Ian Warpole, and Douglas Yasuda drew the clear and concise illustrations. Bonina Cohen, Martha Barrera, and Sharon Sanders were all cooperative models who appear in the patient photographs. Kelly Banks provided excellent secretarial support. We would like to thank Richard Saslow, Howard Wax, Warner Ratzel, and especially Karen Neiner of the Hu-Friedy Manufacturing Company for providing historical and technical information on the Gracey curets, as well as the instruments that were photographed for the book. Hank Greenberg of G.C. American Corporation and Dr. Murray Schwartz also provided instruments and information for this edition.

Our appreciation extends to Dr. Henry Takei and his wife, June Takei, who on several occasions inspired us to go on writing because of their enthusiasm and concern for the periodontal education of dental and dental hygiene students. Likewise, we are sincerely indebted to Dr. Esther Wilkins, colleague and good friend, who has been a constant source of inspiration, encouragement, advice, and professional expertise through both the first and second editions.

We would like to express our gratitude to William Schmitt, Jolene Vezzetti, and Charles Evans of Appleton & Lange for their support and patience in the preparation of this manuscript.

Finally, we would like to say to our parents, family, and friends and especially our children, Geoffrey and Andrew, thank you for bearing with us. We sincerely appreciate your understanding and faithful endurance in support of our endeavor.

Anna Matsuishi Pattison
Gordon L. Pattison
Los Angeles, California
June 1991

Read More Show Less

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