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Module 15—Sickle Scalers
Section 3Technique Practice—Anterior Teeth
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Anterior Teeth
Use of Anterior Sickle Scaler
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Topics
-Calculus removal concepts-Establishing 70- to 80-degree angulation-Application of cutting edges-Step-by-step use on anterior teeth-Adaptation for proximal surfaces and adjacent to papillary gingiva
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Calculus Removal Concepts
-Maintaining correct modified pen grasp is important for effective calculus removal-Pause to check that finger placement in grasp is correct before initiating an instrumentation stroke-Review characteristics of calculus removal stroke
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Calculus Removal Steps
-Stabilization-Adaptation-Angulation-Lateral pressure-Controlled, short strokes-Various stroke directions-Number of strokes
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Design Alert
The face of the working-end is at a 90-degree angle to the lower shank.
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Impact of Design
Positioning the lower shank parallel to the tooth surface creates an incorrect face-to-tooth angulation of 90 degrees.
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Correct Angulation
Correct angulation is achieved by tilting the lower shank toward the tooth surface. This creates a face-to-tooth surface angulation of 70 to 80 degrees.
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Application of Cutting Edges
Anterior Sickle Scaler
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Step-by-Step Technique
Anterior Sickle Scaler
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Always One Step at a Time
Remember: “Me, My patient, My light, My mirror, My grasp, My finger rest, My adaptation”
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Step 1
Begin at the midline of the tooth and work toward the proximal surface.
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Step 2
Position the tip-third of the working-end near the midline of the tooth.Tilt the lower shank toward the tooth surface to establish correct angulation.
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Step 3
Make strokes across the facial surface toward the mesial surface.
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Step 4
At the line angle, roll the instrument handle to maintain adaptation of the tip-third of the working-end.
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Step 5
Continue making strokes as you work along the mesial surface.Make sure your angulation is still between 70 and 80 degrees.
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Step 6
Be sure to make strokes at least halfway across the mesial surface.
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Module 15—Sickle Scalers
Section 4Maintaining Adaptation to Proximal
Surfaces
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Adaptation to Proximal Surfaces
• Another common technique error is failure to adapt the tip-third (or toe-third) of the cutting edge to a proximal surface.
• Correct technique involves rolling the instrument handle in a series of tiny movements as you move around the line angle into the proximal surface.
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Papillary Gingiva
-Instrumentation of proximal surfaces adjacent to papillary gingiva can be challenging-New clinicians may “trace the pointed contours of the papilla” with the working-end—Incorrect-Instead position cutting edge against proximal tooth surface—Correct
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Recap
• Calculus removal strokes with sickle scalers are short, controlled strokes using an angulation between 70 and 80 degrees.
• Strokes are limited to removal of medium- to large-sized deposits on enamel surfaces.
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Module 15—Sickle Scalers
Section 5Technique Practice—Posterior Teeth
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Posterior Sextants
Use of a Posterior Sickle Scaler
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Topics
-Choosing the correct working-end-Establishing angulation-Step-by-step use of a posterior sickle scaler
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Choosing the Correct Working-End
Double-Ended Posterior Instrument
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Methods
There are two methods that can be used to pick the correct working-end for use on a tooth surface.It does not matter which method you use.Use the one that is easiest for you!
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Procedure
Establish a finger rest.Place working-end in the Get Ready Zone of the distal surface. Use the lower shank as a visual clue.
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Lower Shank as Visual Clue
-Lower shank is parallel to the distal surface-Functional shank goes up and over the tooth
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Incorrect Working-End
-Lower shank not parallel-Functional shank is down and around the tooth
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Memory Aid
Think: “Posterior = Parallel”Functional shank up and over
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Procedure
Hold the instrument so that you are looking down at the face.Determine which cutting edge is closer to the handle.
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Identify the Cutting Edges
Because of the bend in the shank, one cutting edge is closer to the handle.Which one?
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Identify the Cutting Edges (cont.)
Inner = closer to handleOuter = farther from handle
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Cutting Edge Use
Inner cutting edges: used on distal surfacesOuter cutting edges: used on facial, lingual, and mesial surfaces
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Memory Aid
Think: “I start in on the distal surface, then move out to the facial and mesial.”
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Establishing Angulation
Face-to-tooth surface angulation:-70 to 80 degrees
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Design Alert
The face of the working-end is perpendicular to the lower shank.
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Impact of Design
Positioning the lower shank parallel to the tooth surface creates an incorrect face-to-tooth surface angulation of 90 degrees.
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Correct Angulation
Correct angulation is achieved by tilting the lower shank toward the tooth surface.
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Application of Cutting Edges
Posterior Sickle Scaler
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Working-End Application
Four cutting edges of a posterior sickle scaler:
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Working-End Application (cont.)
How cutting edges are applied to mandibular molar and mandibular right posterior sextant:
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Step-by-Step Technique
Posterior Sickle Scaler
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Always One Step at a Time
Remember: “Me, My patient, My light, My mirror, My grasp, My finger rest, My adaptation”
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Step 2
Position the tip-third of the working-end at the distofacial line angle.Work back toward the distal surface.
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Step 3
Check your angulation.Tilt the lower shank toward the tooth surface.
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Technique Check
The face should be at a 70- to 80-degree angle to the distal surface.
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Step 4
Roll the instrument handle to maintain adaptation at line angle.Tilt lower shank toward the mesial surface.
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Step 5
Continue strokes at least halfway across the mesial surface.
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Recap
Instrument is used on the proximal surfaces only; not the direct facial or lingual.Use visual clues to select the correct working-end of a posterior sickle scaler.Tilt lower shank slightly toward the tooth to establish correct face-to-tooth surface angulation.
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Module 15—Sickle Scalers
Section 5Skill Application
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Topics
Select the correct adaptation of cutting edge.Select the correct working-end.Determine the correct angulation.
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Cutting Edge and Surface
Which cutting edge is used on the:distal surface?facial surface?lingual surface?mesial surface?
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