Assessment Instruments Explorers and Probes

Report
Assessment Instruments
Explorers and Probes
Presented by:
Mellissa Boyd, RDH, BSDH
Objectives
• Recognize the different types of assessment instruments and their
applications in patient care
• Describe the fundamental applications of the 2 explorers found in the
Chatt State Instrument Kits
• Explain the design features of an explorer
• Indentify the parts of the explorer shank
Objectives
• Describe what is meant by “tactile sensitivity”
• Explain the design features of a calibrated periodontal probe
• Discuss the fundamental applications of a calibrated periodontal
probe
Instrument Classification
Assessment
• Determine oral status and needs
of patient
• Health?
• Disease?
• Consists of several steps
•
•
•
•
•
Review MDHX
Radiographs
Head/Neck Cancer Exam
Dentition Examination*
Comprehensive Periodontal
Examination*
*Explorers and Probes used for
Dentition exam and CPE
Periodontal Exam
Calculus 101
Plaque-Biofilm
Calculus
http://www.edwardbyrne.com/plaque.htm
Dentition Exam
?
Oral Cancer Screening
Periodontal Probe Design Features
• Working‐End
– Blunt
– Rod‐shaped
• Cross‐section
– Round
– Rectangular
• Types
– Calibrated
– Furcation
Periodontal Probe Design Features
• Working-End
• Blunt
• Rod-shaped
• Cross-section
• Round
• Rectangular
• Types
• Calibrated
• Furcation
Purpose
• Used in comprehensive
periodontal exam or PSR
• Measurement
– Sulcus/pocket depths
– Bleeding
– Exudate
– Recession
– Oral lesions
Periodontal Probe
•Determine health of periodontal tissues
Williams Probe
• What are the mm markings
on a Williams Probe?
UNC 12
• What are the mm markings
on the UNC 12 probe?
UNC 15
Marquis Probe
WHO probe (PSR)
Probe Depth
• What is the PD indicated in the
picture?
Sulcus vs. Pocket
• Sulcus
• Space between free gingiva and
tooth
• 1-3mm
• Pocket
• Sulcus deepened because of
disease
• 4mm+
• Gingival vs. Periodontal
Probing Depths
• Entire sulcus probed
• Six sites recorded per tooth
• 3 buccal/facial
• 3 lingual
• Record deepest reading per site
• Depth rounded up to nearest
mm
Bleeding on Probing
Explorer Design Features
• Fine wire-like working-end
• Flexible shank
• Circular in cross-section
• Straight or curved shanks
• Paired or unpaired working ends
Working-End
• 1-2mm length used
• Often referred to as
“tip 1/3”
• Calculus detection
• Side of tip 1/3
• EXD 11/12
• Caries detection
• Point of tip 1/3
• #23 Shepherd Hook
“Tip 1/3”
Shank
Functional shank
• Functional Shank
• Long , complex
• Begins below working end
• Extends to last bend in shank
nearest handle
• Terminal Shank (lower)
• Part of functional shank nearest
to working-end
Terminal shank
Calculus Detection
EXD 11/12
• Long, complex shank
Curved
• Shorter, slightly curved shank
Calculus Detection
Pigtail/Cowhorn
• Extremely curved terminal shank
Orban-type
• Straight terminal shank
Explorer Applications
Detection
• Texture of tooth/root
surfaces
• Calculus
• Caries
• Faulty restorations
• Overhangs
Tactile Sensitivity
• Feel vibrations transferred from
instrument tip, through shank,
to handle
• Learned ability
• Accomplished by using very
light grasp and lots of
PRACTICE!!
Examples of Tactile Sensations
• Catching on overcontoured
restorations
• Dropping into a hole
(carious lesions)
• Bouncing over an elevated
deposit
• Feeling roughness
Calculus Detection
Three Types of Formation
Supragingival Calculus
• Coronal to GM
• Rough, chalky white, beige,
stained
• Visual detection
• Dry with air or cotton 2x2
Subgingival Calculus
• Apical to GM
• Located in sulcus or pocket
• Tactile feeling only
• May show in x-ray
• Brown or Black
Explorer Applications
Evaluation
• Completed treatment
• Calculus removal
• Restoration margins
Caries Detection
Shepherd Hook ( # 23)
Straight
Caries 101
Visible Caries
• Obvious, frank, open lesions
• Chalky, white, gray,
brown, black in color
• May retain food
• Shallow lesions
• Light pressure
• Feels soft, tacky,
leather-like
Do NOT explore large, frank lesions!
Caries
Pit & Fissure Caries
• Catch/stickiness when tracing
fissure with light pressure
Smooth Surface Caries
• Visually check for discoloration
• May feel rough or soft
Caries
Root Surface Caries
• Develop on exposed cementum
• Feel explorer “dip” in/out
• May feel rough or leathery
Recurrent Caries
• Restoration margins
• Feel explorer “dip” or catch
along margin

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