Scaling & Root Planning Fix
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Transcript of Scaling & Root Planning Fix
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caling & Root
Planning
1
PERIODONSIA
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Defnisi
• Scaling adalah suatu prosespengangkatan plak dan kalkulusdari permukaan supragingivaldan subgingival gigi, tanpamengangkat bagian dari gigi.
• Root planning adalah proses
pengangkatan kalkulus ygmelekat pada sementum untukmenghasilkan permukaan akar
gigi yg mulus, keras dan bersih.
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Tujuan scaling dan root planning :
Mengembalikan kesehatan gingiva
Menurunkan jumlah M subgingival : A actinomycetemcomitans,
P.gingivalis, P.intermedia Menghilangkan !aktor lokal "
in#amasi gingiva sembuh
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$apan harus melakukan scalingatau root planning%%%
• perator hrs mempunyaikemampuan mendeteksi kalkulusdg baik
• $alkulus supragingival " scaling
• $alkulus supragingival dansubgingival " scaling dan rootplanning
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Mendeteksi kalkulus
• &isualisasi dan kemampuantaktil yg baik
• &isual : dg cahaya yg cukup danarea yg bersih
• $alkulus yg lunak ' basah ()terkalsifkasi* sulit dilihat(k.supragingival*
• +unakan three way syringe "arah ke daerah poket
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Mendeteksi $alkulus
• ksplorasi taktil : probe atausonde
• -egang dg teknik pen graps
• Dg tekanan ringan dan stabil "ekplorasi semua permukaan gigi
• -d pemula " kesulitanmendeteksi kalkulus yg halusdan sementum yg mengalamiperubahan
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Scaling KalkulusSupragingiva• Menggunakan sickle, kuret dan USS.
Hoe dan fle jrg dgunakan.• Dipegang dgn modifed pens grasp• Finger rest diletakkan dekat dgn area
kerja.• Cutting edge diletakkan sdkt
dibawah apikal kalkulussupragingiva.
• erakan vertikal diangkat• !lade " #$% d er&ukaan i i
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'he (ive !asic scalinginstru&ents
). *uret
!. Sickle
*. (ile
D. *hisel
+. Hoe
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Maca&&aca& Sickle
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-e&akaian sickle scaler
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S*K/+ S*)/+0 anterior
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-e&akaian sickle anterior
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Scaling Kalkulus subgingiva
• /ebih sulit dibanding dgn scalingk.supragingiva area ters&buni.
• )lat g dgunakan Kuret. !lade naberbentuk kurva,toe &e&bulat insersi2adaptasi ke dasar poket.
• Dipegang dgn modifed pens grasp,fnger rest disesuaikan.
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Macam)macam uret
• *uret universal 3 anterior and posterior• *uret grace4 15 , 67 3 gg anterior
89 3 anterior n bicuspid
:;,#1$ 3 posterior
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Hoes '* 51$516
Shank andworking tiphoes
Universal curette >118
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race
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*o&plete gracecurette set
0) 16@17 3 &olar nso&e pre&olars distal
'riple ben shaAt
0) 11@15 Molars npre&olars &esial
/onger shaAt withseveral shallowangulation
0) :@; B#@1$
Molars n pre&olars Aacial dan oral surAace
0) :@; Med length,severel angulatedshaAt
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-erbedaan pe&akaian curet dansickle
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0e&oval soAt deposit n stainwith powder water spra
0e&oval oA hard supragingival concre&ents withan ultra sonic instru&ent
0e&oval oA hard supragingival concre&ents witha sonic instru&ent
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(C+0 0+S'
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*onventional intra oral fnger rest 3 the fnger restestablished on tooth surAaces i&&ediatel adjacentto the working area
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*rossarch fnger rest 3 'he fnger rest is establishedon tooth surAaces on the other side oA the sa&earch
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ppositearch fnger rest 3 the fnger rest isestablished on tooth surAaces on the oppositeAorinstance, a &andibular arch rest Aor instru&entation
on the &aEillar posterior teeth
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(ingeron fnger rest 3 the fnger rest isestablished on the indeE fnger or thu&b oAthe non operating hand
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+Etra oral pal&up hand rest 3 the hand restis established b resting the backs oA thefnger
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+Etra oral pal&down hand rest 3 the hand rest isestablished b resting the Aront surAace on the fngersFatl against the skin overling the lateral aspect oA
the &andible on the leAt side oA the Aace
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ndeE fnger reinAorced rest
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'hu&b reinAorced rest
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Ultrasonic Scaller
• Dapat digunakan untuk kalkulus supradan subgingiva
• Membunuh M dg kenaikan
temperatur• /akukan kombinasi dg hand
instrument (manual*
• Menggunakan vibrasi utk mengangkat
kalkulus (rendah)tinggi* dansemprotan air
• Trauma dan ketidaknyamanan -0 1
•
2aktu kerja lbh cepat
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$ontra 3ndikasi4ltrasonic Scaller
5. -0 dg cardiac pace maker
6. -0 dg penyakit perna!asan ygberesiko
7. -0 dg penyakit yg bisa menularmelalui udara
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Teknik Scaling 4ltrasonic
• Dg tekanan ringan
• 4jung instrument sejajar permukaan gigi
• 2orking end menyentuh permukaan kalkulus
• 2orking tip hrs kontak dg semua permukaangigi dan akar
• -ermukaan gigi hrs sering di periksa dg sonde
• 8erosol dari ultrasonic mengandung darah 'M " p0 kumur antiseptik, alat selalu disteril
sblm dan sesudah, operator (masker, sarungtangan, kacamata*, penyaring udara (9-8flter*
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-enggunaan ultrasonicscaler:
1. Alat steril, unit dan slang lapisi dg plastik
2. Px kumur 1 mnt dg klorheksidin 0,12%
3. Operator dan asisten → kacamata, sarung tangan, masker
4. !alakan unit dimulai dg kekuatan !g rendah
". Pasang suction#. Pen graps, dg $iksasi
. &erakan 'ertikal, hori(ontalatau o)li*ue o'erlapping
+. orking end se-a-ar gigi, konstan, tdk )oleh ditahan terlalu
lama → gigi tergores. /nstrument dimatikan secara )erkala
10.Permukaan akar dirapikan dg curret
11./nstruksi px
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-osisi pasien dan operator
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Scaling techniGue
Mini&u& 0) set
!asic ar&a&entariu& 3
• anaesthesia
•Mirror, cotton Aorceps,sharp eEplorer
•-eriodontal probe
•Mini&u& 0) set 8@9,:@;, 11@15, 16@17
•Scalers, universal curettes
•-erio set dia&ond
•0insing solution
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0egio )nterior (acial
Scaling distobuccal surAace tooth 55
-atientIs head 3 reclined position,head inclined to the right
Dentist # oIclock position
0est position intra oral, indirect uponthe thu&b oA the leAt hand
Jision 3 direct
Scaling disto palatinal surAace tooth 55
-atientIs head 3 eEtended to theright n dorsall
Dentist 11 oIclock position
0est position3 intra oral, directlon tooth51
Jision indirect
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Scaling posterior seg&en &esial
Scaling on &esial suAace Aro&the buccal tooth 59
Scaling on &esialsurAace Aro& palataltooth 59
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-osterior seg&ent distal
Scaling on distal surAaceAro& buccal tooth 59
Scaling on distal surAaceAro& palatal tooth 59
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'ooth cleaning power driven instru&ents
-owderwater spra
instru&ent 3
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-olishing
• Menggunakan rubber cup atau bristlebrushes
• Dipegang dengan modifed pensgrasp
• Rubber / brushes dioles dgn pastapoles ke se&ua per&. igi.
• )ktiAkan handpiece, rubberdigerakkan perlahan.
• Menghilangkan sisa5 stain
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+valuasi Scaling 2 0-
• 0eepitelisasi luka jaringan lunakberlangsung antara 15 &ggu.
• !- B krg brsih @ krg baik kontrolplak inFa&&asi
• dealna evaluasi 5 &ggu pascascaling &e&baik tdk diperlukan
S* 2 0- ulang.• !ila &sh tdk baik S* 2 0- ulang.
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'eri&a Kasih