Module 15- Sickle Scalers

Copyright © 2017 Wolters Kluwer • All Rights ReservedCopyright © 2014 Wolters Kluwer • All Rights Reserved

Module 15—Sickle Scalers

Section 3Technique Practice—Anterior Teeth

Copyright © 2017 Wolters Kluwer • All Rights Reserved

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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Copyright © 2017 Wolters Kluwer • All Rights Reserved4

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


Calculus Removal Steps

-Stabilization-Adaptation-Angulation-Lateral pressure-Controlled, short strokes-Various stroke directions-Number of strokes

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Establishing Angulation

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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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Incorrect Correct

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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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Sequence: Surfaces Toward and Away



Section 4Maintaining Adaptation to Proximal

Surfaces


Adaptation to Proximal Surfaces: Incorrect


Adaptation to Proximal Surfaces: Correct


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.


Adaptation Adjacent to Papillary Gingiva

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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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Anatomy of Gingiva


Incorrect

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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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Section 5Technique Practice—Posterior Teeth


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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Posterior Sickle: Two Working-Ends

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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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Method 1

Lower Shank as Visual Clue

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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 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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Method 2

Inner and Outer Cutting Edges

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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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Incorrect

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Correct

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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 1

Select the correct working-end.

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Sequence: Area 1

Distal surface

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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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Section 5Skill Application


Practical Focus

Sickle Scalers

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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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Correct Adaptation of Cutting Edge

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Correct or Incorrect?


Correct of Incorrect? (cont.)


Correct Working-End Selection

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Method 1


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Correct or Incorrect? (cont.)

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Method 2

Inner or Outer Cutting Edge

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Which Is the Inner Cutting Edge?

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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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Correct Angulation

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Correct or Incorrect? (cont.)

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Module 15- Sickle Scalers

Education