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Module 21: Advanced Techniques for Root Instrumentation (instrumentation…
Module 21: Advanced Techniques for Root Instrumentation
Anatomical features of root surfaces
root concavity: linear developmental depression in the root surface
bone loss exposes concavities
palatal groove - max lateral incisor
deep linear root concavity - proximal surface mandibular canine
wide shallow concavity - mesial surface mandibular molar
deep linear proximal concavity and furcation - max first premolar
deep depression on root trunk and furcation - mandibular molar
proximal concavity - extending from furcation to CEJ on max molar
Fulcruming techniques
finger on finger fulcrum: resting ring finger of dominant hand on finger of nondominant hand
extraoral
Advantages
easier access to max molars
easier acesss to deep pockets on molars
improved parallelism of lower shank to molars
neutral wrist position for molars
Disadvantages
requires greater degree of muscle coordination
greater instrument stick risk
reduce tactile sensitivity
not well tolerated for TMJ patients
palm facing out - max posteriors
chin cup - max posteriors
instrumentation sequence
begin with root trunk
use distal curet on distal aspect of roots
use mesial curet on facial and mesial surfaces of root trunk