module 13- explorers

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

Module 13—Explorers

Section 1Explorers

Copyright © 2017 Wolters Kluwer • All Rights Reserved

Topics

Functions of ExplorersDesign CharacteristicsTypes of Explorer Designs

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Functions of Explorers

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Explorer

-An assessment instrument with a flexible wire-like working-end-Used to detect subgingival calculus deposits and anatomic features

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Functions—An Assessment Instrument

Used to examine tooth surfaces for:Calculus depositsDental anomaliesAnatomic features of the teethAssess dental restorations and sealants

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Sub- or Supragingival?

Supragingival: use of an instrument coronal to (above) the gingival marginSubgingival: use of an instrument apical to (beneath) the gingival margin

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Design Characteristics

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Explorer

-Made of flexible metal that conducts vibrations from the working-end to the clinician’s fingers

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Parts of the Explorer

The tip is 1 to 2 mm of the side of the explorer.The tip is adapted to the tooth for detection of calculus deposits.

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Explorer Tip Design

This explorer has a tip that is bent at a 90-degree angle to the lower shank.-Ideal for subgingival use-Point not used for detection

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Lower Shank

The lower shank of an explorer is the section of the shank that is nearest to the explorer tip.

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Types of Explorer Designs

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Variety of Designs

Explorers are available in many different designs.The clinician should be knowledgeable about the recommended use of each basic design type.All design types are not well suited to subgingival use.

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Basic Explorer Design Types

-Pigtail and cowhorn-Orban type-11/12 type

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Pigtail and Cowhorn Explorers

-So named because they resemble a pig’s tail or a bull’s horns

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Pigtail and Cowhorn Use

-Calculus detection in normal sulci or shallow pockets extending no deeper than the cervical-third of the root

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Pigtail and Cowhorn Disadvantages

The curved lower shank causes considerable stretching of the tissue away from the root surface.

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Orban-Type Explorer Design

-Tip bent at 90 degrees to the lower shank-Straight lower shank

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Uses of Orban Type

Subgingival calculus detection on:

– Anterior root surfaces

– Facial and lingual root surfaces of posterior teeth

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Orban-Type Advantages

-Bent tip allows the back of the tip (instead of the point) to be directed against the soft tissue base of the sulcus/pocket-Excellent for use on anterior teeth

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Orban-Type Disadvantages

-Straight shank makes it difficult to use on the line angles, mesial, and distal surfaces of posterior teeth

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11/12-Type Explorer Design

-Tip bent at 90-degree angle to lower shank-Long, complex shank design

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11/12-Type Advantages

-Smooth back of tip is in contact with soft tissue base of sulcus or pocket-Complex shank excellent for anterior and posterior teeth

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11/12-Type Disadvantages

NONE!This explorer works well throughout the mouth and can be used in healthy sulci and deep periodontal pockets.

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The 11/12 Type is Ideal

-Curved back of the working-end touches the soft tissue base of sulcus or periodontal pocket-Complex shank makes it easy to reach root surfaces of anterior and posterior teeth-Can be used in shallow sulci and deep pockets

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Recap

There are many types of explorer designs.The clinician must be knowledgeable about the recommended uses of each design type to avoid injury to the soft tissues of the periodontium.

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The Best Design for the Job

The fine working-end and flexible shank of an explorer enhance tactile information to the clinician’s fingers.An explorer is the instrument of choice for calculus detection.

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The Assessment Stroke

Exploratory Stroke

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An assessment stroke is used to detect calculus deposits or other tooth surface irregularities on the tooth surface.It is also called an “exploratory stroke.”

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Finding Hidden Subgingival Calculus

During subgingival instrumentation, the clinician relies on his or her sense of touch to locate calculus deposits hidden beneath the gingival margin.

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Tactile sensitivity is the ability to detect tooth irregularities, such as calculus deposits, by feeling vibrations transferred from the explorer tip to the instrument shank and handle.

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Example

1. The explorer tip quivers as it passes over a calculus deposit on the root of the tooth.

2. These vibrations are transmitted from the tip through the instrument shank and handle.

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Example (cont.)

3. The clinician feels these vibrations with his or her fingers resting on the instrument shank and handle.

4. The clinician recognizes these vibrations as calculus deposits.

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Technique for Assessment Strokes

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Subgingival Exploring

Assessment strokes should be short in length and involve many overlapping strokes.

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Technique Tips for Exploring

Grasp—relaxed grasp, middle finger rests lightly on shankAdaptation—1 to 2 mm of side of tipLateral Pressure—feather-light pressure against toothStrokes—fluid, sweeping strokes

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Technique Errors: Exploring

AVOID a firm, tense, “death grip.”AVOID applying pressure with the middle finger against the shank. Both of these errors reduce tactile information to the fingers.

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More Technique Errors

Do NOT remove the explorer tip from the sulcus or pocket as you make an upward stroke. Keep the tip beneath the gingival margin.Removing and reinserting the tip repeatedly can injure the gingival tissue.

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Good Technique

Keep the tip in contact with the root surface as you move across the tooth.Keep strokes short, about 2 to 3 mm in length.Make many overlapping, multidirectional strokes to assess the entire root surface.

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Exploring Proximal Surfaces

On proximal surfaces, lead with the explorer tip.Do NOT “back” into proximal surface.Strokes reach under contact area.

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Recap

An assessment stroke is used to detect calculus deposits or other tooth surface irregularities on the tooth surface.Tactile sensitivity is the ability to detect calculus deposits by feeling vibrations transferred from the explorer tip to the instrument shank and handle.

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Anterior Teeth

Using 11/12-Type Explorer

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Select Correct Working-End

-Tip is at 90-degree angle to the lower shank-Only the terminal 2 mm of the side tip is adapted to tooth surface

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Correct Working-End

-Working-end curves inward toward the facial surface-“Wraps around” facial surface

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Incorrect Working-End

-Working-end curves outward away from the facial surface

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Step 1

-Select correct working-end

-Insert to base of the pocket

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Step 2

-Make assessment strokes across facial surface

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Step 3

-Roll the instrument handle to move tip around mesiofacial line angle

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Step 4

-Assess at least halfway across the mesial surface from facial aspect

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Step 5

-Select correct working-end-Assess other half of tooth

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Posterior Sextants

Step-by-Step Technique for Exploring

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Review Instrument Design

Identify the tip and lower shank of the explorer that you will use for the posterior teeth.

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Correct Working-End

To select the correct working-end for the sextant to be explored, observe the relationship of the lower shank to the distal surface of a premolar tooth.Use the premolar tooth for selection, because this tooth is easily seen.

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Visual Clue: Correct

The lower shank is parallel to the distal surface.The functional shank goes “up and over” the tooth.

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Visual Clue: Incorrect

The lower shank crosses the facial surface.The functional shank is “down and around” the tooth.

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Rule for Working-End Selection

When selecting the correct working-end for posterior teeth think: “Functional shank up and over” “Posterior = Parallel”

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Tooth Surface Sequence

Start at the distofacial line and work back toward the distal surface.

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Step 1

Place the explorer tip in the Get Ready Zone.

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Step 2

Lower the instrument handle.Gently insert beneath the gingival margin.Make feather-light strokes toward the distal surface.

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Step 3

As you approach the distal surface, roll the instrument handle slightly to maintain adaptation.Explore at least halfway across the distal surface.

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Sequence for Tooth Surfaces

You are now ready to explore the facial and mesial surfaces of the tooth. Begin at the distofacial line angle.

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Step 4

Get ready.Position the tip in the middle-third of the crown.

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Step 5

Lower the instrument handle.Gently insert beneath the gingival margin.Make a series of feather-light strokes across the facial surface.

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Step 6

Roll the instrument handle as you approach the mesiofacial line angle to maintain adaptation.

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Step 7

Explore at least halfway across the mesial surface from the facial aspect.

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Sequence for Posterior Sextant

Use the sequence shown here when exploring a posterior sextant.

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Posterior Sextants

Maxillary Posterior with 11/12-Type Explorer

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Step 1

Maxillary Left Lingual Aspect

-Position tip at distolingual line angle-Assess distal surface to the midline

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Step 2

-Reposition tip at distolingual line angle-Assess the lingual surface with feather-light strokes

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Step 3

-Roll the instrument handle to keep tip adapted around the mesiolingual line angle

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Step 4

-Assess at least halfway across the mesial surface

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module 13- explorers

Education