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CASE STUDY #1: Your patient presents for a periodontal maintenance appointment after being gone for 10 months due to the pandemic.  She is usually on a 4 month recall, so this is an amount of time that would usually have included two appointments.   She reports hypertension and diabetes, both of which she controls with medications, and her vitals today are BP 130/86, pulse 88, respirations 14. In doing your periodontal assessments and radiographs, you determine that she has 4mm probe depths in the anterior teeth, several 5-6mm probe depths in the posterior teeth with isolated furcation involvement and generalized moderate to heavy calculus.  She has several amalgam restorations and crowns and you notice several areas of demineralization and recurrent decay, but she is not having any pain or sensitivity.  Use this information to answer the following questions. QUESTION: What ultrasonic inserts would be recommended for use on this patient?

CASE STUDY #2: You are getting ready to see a difficult .3 periodontal maintenance patient. You want to verify that you are using sharp instruments throughout the appointment so you check and sharpen them carefully.  You work carefully during instrumentation to make sure that you are using accurate scaling strokes to avoid incomplete removal of the calculus. Use this information to answer the next 5 questions. QUESTION: How do you position the instrument to begin sharpening?

Your new  patient is a mechanical engineer who has been away from the dentist for a few years.  He had been going to an older dentist who retired and hadn’t been up on newer technology in the dental office.  His very interested in learning about what and how you are doing  the procedures of the appointment and asks a lot of good questions.  Choose the right answer to each of his questions.   QUESTION: How does the ultrasonic instrument work?  (choose the answer that correctly lists the four mechanisms of action of an ultrasonic)

CASE STUDY #2: You are getting ready to see a difficult .3 periodontal maintenance patient. You want to verify that you are using sharp instruments throughout the appointment so you check and sharpen them carefully.  You work carefully during instrumentation to make sure that you are using accurate scaling strokes to avoid incomplete removal of the calculus. Use this information to answer the next 5 questions. QUESTION: When you explore after scaling, you detect some burnished calculus. Which of the following would NOT have contributed to this issue?

CASE STUDY #2: You are getting ready to see a difficult .3 periodontal maintenance patient. You want to verify that you are using sharp instruments throughout the appointment so you check and sharpen them carefully.  You work carefully during instrumentation to make sure that you are using accurate scaling strokes to avoid incomplete removal of the calculus. Use this information to answer the next 5 questions. QUESTION: Which scaling approach would inhibit calculus removal?

CASE STUDY #1: You have completed your assessments on your patient and are getting ready to scale.  You don’t see a test stick in your cassette, so you are going to use the Visual Test using light to determine if your instruments are sharp or dull.  Once you have determined this, you sharpen several of your instruments using the technique that we practiced in class.  Once your instruments are sharpened, you decide to use the sickle scalers as your first hand instruments on your patient since they are periodontally healthy and do not have periodontal pockets to scale.  Use this information to answer the following questions.  QUESTION: As you are using your S204S, which surfaces of the posterior teeth are not typically scaled with this instrument?

You are treating a new patient who reports a history of gastrointestinal issues, including irritable bowel syndrome and acid reflux. The patient is concerned that the acid reflux will cause cavities, so you assure them that you will complete a thorough exam. Below is a photo that you took as part of the exam for a baseline image of the state of the teeth and for patient education. Use this information to answer the following questions: QUESTION: What would you chart for the porcelain restoration that was placed for esthetics on the facial and incisal of #7? 

Your new patient is a mechanical engineer who has been away from the dentist for a few years.  He had been going to an older dentist who retired and hadn’t been up on newer technology in the dental office.  He is very interested in learning about what and how you are doing  the procedures of the appointment and asks a lot of good questions.  Choose the right answer to each of his questions. QUESTION: How do you disinfect the instruments after use on a patient?

You are beginning the periodontal treatment on this patient which includes full quadrants of scaling and root planing on the mandibular arch and partial quadrants of scaling and root planing on the maxillary arch. You will using ultrasonic and hand scaling instruments to treat this patient. QUESTION: Where and at what power setting would the slimline area specific inserts (left/right) be used on this patient?

Case #4: You are seeing a new patient and are finishing their assessments by taking intraoral camera photos. Through your assessments, you have determined that the patient does not have recession, gingival inflammation, or periodontal pockets and has a .2 level of calculus. You are primarily going to be using the sickles for scaling their teeth today. Use this information to answer the following questions.  QUESTION: Which would not be part of your preparation for using the Nevi 4?