Coronal Polishing Chapter 58

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Clinical Crown

The portion of the tooth that is visible in the oral cavity.

Coronal Polishing

A technique used to remove plaque and stains from the coronal surfaces of the teeth.

Endogenous stains

Stains developed from within the structure of the tooth.

Exogenous stains

Stains developed from external sources.

Extrinsic stains

Stains that occur on the external surfaces of the teeth and that may be removed by polishing.

Fulcrum

Finger rest used when holding an instrument or hand piece for a specific time.

Intrinsic stains

Stains that occur within the tooth structure and that cannot be removed by polishing.

Oral prophylaxis

The complete removal of calculus, debris, stain, and plaque from the teeth.

Rubber cup polishing

A technique used to remove plaque and stains from the coronal surfaces of the teeth.

Indication

Before placement of dental sealants.

Indication

Before placement of dental dams.

Indication

Before cementation of orthodontic bands.

Indication

Before application of acid etching solution on enamel (if indicated by the manufacturer's instructions)

Indication

Before cementation of crowns and bridges.

Contraindication

When no stain is present

Contraindication

Patients who are at high risk for dental caries, such as nursing bottle caries, root caries, or areas of thin demineralized enamel because small amounts of enamel are removed during the polishing procedure.)

Contraindication

Sensitive teeth.

Contraindication

Newly erupted teeth (because the mineralization of the surfaces may be incomplete)

Selective Polishing

A procedure in which only those teeth or surfaces with stain are polished.

Therapeutic Polishing

Polishing the root surfaces that have been exposed during periodontal surgery.

Benefits of Coronal Polishing

Prepares the teeth for placement of dental sealants, smooth surfaces are easier for the patient to keep clean, formation of new deposits is slowed, patients appreciate the smooth feeling and clean appearance, polishing prepares the teeth for placement of orthodontic brackets and or bands.

Possible tooth surface damage

Newly erupted teeth are incompletely mineralized, and excessive polishing with an abrasive could remove a small amount of surface enamel

Possible tooth surface damage

Avoid polishing exposed cementum in areas of recesiion because cementum is softer than enamel and is more easily removed.

Possible tooth surface damage

Avoid polishing areas of demineralization due to possibility of loss of surface enamel.

Possible gingival tissue damage

Potential to damage the gingival tissue if the cup is run at a high speed and applied too long.

Possible gingival tissue damage

Potential with fast rotation to force particles of the polishing agent into the sulcus and create a source of irritation.

Possible restoration damage

Abrasive pastes can leave scratches or rough surfaces on gold, composite restorations, acrylic veneers, and porcelain-filled surfaces.

Black stain (extrinsic)

Thin black line on the teeth near the gingival margin. More common in girls. Frequently found in clean mouths. Difficult to remove. Caused by natural tendencies.

Tobacco stain (extrinsic)

A very tenacious dark brown or black stain. Caused by products of coal tar in the tobacco and from the penetration of tobacco juices into pits and fissures, enamel, and dentin of the teeth. Use of any tobacco-containing products.

Brown or yellow stain (extrinsic)

Most commonly found on the buccal surfaces of the maxillary molars and the lungual sufraces of the lower anterior incisors (caused by poor oral hygiene or using a toothpaste with inadequate cleansing action.

Green stain (extrinsic)

Appears as a green or green-yellow stain usually occuring on the facial surfaces of the maxillary anterior teeth. Most common stain in children. Caused by poor oral hygiene when bacteria or fungi are retained in the bacterial plaque.

Dental plaque agents (extrinsic)

Reddish brown stain appears on the interproximal and cervical areas of the teeth. It can also appear on restorations, in plaque, and on the surface of the tongue. Caused by the use of prescription mouthrinses that contain chlorhexidine. (disinfectant with broad antibacterial action)

Food and drink (extrinsic)

Light brownish stain. Stain is lessened with good oral hygiene. Caused by tea, coffee, colas, soy sauce, berries, and other foodstuff.

Pulpless teeth (intrinsic)

Not all pulpless teeth discolor. A wide range of colors exists: light yellow, gray, reddish brown, dark brown, or black; sometimes an orange or greenish color is seen.

Tetracycline antibiotics (intrinsic)

Light green to dark yellow or gray brown. Discoloration depends on the dosage, length of time the drug was used, and the type of tetracycline.

Dental Fluorosis (intrinsic)

Also termed "mottled enamel" it results from igestion of excessive fluoride during the mineralization period of tooth development.

Imperfect tooth development (intrinsic)

Teeth are yellowish brown or gray brown. Teeth appear translucent or opalescent and vary in color. Genetic abnormality.

Silver amalgam (intrinsic)

Appears as a gray or black discoloration around a restoration

Other systemic causes (intrinsic)

Appears as a yellowish or greenish discoloration in the teeth.

Air powder polishing

Uses a specially designed handpiece with a nozzle that delivers a high pressure stream of warm water and sodium bicarbonate.

Silex

Fairly abrasive and is used for cleaning more heavily stained tooth surfaces.

Super-fine silex

Used for removal of light stains on tooth enamel.

Fine pumice

Mildly abrasive and is used for more persistent stains, such as tobacco stains.

Zirconium silcate

Used for cleaning and polishing tooth surfaces (this material is highly effective and does not abrade tooth enamel.)

Chalk

Also known as whiting; chalk is precipitated calcium carbonate (it is frequently incorporated into toothpaste and polishing pastes to whiten the teeth.)

Commercial premixed preparations

Contain an abrasive, water, humectant (to keep the preparation moist), a binder (to prevent seperation of the ingredients), flavoring agents, and color. Some commerical preparations are available in small plastic containers or individual packets that contribute to the cleanliness and sterility of the procedure.

Fluoride prophylaxis pastes

Replace some of the fluoride that is lost from the surface layer during the polishing process. These pastes are not a substitute for topical application of fluoride. Use of fluoride paste is contraindicated before acid etching of the enamel when followed with bonding of sealants for other bonded materials.

Pen grasp

how to grasp the prophy angle.

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