Deck 27: Ultrasonic Instrumentation

Question 1

Precision thin inserts are designed and indicated for which of the following?

A) Heavy calculus removal
B) Light periodontal root debridement
C) Removal of extrinsic tooth stain only
D) Removal of orthodontic cement
E) Tenacious deposits

Answer 1

Light periodontal root debridement

Question 2

What parts of the working end surfaces of a magnetostrictive ultrasonic insert are adapted to the root of the tooth for debridement?

A) Back and point
B) Point and lateral surfaces
C) Back and lateral surfaces
D) Concave surface and back
E) Concave surface and point

Answer 2

Back and lateral surfaces

Question 3

Which one of the following is an indication for using a standard ultrasonic insert or tip?

A) Generalized tobacco stain or localized light subgingival calculus in a child
B) Moderate to heavy supragingival calculus in a young adult, accompanied by tobacco stain
C) Fine subgingival deposit in deep periodontal pockets and intrinsic tooth stain
D) Light generalized tobacco stain and fine subgingival scaling generalized in the mouth of a senior citizen
E) Subgingival deposits that are light and are associated with tight gingival tone indicating little inflammation

Answer 3

Moderate to heavy supragingival calculus in a young adult, accompanied by tobacco stain

Question 4

Which of the following is the main difference between a manually tuned and an autotuned ultrasonic instrument or unit?

A) The manually tuned instrument has less "clinical power" than the autotuned instrument.
B) The autotuned unit has a preset frequency, and the manually tuned unit does not.
C) The manually tuned unit does not require water as a coolant, but the autotuned unit does.
D) Amplitude is greater with the autotuned unit than with the manually tuned unit.
E) Autotuned units have inserts and manually tuned have tips to contact the tooth.

Question 5

Which of the following are disadvantages of mechanized instrumentation when compared with hand-activated instrumentation?

A) Increased efficiency, no need to sharpen, reduced lateral pressure
B) Less tissue distention, lavage, acoustic microstreaming
C) Water, increased efficiency, and increased lateral pressure
D) More precautions and limitations, aerosol production, possible temporary hearing shifts
E) Efficacy, time involved and cost

Question 6

What is the action created by the formation and collapse of bubbles in water by high-frequency sound waves surrounding an ultrasonic tip?

A) Clinical power
B) Mechanical action
C) Cavitation
D) Acoustic microstreaming
E) Amplitude

Question 7

Which of the following is true about the correct adaptation of an ultrasonic working end to the tooth surface?

A) The working end is angulated at more than 45 degrees and less than 60 degrees.
B) The working end should be angulated at 15 degrees or almost parallel to the long axis of the tooth.
C) The working end is angulated at 60 degrees to 80 degrees to the tooth surface.
D) The working end is angulated at zero degrees to the tooth surface.
E) The working end is adapted at a different angle depending on if it is a piezoelectric tip or a magnetostrictive insert.

Question 8

When a thin insert is used for ultrasonic periodontal debridement, what tuning is recommended?

A) Out of phase
B) In phase
C) Neither of the above
D) Both out of phase and in phase tuning are routinely used

Question 9

Which of the following best describes the water spray that is recommended when precision thin inserts are used for nonsurgical periodontal therapy?

A) A narrow steady stream of water
B) Large droplets of water over a large area
C) Very fine droplets of water in a fine mist or spray
D) Fine droplets of water and a narrow stream of water covering a large area
E) None of the above

Question 10

One of the major differences between the piezoelectric ultrasonic instrument and the magnetostrictive ultrasonic instrument is which of the following?

A) The purpose of the water that is emitted at the working end
B) The surfaces of the working end that are adapted to the tooth
C) The frequency used
D) The type of stroke employed when activating
E) The power used

Question 11

All of the following influence the energy emitted from the working end of an ultrasonic instrument except:

A) pressure.
B) time of exposure.
C) angle of application.
D) amount of water.
E) shape.

Question 12

Excessive cementum removal during periodontal debridement could result in which of the following?

A) Caries
B) Root surface damage
C) Pulpitis
D) Loss of enamel
E) Dentinal sensitivity

Question 13

Power-driven instrumentation produces all of the following modes of action except:

A) cavitation.
B) transduction.
C) mechanical action.
D) acoustic microstreaming.
E) atomization.

Question 14

What actually causes the working end of an ultrasonic insert or tip to vibrate?

A) The voltage in the generator
B) The transducer contracting and expanding
C) The cavitation
D) Acoustic microstreaming
E) The wireless or wired foot pedal

Question 15

Which of the following descriptions provides a visual cue to the clinician to correct the tuning of a standard ultrasonic insert?

A) A narrow steady stream of water
B) Very fine droplets of water covering a large area
C) Large drops of water covering a large area
D) Fine droplets of water and a narrow stream of water covering a large area
E) A steady stream of water

Question 16

Which of the following describes the power (amplitude) of ultrasonic energy?

A) It is the length of the stroke.
B) It adjusts the volume of water.
C) It is how fast the stroke moves.
D) It is the speed of movement across the tooth.
E) It relates to the direction of the stroke.

Question 17

Sensitivity experienced by a client during power-driven instrumentation is most likely due to which of the following?

A) Fulcrum placement
B) Methodical activation
C) "Vibrato" or fast activation
D) Inappropriate stroke direction
E) Incorrect adaptation

Question 18

All of the following are contraindications for use of ultrasonic instrumentation except:

A) cardiovascular disease with secondary pulmonary disease.
B) communicable diseases.
C) multiple dystrophy with dysphagia.
D) chronic pulmonary disease with a history of acute conditions.
E) cardiac pacemaker.

Question 19

In which of the following ways could an ultrasonic working end cause an undesirable surface alteration?

A) Power setting is too low.
B) Water spray is too great.
C) Point is adapted to the tooth.
D) Light pressure is used on the tooth.
E) The tooth to working end angulation is less than 15 degrees.

Question 20

When magnetostrictive ultrasonic instrumentation is used, the function of the water that circulates through the handpiece and exits as a spray at the working end is which of the following?

A) To lubricate the moving parts of the handpiece
B) To cool the transducer and the tip
C) To stop bleeding
D) To destroy or disrupt bacteria
E) To aid in calculus removal

Question 21

Working end wear of inserts and tips results in which of the following?

A) Frequency adjustment problems
B) Lack of efficiency
C) Limited cavitation
D) Need for decreased power settings
E) Inadequate water flow for cooling

Question 22

Periodontal debridement of implants can be accomplished by power-driven instruments in which of the following situations?

A) When no inflammation is determined adjacent to implants
B) When specialized inserts or tips are used
C) When precision thin inserts are used
D) When standard inserts or tips are used
E) When only oral biofilm removal is the objective and not calculus removal

Question 23

The limited research on patient preference has resulted in which of the following outcomes?

A) The magnetostrictive unit is preferred when compared to the piezoelectric method.
B) The piezoelectric unit seems to elicit the least pain and discomfort when compared to the magnetostrictive unit.
C) The magnetostrictive unit results in greater efficiency than the piezoelectric unit.
D) The piezoelectric unit results in greater efficacy when compared to the piezoelectric unit.
E) None of the above are correct.

Question 24

All of the following are true about the adaptation of working ends of ultrasonic instruments except:

A) the terminal 2 to 4 mm of the insert or tip should be adapted to the deposit.
B) the appropriate surfaces of the working end should be adapted.
C) the angle of the working end to the tooth should be maintained around 15 degrees.
D) adaptation should star with moderate pressure being applied.
E) activation should occur after correct adaptation to the deposit.

Question 25

All of the following are true about activation of ultrasonic instruments except:

A) the working end is in motion at all times.
B) overlapping and multidirectional strokes are used.
C) excessive lateral pressure is used.
D) immediate clinical outcome from instrumentation is evaluated using the dental light, air, and a periodontal explorer.
E) movement on the tooth is in an elliptical pattern.

Question 26

A combination of hand and power-driven instrumentation is recommended to obtain optimal results from periodontal debridement. Advantages of mechanized instrumentation over hand-activated instrumentation include increased efficiency, water for lavage, and less pressure at times.

A) Both statements are true.
B) Both statements are false.
C) The first statement is true, and the second statement is false.
D) The first statement is false, and the second statement is true.

Question 27

All of the following are true about the micro thin insert or tip except it is:

A) to be used with any level of power.
B) intended to reach further into deep pockets than other designs.
C) intended for periodontal debridement for light deposits including oral biofilm.
D) indicated for furcations.
E) intended for use in developmental depressions and concavities.

Question 28

Hand-activated and mechanized instrumentation are equally effective in removing subgingival oral biofilm and dental calculus. The effort to remove endotoxin is also equal with hand-activated and mechanized instrumentation.

A) Both statements are true.
B) Both statements are false.
C) The first statement is true, and the second statement is false.
D) The first statement is false, and the second statement is true.

Question 29

Which of the following necessitate precautions when mechanized instrumentation is used?

A) Pacemakers, demineralized tooth surfaces, and children
B) Tobacco stain, orthodontic cement, and pericoronitis
C) Necrotizing periodontal diseases, communicable diseases, and immunosuppression
D) Periodontal debridement, dysphagia, and intrinsic tooth stain
E) Restorations, periodontal debridement, and coffee staining

Question 30

All of the following are verified health-related issues or outcomes associated with power-driven instrumentation except:

A) interproximal areas, furcations, the cementoenamel junction, and multirooted teeth will most likely exhibit residual calculus regardless of instrument method.
B) bleeding on probing and probing depths are both reduced to equivalent levels when ultrasonic methods are compared with each other and with hand scaling.
C) aerosol production is created with ultrasonic instrumentation.
D) All of the above are verified health-related issues or outcomes associated with power-driven instrumentation.
E) None of the above are verified health-related issues or outcomes associated with power-driven instrumentation.