Clinician Position in Relation to the Treatment Area

MODULE 2 © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC NOT FOR SALEClinician OR DISTRIBUTION Position inNOT Relation FOR SALE OR DISTRIBUTION to the Treatment Area © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC NOT FOR SALEModule OR DISTRIBUTION Overview NOT FOR SALE OR DISTRIBUTION The manner in which the seated clinician is positioned in relation to a treatment area is known as the clock position. This module introduces the traditional clock positions for periodontal instrumentation. © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTIONModule Outline NOT FOR SALE OR DISTRIBUTION Section 1 Clock Positions for Instrumentation 41

Section 2 Positioning for the RIGHT-Handed Clinician 43 © Jones & BartlettSkill Building. Learning, Clock LLCPositions for the RIGHT-Handed© JonesClinician, & p. Bartlett 43 Learning, LLC NOT FOR SALEFlow OR Chart: DISTRIBUTION Sequence for Practicing Patient/ClinicianNOT Position FOR SALE OR DISTRIBUTION Use of Textbook during Skill Practice Quick Start Guide to the Anterior Sextants, p. 47 Skill Building. Clock Positions for the Anterior Surfaces Toward, p. 48 © Jones & Bartlett Learning,Skill LLC Building. Clock Positions for© the Jones Anterior & SurfacesBartlett Away, Learning, p. 49 LLC Quick Start Guide to the Posterior Sextants, p. 50 NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION Skill Building. Clock Positions for the Posterior Sextants, Aspects Facing Toward the Clinician, p. 51 Skill Building. Clock Positions for the Posterior Sextants, Aspects Facing Away From the Clinician, p. 52 © Jones & Bartlett Learning, LLC Reference Sheet:© Position Jones for & the Bartlett RIGHT-Handed Learning, Clinician LLC NOT FOR SALE OR DISTRIBUTIONSection 3 PositioningNOT for theFOR LEFT-Handed SALE OR DISTRIBUTION Clinician 54 Skill Building. Clock Positions for the LEFT-Handed Clinician, p. 54 Flow Chart: Sequence for Practicing Patient/Clinician Position Use of Textbook During Skill Practice © Jones & BartlettQuick StartLearning, Guide to LLC the Anterior Sextants, p. 58© Jones & Bartlett Learning, LLC NOT FOR SALESkill OR Building. DISTRIBUTION Clock Positions for the Anterior SurfacesNOT Toward, FOR p.SALE 59 OR DISTRIBUTION Skill Building. Clock Positions for the Anterior Surfaces Away, p. 60 Quick Start Guide to the Posterior Sextants, p. 61 Skill Building. Clock Positions for the Posterior Sextants, Aspects Facing Toward the Clinician, p. 62 © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC Skill Building. Clock Positions for the Posterior Sextants, Aspects NOT FOR SALE OR DISTRIBUTIONFacing Away from the Clinician,NOT p. 63FOR SALE OR DISTRIBUTION Reference Sheet: Position for the LEFT-Handed Clinician Section 4 Modified Positioning: Working from a Standing Position 65 © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION 39

9781284456769_CH02_039_068.indd 39 07/01/20 1:15 PM © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION Section 5 Skill Application 66 Practical Focus. Assessing Patient and Clinician Position Student Self Evaluation Module 2: Positioning and Clock Positions © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC NOT FOR SALEOnline OR resources DISTRIBUTION for this module: NOT FOR SALE OR DISTRIBUTION • Clock Positions for Anterior Teeth (right- and left-handed versions) • Clock Positions for Posterior Teeth (right- and left-handed versions) Available online. © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION Key Terms Clock positions Anterior surfaces away from Posterior aspects facing away © Jones & Bartlett Learning,Anterior surfacesLLC toward the clinician© Jones & Bartlett Learning,from the clinician LLC NOT FOR SALE OR DISTRIBUTIONthe clinician PosteriorNOT aspects FOR facing SALE OR DISTRIBUTION toward the clinician Learning Objectives • Demonstrate© Jones and& Bartlett maintain neutralLearning, seated LLC posture for each of the mandibular© Jones and maxillary& Bartlett Learning, LLC treatment areas. NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION • Demonstrate correct patient position relative to the clinician. • Demonstrate, from memory, the clock position(s) for each of the mandibular and maxillary treatment areas. • Demonstrate standing clinician position for the mandibular treatment areas. © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC • Recognize incorrect position and describe or demonstrate how to correct the problem. NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION

RIGHT- AND LEFT-HANDED SECTIONS IN THIS MODULE • Beginning with Section 2, the sections in this module are custom- © Jones & Bartlett Learning, LLC ized for right-handed© Jones and left-handed & Bartlett clinicians. Learning, LLC NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION • Having two different versions of the content in the Module sometimes can be annoying or confusing. For example, a left-handed clinician finds it time consuming to bypass all the right-handed pages to locate the left-handed version. Sometimes readers turn © Jones & Bartlettto the wrong Learning, version LLCand become confused. © Jones & Bartlett Learning, LLC NOT FOR SALE• For ease OR of DISTRIBUTION use—and avoidance of confusion—if youNOT are FOR right- SALE OR DISTRIBUTION handed, it is recommended that you either (1) tear the left-handed pages from the book or (2) staple these pages together. If you are left-handed, use the same approach with the right-handed pages. © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION

9781284456769_CH02_039_068.indd 40 10/04/20 4:45 PM Module 2 Clinician Position in Relation to the Treatment Area 41 © Jones & Bartlett Learning, LLC © Jones & BartlettSection Learning, 1 LLC NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION Clock Positions for Instrumentation

1. Range of Clinician Positions. During periodontal instrumentation the seated clinician moves around the patient to maintain neutral body posture. © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC A. Goal of Positioning. Correct positioning of the seated clinician in relation to the treatmentNOT area FOR (1) SALEfacilitates OR neutral DISTRIBUTION posture of the clinician’s head, NOTarms, wrists,FOR SALE OR DISTRIBUTION and hands and (2) provides optimal vision of the tooth surfaces. B. Clock Positions 1. Instrumentation of the various treatment areas may be accomplished from a © Jones &range Bartlett of clinician Learning, positions LLC in relation to the patient’s© Jones head (Fig. & Bartlett 2-1). Learning, LLC NOT FOR2. SALEUsing an OR analog DISTRIBUTION clock face as a guide—with the patient’sNOT head FOR being SALE at 12 OR o’clock DISTRIBUTION and the feet being at 6 o’clock—is a common method of identifying the clinician’s position in relation to the patient (Fig. 2-2). 3. The positions that the clinician assumes in relation to the patient’s head are known as “clock positions”. © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC 2. Range of Patient Head Positions. In addition to assuming an optimal clock position, NOT FOR SALE ORit is DISTRIBUTION important to ask the patient to assumeNOT a head FOR position SALE thatOR facilitatesDISTRIBUTION neutral arm, wrist, and hand position for the clinician (Fig. 2-3).

Figure 2-1. Movement Around the Patient. © Jones• The seated & Bartlett clinician Learning, can assume LLC © Jones & Bartlett Learning, LLC a range of positions around NOT theFOR patient SALE during OR periodontal DISTRIBUTION NOT FOR SALE OR DISTRIBUTION instrumentation. • This illustration shows two examples of possible seated © Jones & Bartlettpositions Learning, in relation LLC to the patient. © Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION 12 11 1

Figure 2-2. Clinician Clock Positions. Clinician clock positions are identified • 9 3 using the face of an analog clock as the © Jonesguide & (Box Bartlett 2-1). Learning, LLC © Jones & Bartlett Learning, LLC NOT• TheFOR patient’s SALE head OR isDISTRIBUTION at the 12 o’clock NOT FOR SALE OR DISTRIBUTION position and the feet are at the 6 o’clock 8 4 position. • Right-handed clinicians sit from 8 to © Jones & Bartlett1 o’clock;Learning, left-handed LLC from 11 to 4 o’clock.© Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION

9781284456769_CH02_039_068.indd 41 07/01/20 1:15 PM 42 Fundamentals of Periodontal Instrumentation & Advanced Root Instrumentation

© Jones & FigureBartlett 2-3. Learning, Patient Head LLC Positions. © Jones & Bartlett Learning, LLC NOT FOR SALE• The ORpatient’s DISTRIBUTION head should be positioned to facilitateNOT neutralFOR SALE OR DISTRIBUTION arm, wrist, and hand posture for the clinician. The patient’s head may be straight or turned toward or away from the clinician. • The clinician should© Jones request & thatBartlett the patient Learning, position LLC the head © Jones & Bartlett Learning, LLC to facilitate visibilityNOT andFOR access SALE to theOR treatment DISTRIBUTION area. The NOT FOR SALE OR DISTRIBUTION patient is in the dental chair only for 45 to 60 minutes, while the clinician works at chairside throughout an 8-hour day.

1. The next two sections of this Module contain instructions for practicing the traditional clock positions for each treatment area of the mouth. © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC 2. For this module, you should concentrate on mastering your positioning for each treatment NOT FOR SALE ORarea. DISTRIBUTION NOT FOR SALE OR DISTRIBUTION • Work without dental instruments and just concentrate on learning positioning. • Before picking up a periodontal instrument you should master the large motor skills of positioning yourself, your patient, and the dental equipment to facilitate neutral © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC position. NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION 3. As you practice each clock position, position your arms and hands as described in this module. • You will use both of your hands for periodontal instrumentation, the periodontal instrument is held in your dominant hand and the mirror is held in your nondominant hand. © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC NOT •FOR For this SALE module, OR prac DISTRIBUTIONtice placing the fingertips of your handsNOT as FOR shown SALE in the illustrationOR DISTRIBUTION for each clock position. 0 Place your dominant hand on the teeth in the treatment area. 0 Rest your nondominant hand on the patient’s cheek or chin. © Jones & Bartlett4. You Learning, will not be LLC able to obtain a clear view of© allJones tooth surfaces& Bartlett as you Learning, practice positioning LLC NOT FOR SALE ORin this DISTRIBUTION module. In Modules 4 to 7, you will learnNOT to FOR use a SALEdental mouth OR DISTRIBUTION mirror to view these “hidden” tooth surfaces. 5. Do not wear magnification loupeswhen practicing and perfecting your positioning skills in this module. You need an unrestricted visual field for self-evaluation. The remainder© Jonesof this module & Bartlett is divided Learning, into right- LLC and left-handed sections.© Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION

9781284456769_CH02_039_068.indd 42 07/01/20 1:15 PM RIGHT-HANDED CLINICIAN 07/01/20 1:15 PM 43

1 © Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, NOT FOR SALE OR DISTRIBUTION Option 2 Option © Jones & Bartlett Learning, LLC © Jones & Bartlett OR DISTRIBUTION NOT FOR SALE Option © Jones & Bartlett Learning, LLC © Jones & Bartlett OR DISTRIBUTION NOT FOR SALE © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, NOT FOR SALE OR DISTRIBUTION © Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION Clinician Position in Relation to the Treatment Area to the Treatment in Relation Position Clinician

SKILL BUILDING SKILL Clock Positions for the RIGHT-Handed Clinician Clock Positions for © Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, NOT FOR SALE OR DISTRIBUTION © Jones & Bartlett Learning, LLC © Jones & Bartlett OR DISTRIBUTION NOT FOR SALE © Jones & Bartlett Learning LLC, an Ascend Learning Company. NOT FOR SALE OR DISTRIBUTION. Arm Positions. To reach the patient’s mouth, hold the lower half of your right arm in approximate alignment with the patient’s shoulder. Hold your left hand and wrist over the region of the patient’s right eye. Line of Vision. Your line of vision is straight down into the mouth. Torso Position. Sit facing the side of the patient’s head. The midline of your torso is even with the patient’s mouth. Leg Position. Your legs may be in either of two acceptable positions: (1) straddling the patient chair or (2) underneath the headrest of the patient chair—not under the chair back. Neutral position is best achieved by straddling the chair; however, you should use the alternative position if you find straddling uncomfortable. To reach the patient’s mouth, hold your arms Arm Positions. To reach the patient’s mouth, hold your lower right arm slightly away from your sides. Hold not rest your arm on the over the patient’s chest. NOTE: Do patient’s head or chest. into the Line of Vision. Your line of vision is straight ahead, patient’s mouth. Sit facing the patient with your hip in line with Torso Position. Sit facing the patient the patient’s upper arm. side of the Leg Position. Your thighs should rest against the patient chair. should be limited since it is difficult to maintain neutral armshould be limited since it is difficult and torso posture in this clock position. Ergonomic Considerations: Ergonomic postural abnormalities whenever possible.

• 9 o’clock Position (To the Side of the Patient) the Side of (To Position 9 o’clock • • • 2 Section Clinician the RIGHT-Handed for Positioning • Practice each clock position by following the criteria outlined below. position by following the criteria Directions: Practice each clock of the Patient) the Front (To Positions 8 o’clock • • • © Jones & Bartlett Learning, LLC © Jones & Bartlett OR DISTRIBUTION NOT FOR SALE © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, NOT FOR SALE OR DISTRIBUTION © Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION 9781284456769_CH02_039_068.indd 43 © Jones & Bartlett Learning, LLC & Bartlett Learning, © Jones SALE OR DISTRIBUTION NOT FOR © Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, NOT FOR SALE OR DISTRIBUTION © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, NOT FOR SALE OR DISTRIBUTION 07/01/20 1:15 PM © Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, NOT FOR SALE OR DISTRIBUTION © Jones & Bartlett Learning, LLC © Jones & Bartlett OR DISTRIBUTION NOT FOR SALE © Jones & Bartlett Learning, LLC © Jones & Bartlett OR DISTRIBUTION NOT FOR SALE © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, NOT FOR SALE OR DISTRIBUTION © Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION © Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, NOT FOR SALE OR DISTRIBUTION © Jones & Bartlett Learning, LLC & Bartlett Learning, © Jones SALE OR DISTRIBUTION NOT FOR LLC © Jones & Bartlett Learning, NOT FOR SALE OR DISTRIBUTION atient) © Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, NOT FOR SALE OR DISTRIBUTION © Jones & Bartlett Learning, LLC © Jones & Bartlett OR DISTRIBUTION NOT FOR SALE © Jones & Bartlett Learning LLC, an Ascend Learning Company. NOT FOR SALE OR DISTRIBUTION. Fundamentals of Periodontal Instrumentation & Advanced Root Instrumentation Advanced & Instrumentation of Periodontal Fundamentals

Leg Position. Your legs should straddle the corner of the headrest. Arm Positions. To reach the patient’s mouth, hold your left hand directly across the corner of the patient’s mouth. Hold your right hand and wrist above the patient’s nose and forehead. Line of Vision. Your line of vision is straight down into the mouth. Torso Position. Sit at the top left corner of the headrest; the midline of your torso is even with the temple region of the patient’s head. Torso Position. Sit behind the patient’s head. Leg Position. Your legs should straddle the headrest. your wrists Arm Positions. To reach the patient’s mouth, hold patient’s ears and cheeks. and hands above the region of the into the Line of Vision. Your line of vision is straight down patient’s mouth. Your line of vision is straight down into the Line of Vision. Your line of vision is straight down mouth. Your legs should straddle the corner of the Leg Position. Your legs should headrest. mouth, hold your right Arm Positions. To reach the patient’s Hold the corner of the patient’s mouth. hand directly across forehead. wrist above the patient’s nose and your left hand and Sit at the top right corner of the headrest; the Torso Position. Sit at the top right of the is even with the temple region midline of your torso patient’s head. © Jones & Bartlett Learning, LLC © Jones & Bartlett OR DISTRIBUTION NOT FOR SALE © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, NOT FOR SALE OR DISTRIBUTION © Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION

• • 1 to 2 o’clock Position (Near Corner of Headrest) Position 1 to 2 o’clock • • • • • • 12 o’clock Position (Behind the P (Behind the Position 12 o’clock • • • 44 (Near Corner of Headrest) Position 10 to 11 o’clock •

RIGHT-HANDED CLINICIAN 9781284456769_CH02_039_068.indd 44 © Jones & Bartlett Learning, LLC & Bartlett Learning, © Jones SALE OR DISTRIBUTION NOT FOR © Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, NOT FOR SALE OR DISTRIBUTION © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, NOT FOR SALE OR DISTRIBUTION RIGHT-HANDED CLINICIAN 07/01/20 1:15 PM 45

ME. PA © Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, NOT FOR SALE OR DISTRIBUTION © Jones & Bartlett Learning, LLC & Bartlett Learning, © Jones SALE OR DISTRIBUTION NOT FOR LLC © Jones & Bartlett Learning, NOT FOR SALE OR DISTRIBUTION MY Module 2 Module MY EQUIPMENT Sequence for E for Sequence

MY DOMINANT HAND. MY NONDOMINANT HAND. Figure 2-4. Figure Establish patient chair and head position. Establish patient chair and head clinician, patient, and equipment position. clinician, patient, and equipment Place the fingertips of my dominant hand as Place the fingertips of my dominant shown in the illustration for the clock position. shown in the illustration for the clock position. shown in the illustration for the Adjust the unit light. Pause and self-check the Adjust the unit light. Pause and Sequence for Establishing Position Sequence Place the fingertips of my nondominant hand as Place the fingertips of my nondominant Assume the clock position for the treatment area. position for the treatment Assume the clock © Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, NOT FOR SALE OR DISTRIBUTION 1 2 3 4 5 © Jones & Bartlett Learning, LLC © Jones & Bartlett OR DISTRIBUTION NOT FOR SALE © Jones & Bartlett Learning LLC, an Ascend Learning Company. NOT FOR SALE OR DISTRIBUTION. FLOW CHART: SEQUENCE FOR PRACTICING PATIENT/CLINICIAN POSITION PATIENT/CLINICIAN PRACTICING FOR SEQUENCE CHART: FLOW in a step-by-step to proceed it is important instrumentation, periodontal For successful My “Me, is approach remember the step-by-step to help you A useful saying manner. 2-4). (Fig. ” Dominant hand My hand, Non-dominant My Light, My Patient, © Jones & Bartlett Learning, LLC © Jones & Bartlett OR DISTRIBUTION NOT FOR SALE © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, NOT FOR SALE OR DISTRIBUTION © Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION 9781284456769_CH02_039_068.indd 45 © Jones & Bartlett Learning, LLC & Bartlett Learning, © Jones SALE OR DISTRIBUTION NOT FOR © Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, NOT FOR SALE OR DISTRIBUTION © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, NOT FOR SALE OR DISTRIBUTION 07/01/20 1:15 PM © Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, NOT FOR SALE OR DISTRIBUTION © Jones & Bartlett Learning, LLC © Jones & Bartlett OR DISTRIBUTION NOT FOR SALE © Jones & Bartlett Learning, LLC © Jones & Bartlett OR DISTRIBUTION NOT FOR SALE © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, NOT FOR SALE OR DISTRIBUTION © Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION © Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, NOT FOR SALE OR DISTRIBUTION © Jones & Bartlett Learning, LLC & Bartlett Learning, © Jones SALE OR DISTRIBUTION NOT FOR LLC © Jones & Bartlett Learning, NOT FOR SALE OR DISTRIBUTION or Ease of osition When Working Working osition When © Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, NOT FOR SALE OR DISTRIBUTION © Jones & Bartlett Learning, LLC © Jones & Bartlett OR DISTRIBUTION NOT FOR SALE © Jones & Bartlett Learning LLC, an Ascend Learning Company. NOT FOR SALE OR DISTRIBUTION. Book P Position the Book f Position

Fundamentals of Periodontal Instrumentation & Advanced Root Instrumentation Advanced & Instrumentation of Periodontal Fundamentals

© Jones & Bartlett Learning, LLC © Jones & Bartlett OR DISTRIBUTION NOT FOR SALE © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, NOT FOR SALE OR DISTRIBUTION © Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION USE OF TEXTBOOK DURING SKILL PRACTICE SKILL DURING TEXTBOOK OF USE Figure 2-6. Figure Position the book so Position Behind the Patient. behind the view when seated it is easy to that patient. Position the book so that it is easy to it is easy to the book so that Position Viewing. along step- view during skill Follow practice. in the book. shown with the steps by-step Figure 2-5. Figure 46 the reader step-by-step are designed to lead of each module Building sections The Skill ease of viewing the textbook for to position It is important each skill practice. through 2-5 and 2-6). (Figs. each skill practice throughout

RIGHT-HANDED CLINICIAN 9781284456769_CH02_039_068.indd 46 © Jones & Bartlett Learning, LLC & Bartlett Learning, © Jones SALE OR DISTRIBUTION NOT FOR © Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, NOT FOR SALE OR DISTRIBUTION © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, NOT FOR SALE OR DISTRIBUTION RIGHT-HANDED CLINICIAN 07/01/20 1:16 PM 47

clock position for anterior clock position for the anterior anterior surfaces away from The surfaces away from the clinician ranges from 11 to 1 o’clock. The anterior surfaces shaded in purple on this drawing are called the the clinician. The anterior tooth surfaces shaded The anterior tooth surfaces shaded in yellow on this drawing are called the anterior surfaces toward the clinician. The surfaces toward the clinician ranges from 8 to 9 o’clock.

Figure 2-8. Figure Right-Handed Clinician. • • Figure 2-7. Figure • • There is no need to waste time memorizing the clock position for each time memorizing the clock position There is no need to waste Directions: if you learn to recognize clock positions are easy to remember The treatment area. periodontal For 2-7 and 2-8). for the anterior teeth (Figs. the positioning pattern the midline. tooth is divided in half at each the anterior teeth, instrumentation of Handed Clinician.

© Jones & Bartlett Learning, LLC © Jones & Bartlett OR DISTRIBUTION NOT FOR SALE © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, NOT FOR SALE OR DISTRIBUTION © Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION © Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, NOT FOR SALE OR DISTRIBUTION © Jones & Bartlett Learning, LLC & Bartlett Learning, © Jones SALE OR DISTRIBUTION NOT FOR LLC © Jones & Bartlett Learning, NOT FOR SALE OR DISTRIBUTION

nterior Surfaces, TOWARD. Surfaces, nterior y Anterior Surfaces, TOWARD. Surfaces, y Anterior

3 3 2 2 SKILL BUILDING SKILL Clock Positions for the Anterior Surfaces Toward for the Anterior Clock Positions 4 4 © Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, NOT FOR SALE OR DISTRIBUTION © Jones & Bartlett Learning, LLC © Jones & Bartlett OR DISTRIBUTION NOT FOR SALE © Jones & Bartlett Learning LLC, an Ascend Learning Company. NOT FOR SALE OR DISTRIBUTION. 5 5 1 1 Maxillar A–D:

Mandibular A A–D:

6 6 12 12 Fundamentals of Periodontal Instrumentation & Advanced Root Instrumentation Advanced & Instrumentation of Periodontal Fundamentals 7 7 11 11

Clinician in the 8 to 9 o’clock position. the floor. Patient chin UP; place the maxillary occlusal plane perpendicular to to facilitate Patient head position ranges from neutral to turned to the right or left vision of the tooth surfaces. Clinician in the 8 to 9 o’clock position. occlusal plane as parallel to the floor as Patient chin DOWN; place the mandibular possible. neutral to turned to the right or left to facilitate Patient head position ranges from vision of the tooth surfaces. © Jones & Bartlett Learning, LLC © Jones & Bartlett OR DISTRIBUTION NOT FOR SALE © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, NOT FOR SALE OR DISTRIBUTION © Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION 8 8

10 10 9 9 Figure 2-10. Figure • • • Figure 2-9. Figure • • • Practice the recommended clinician clock and patient head positions for the anterior head positions for the anterior clinician clock and patient Directions: Practice the recommended below in Figures 2-9 and 2-10. by following the illustrations shown TOWARD” “SURFACES 48

RIGHT-HANDED CLINICIAN 9781284456769_CH02_039_068.indd 48 © Jones & Bartlett Learning, LLC & Bartlett Learning, © Jones SALE OR DISTRIBUTION NOT FOR © Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, NOT FOR SALE OR DISTRIBUTION © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, NOT FOR SALE OR DISTRIBUTION RIGHT-HANDED CLINICIAN 07/01/20 1:16 PM 49

Clinician Position in Relation to the Treatment Area to the Treatment in Relation Position Clinician

3 2 4

3 2 SKILL BUILDING SKILL Clock Positions for the Anterior Surfaces Away for the Anterior Clock Positions 4 5 1 5 1 Maxillar A–D: Mandibular A A–D: © Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, NOT FOR SALE OR DISTRIBUTION © Jones & Bartlett Learning, LLC © Jones & Bartlett OR DISTRIBUTION NOT FOR SALE © Jones & Bartlett Learning LLC, an Ascend Learning Company. NOT FOR SALE OR DISTRIBUTION. 6

12 6 12 7 11 7 11 Clinician in the 11 to 1 o’clock position. the floor. Patient chin UP; place the maxillary occlusal plane perpendicular to the right or left Patient head position ranges a neutral position to turning the head to to facilitate vision of the tooth surfaces. Clinician in the 11 to 1 o’clock position. occlusal plane as parallel to the floor as Patient chin DOWN; place the mandibular possible. a neutral position to turning the head to the right or Patient head position ranges from surfaces. left to facilitate vision of the tooth 8 8

10 10 9 9 Figure 2-12. Figure • • • Figure 2-11. Figure • • • Practice the recommended clinician clock and patient head positions for the anterior head positions for the anterior clinician clock and patient Directions: Practice the recommended 2-12. shown below in Figures 2-11 and by following the illustrations AWAY” “SURFACES

© Jones & Bartlett Learning, LLC © Jones & Bartlett OR DISTRIBUTION NOT FOR SALE © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, NOT FOR SALE OR DISTRIBUTION © Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION 9781284456769_CH02_039_068.indd 49 © Jones & Bartlett Learning, LLC & Bartlett Learning, © Jones SALE OR DISTRIBUTION NOT FOR © Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, NOT FOR SALE OR DISTRIBUTION © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, NOT FOR SALE OR DISTRIBUTION 07/01/20 1:16 PM © Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, NOT FOR SALE OR DISTRIBUTION © Jones & Bartlett Learning, LLC © Jones & Bartlett OR DISTRIBUTION NOT FOR SALE © Jones & Bartlett Learning, LLC © Jones & Bartlett OR DISTRIBUTION NOT FOR SALE © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, NOT FOR SALE OR DISTRIBUTION © Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION © Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, NOT FOR SALE OR DISTRIBUTION © Jones & Bartlett Learning, LLC & Bartlett Learning, © Jones SALE OR DISTRIBUTION NOT FOR LLC © Jones & Bartlett Learning, NOT FOR SALE OR DISTRIBUTION from the from Away cts Facing the Toward cts Facing Aspe Aspe QUICK START GUIDE TO THE POSTERIOR SEXTANTS POSTERIOR THE TO GUIDE START QUICK © Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, NOT FOR SALE OR DISTRIBUTION © Jones & Bartlett Learning, LLC © Jones & Bartlett OR DISTRIBUTION NOT FOR SALE © Jones & Bartlett Learning LLC, an Ascend Learning Company. NOT FOR SALE OR DISTRIBUTION. Posterior Posterior Posterior Posterior

Fundamentals of Periodontal Instrumentation & Advanced Root Instrumentation Advanced & Instrumentation of Periodontal Fundamentals clock position for posterior aspects away clock position for posterior aspects

from the clinician ranges from 10 to 11 o’clock. The posterior surfaces shaded in blue on this drawing are called the posterior aspects facing away from the clinician. The toward the clinician is 9 o’clock. The The posterior surfaces shaded in yellow The posterior surfaces shaded in yellow on this drawing are called the posterior . aspects facing toward the clinician © Jones & Bartlett Learning, LLC © Jones & Bartlett OR DISTRIBUTION NOT FOR SALE © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, NOT FOR SALE OR DISTRIBUTION © Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION

• • Figure 2-14. Figure Right-Handed Clinician. Figure 2-13. Figure Right-Handed Clinician. • • There is no need to waste time memorizing the clock position for each posterior time memorizing the clock position There is no need to waste Directions: positioning if you learn to recognize the clock positions are easy to remember The treatment area. instrumentation each periodontal For and 2-14). 2-13 sextants (Figs. pattern for the posterior aspect of the aspect and (2) lingual facial is divided into two aspects: the (1) posterior sextant sextant. 50

RIGHT-HANDED CLINICIAN 9781284456769_CH02_039_068.indd 50 © Jones & Bartlett Learning, LLC & Bartlett Learning, © Jones SALE OR DISTRIBUTION NOT FOR © Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, NOT FOR SALE OR DISTRIBUTION © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, NOT FOR SALE OR DISTRIBUTION RIGHT-HANDED CLINICIAN 07/01/20 1:16 PM 51

© Jones & Bartlett Learning, LLC © Jones & Bartlett OR DISTRIBUTION NOT FOR SALE © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, NOT FOR SALE OR DISTRIBUTION © Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION Clinician Position in Relation to the Treatment Area to the Treatment in Relation Position Clinician

2 4 3 SKILL BUILDING SKILL Clock Positions for the Posterior Sextants, Aspects Facing Toward the Clinician Facing Toward Sextants, Aspects for the Posterior Clock Positions 2 4 5 1 5 1 Maxillar A–D: Mandibular P A–D: © Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, NOT FOR SALE OR DISTRIBUTION © Jones & Bartlett Learning, LLC © Jones & Bartlett OR DISTRIBUTION NOT FOR SALE © Jones & Bartlett Learning LLC, an Ascend Learning Company. NOT FOR SALE OR DISTRIBUTION.

6 12 6 12 7 7 11 11 Clinician in the 9:00 o’clock position. Chin UP; place the maxillary occlusal plane perpendicular to the floor. slightly away Patient head position ranges from a neutral position to turning the head from the clinician. Clinician in the 9 o’clock position. occlusal plan as parallel to the floor as possible. Chin DOWN; place the mandibular a neutral position to turning the head slightly away Patient head position ranges from from the clinician. 8 8

10 10 9 9 Figure 2-16. Figure • • • Figure 2-15. Figure • • • Practice the recommended clinician clock and patient head positions for clinician clock and patient Directions: Practice the recommended the illustrations the clinician by following TOWARD” “FACING the posterior sextants 2-15 and 2-16. shown below in Figures

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osterior Aspects Facing AWAY. Aspectsosterior Facing y Posterior Aspects Facing AWAY. Aspects Facing y Posterior

3 3 2 4 SKILL BUILDING SKILL Clock Positions for the Posterior Sextants, Aspects Facing Away From the Facing Away Sextants, Aspects for the Posterior Clock Positions Clinician 2 4 © Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, NOT FOR SALE OR DISTRIBUTION © Jones & Bartlett Learning, LLC © Jones & Bartlett OR DISTRIBUTION NOT FOR SALE © Jones & Bartlett Learning LLC, an Ascend Learning Company. NOT FOR SALE OR DISTRIBUTION. 5 1 5 1 Maxillar A–D: Mandibular P A–D:

6 12 6 12 Fundamentals of Periodontal Instrumentation & Advanced Root Instrumentation Advanced & Instrumentation of Periodontal Fundamentals 7 7 11 11

Clinician seated in the 10 to 11 o’clock position. Chin UP; place the maxillary occlusal plane perpendicular to the floor. Patient head position is turned toward the clinician. Clinician seated in the 10 to 11 o’clock position. Clinician seated in the 10 to 11 o’clock occlusal plan as parallel to the floor as possible. Chin DOWN; place the mandibular the clinician. Patient head position is turned toward © Jones & Bartlett Learning, LLC © Jones & Bartlett OR DISTRIBUTION NOT FOR SALE © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, NOT FOR SALE OR DISTRIBUTION © Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION 8 8

10 10 9 9 Figure 2-18. Figure • • • Figure 2-17. Figure • • • Practice the recommended clinician clock and patient head positions for the clinician clock and patient Directions: Practice the recommended by following the illustrations the clinician FROM” AWAY “FACING posterior sextants 2-17 and 2-18. shown below in Figures 52

RIGHT-HANDED CLINICIAN 9781284456769_CH02_039_068.indd 52 © Jones & Bartlett Learning, LLC & Bartlett Learning, © Jones SALE OR DISTRIBUTION NOT FOR © Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, NOT FOR SALE OR DISTRIBUTION © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, NOT FOR SALE OR DISTRIBUTION RIGHT-HANDED CLINICIAN 07/01/20 1:16 PM 53

ARY © Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, NOT FOR SALE OR DISTRIBUTION © Jones & Bartlett Learning, LLC © Jones & Bartlett OR DISTRIBUTION NOT FOR SALE Chin-up: neutral to turned away slightly to Chin-up: neutral Chin-down; neutral Chin-down; neutral to turnedChin-down; right or left to neutral Chin-down; neutral to turnedChin-down; right or left to neutral © Jones & Bartlett Learning, LLC © Jones & Bartlett OR DISTRIBUTION NOT FOR SALE © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, NOT FOR SALE OR DISTRIBUTION © Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION 9 9 Clinician Position in Relation to the Treatment Area to the Treatment in Relation Position Clinician 8–9 turned right or left to Chin-up; neutral 11–1 turned right or left to Chin-up; neutral 11–1

10–11 Chin-up; toward © Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, NOT FOR SALE OR DISTRIBUTION © Jones & Bartlett Learning, LLC & Bartlett Learning, © Jones SALE OR DISTRIBUTION NOT FOR LLC © Jones & Bartlett Learning, NOT FOR SALE OR DISTRIBUTION Clock Position Patient Head Position Module 2 Module CLOCK POSITIONS—POSITIONING SUMM POSITIONS—POSITIONING CLOCK

© Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, NOT FOR SALE OR DISTRIBUTION © Jones & Bartlett Learning, LLC © Jones & Bartlett OR DISTRIBUTION NOT FOR SALE © Jones & Bartlett Learning LLC, an Ascend Learning Company. NOT FOR SALE OR DISTRIBUTION. TABLE 2-1. TABLE Mandibular arch—Posterior aspects awayMandibular arch—Posterior aspectsMaxillary away arch—Posterior 10–11 Chin-down: toward Maxillary arch—Posterior aspectsMaxillary toward arch—Posterior Mandibular arch—Posterior aspects toward Mandibular arch—Posterior Maxillary surfaces arch—Anterior away Mandibular arch—Anterior surfacesMandibular arch—Anterior away Treatment Area surfacesMandibular arch—Anterior towardMaxillary surfaces arch—Anterior toward 8–9 This ends Section 2 for the RIGHT-Handed clinician. clinician. This ends Section 2 for the RIGHT-Handed Clinicians: RIGHT-Handed from a Standing Position. Working Please turn to Section 4. REFERENCE SHEET: POSITION FOR THE RIGHT-HANDED CLINICIAN RIGHT-HANDED THE FOR POSITION SHEET: REFERENCE this Photocopy clinician. for the right-handed the clock positions 2-1 summarizes Table Place the skills. practice your positioning reference as you use it for quick page and use. protector for longer in a plastic page reference sheet photocopied © Jones & Bartlett Learning, LLC © Jones & Bartlett OR DISTRIBUTION NOT FOR SALE © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, NOT FOR SALE OR DISTRIBUTION © Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION 9781284456769_CH02_039_068.indd 53 © Jones & Bartlett Learning, LLC & Bartlett Learning, © Jones SALE OR DISTRIBUTION NOT FOR © Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, NOT FOR SALE OR DISTRIBUTION © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, NOT FOR SALE OR DISTRIBUTION 07/01/20 1:16 PM 1 Option Option 2 © Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, NOT FOR SALE OR DISTRIBUTION © Jones & Bartlett Learning, LLC © Jones & Bartlett OR DISTRIBUTION NOT FOR SALE © Jones & Bartlett Learning, LLC © Jones & Bartlett OR DISTRIBUTION NOT FOR SALE © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, NOT FOR SALE OR DISTRIBUTION © Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION

SKILL BUILDING SKILL Clock Positions for the LEFT-Handed Clinician Clock Positions for © Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, NOT FOR SALE OR DISTRIBUTION © Jones & Bartlett Learning, LLC © Jones & Bartlett OR DISTRIBUTION NOT FOR SALE © Jones & Bartlett Learning LLC, an Ascend Learning Company. NOT FOR SALE OR DISTRIBUTION. Fundamentals of Periodontal Instrumentation & Advanced Root Instrumentation Advanced & Instrumentation of Periodontal Fundamentals

Hand Positions. Rest your right hand in the area of the patient’s left cheekbone. Rest the fingertips of your left hand on the premolar teeth of the mandibular left posterior sextant. Line of Vision. Your line of vision is straight down into the mouth. Arm Positions. To reach the patient’s mouth, hold the lower half of your left arm in approximate alignment with the patient’s shoulder. Hold your right hand and wrist over the Torso Position. Sit facing the side of the patient’s head. The midline of your torso is even with the patient’s mouth. Leg Position. Your legs may be in either of two acceptable positions: (1) straddling the patient chair or (2) underneath the headrest of the patient chair. Neutral position is best achieved by straddling the chair, however you should use the alternative position if you find straddling uncomfortable. region of patient’s left eye. Your line of vision is straight ahead, into the Line of Vision. Your line of vision is straight ahead, patient’s mouth. Sit facing the patient with your hip in line Torso Position. Sit facing the patient with the patient’s upper arm. side of the Leg Position. Your thighs should rest against the patient chair. your arms Arm Positions. To reach the patient’s mouth, hold your lower left arm over slightly away from your sides. Hold right hand rests in the the patient’s chest. The side of your and upper lip. NOTE: area of the patient’s right cheekbone head or chest. Do not rest your arm on the patient’s Ergonomic Considerations: Ergonomic should be limited since it is difficult to maintain neutral should be limited since it is difficult goal is to The position. arm and torso posture in this clock possible. minimize postural abnormalities whenever © Jones & Bartlett Learning, LLC © Jones & Bartlett OR DISTRIBUTION NOT FOR SALE © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, NOT FOR SALE OR DISTRIBUTION © Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION

• 3 o’clock Position (To the Side) (To Position 3 o’clock • • • • Positioning for the LEFT-Handed Clinician the LEFT-Handed for Positioning 54 3 Section • • • Practice each clock position by following the criteria outlined below. position by following the criteria Directions: Practice each clock of the Patient) the Front (To Position 3 to 4 o’clock •

LEFT-HANDED CLINICIAN 9781284456769_CH02_039_068.indd 54 © Jones & Bartlett Learning, LLC & Bartlett Learning, © Jones SALE OR DISTRIBUTION NOT FOR © Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, NOT FOR SALE OR DISTRIBUTION © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, NOT FOR SALE OR DISTRIBUTION LEFT-HANDED CLINICIAN 07/01/20 1:16 PM 55

© Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, NOT FOR SALE OR DISTRIBUTION © Jones & Bartlett Learning, LLC & Bartlett Learning, © Jones SALE OR DISTRIBUTION NOT FOR LLC © Jones & Bartlett Learning, NOT FOR SALE OR DISTRIBUTION Module 2 Module y behind Patient) © Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, NOT FOR SALE OR DISTRIBUTION © Jones & Bartlett Learning, LLC © Jones & Bartlett OR DISTRIBUTION NOT FOR SALE © Jones & Bartlett Learning LLC, an Ascend Learning Company. NOT FOR SALE OR DISTRIBUTION. Leg Position. Your legs should straddle the corner of the headrest. Arm Positions. To reach the patient’s mouth, hold your right hand directly across the corner of the patient’s mouth. Hold your left hand and wrist above the patient’s nose and forehead. Line of Vision. Your line of vision is straight down into the mouth. Leg Position. Your legs should straddle the headrest. your wrists Arm Positions. To reach the patient’s mouth, hold patient’s ears and cheeks. and hands above the region of the into the Line of Vision. Your line of vision is straight down patient’s mouth. Torso Position. Sit at the top right corner of the headrest; the midline of your torso is even with the temple region of the patient’s head. Sit directly behind the patient’s head; you may sit Torso Position. Sit directly behind the patient’s head; headrest to directly behind anywhere from the left corner of the the headrest. Sit at the top left corner of the headrest; the Torso Position. Sit at the top left of the is even with the temple region midline of your torso patient’s head. the corner of should straddle Position. Your legs Leg mouth, hold your left hand Arm Positions. To reach the patient’s your right corner of the patient’s mouth. Hold directly across the the patient’s nose and forehead. hand and wrist above is straight down into the Line of Vision. Your line of vision mouth.

• • • • (Near Corner of Headrest) Position 10 to 11 o’clock • • 12 o’clock Position (Directl Position 12 o’clock • 1 to 2 o’clock Position (Near Corner of Headrest) Position 1 to 2 o’clock • • • • •

© Jones & Bartlett Learning, LLC © Jones & Bartlett OR DISTRIBUTION NOT FOR SALE © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, NOT FOR SALE OR DISTRIBUTION © Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION 9781284456769_CH02_039_068.indd 55 © Jones & Bartlett Learning, LLC & Bartlett Learning, © Jones SALE OR DISTRIBUTION NOT FOR © Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, NOT FOR SALE OR DISTRIBUTION © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, NOT FOR SALE OR DISTRIBUTION 07/01/20 1:17 PM © Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, NOT FOR SALE OR DISTRIBUTION © Jones & Bartlett Learning, LLC © Jones & Bartlett OR DISTRIBUTION NOT FOR SALE © Jones & Bartlett Learning, LLC © Jones & Bartlett OR DISTRIBUTION NOT FOR SALE © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, NOT FOR SALE OR DISTRIBUTION © Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION . . stablishing Position. TIENT © Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, NOT FOR SALE OR DISTRIBUTION © Jones & Bartlett Learning, LLC & Bartlett Learning, © Jones SALE OR DISTRIBUTION NOT FOR LLC © Jones & Bartlett Learning, NOT FOR SALE OR DISTRIBUTION ME. PA MY MY EQUIPMENT Sequence for E for Sequence

MY DOMINANT HAND. MY NONDOMINANT HAND. Establish patient chair and head position. Establish patient chair and head clinician, patient, and equipment position. clinician, patient, and equipment Place the fingertips of my dominant hand as Place the fingertips of my dominant shown in the illustration for the clock position. shown in the illustration for the clock position. shown in the illustration for the clock Adjust the unit light. Pause and self-check the Adjust the unit light. Pause and self-check Figure 2-19. Figure Sequence for Establishing Position Sequence for Place the fingertips of my nondominant hand as Place the fingertips of my nondominant Assume the clock position for the treatment area. position for the treatment Assume the clock © Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, NOT FOR SALE OR DISTRIBUTION © Jones & Bartlett Learning, LLC © Jones & Bartlett OR DISTRIBUTION NOT FOR SALE © Jones & Bartlett Learning LLC, an Ascend Learning Company. NOT FOR SALE OR DISTRIBUTION. 1 2 3 4 5 Fundamentals of Periodontal Instrumentation & Advanced Root Instrumentation Advanced & Instrumentation of Periodontal Fundamentals

© Jones & Bartlett Learning, LLC © Jones & Bartlett OR DISTRIBUTION NOT FOR SALE © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, NOT FOR SALE OR DISTRIBUTION © Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION FLOW CHART: SEQUENCE FOR PRACTICING PATIENT/CLINICIAN POSITION PATIENT/CLINICIAN PRACTICING FOR SEQUENCE CHART: FLOW 56 in a step-by-step to proceed it is important instrumentation, periodontal For successful My “Me, is approach remember the step-by-step to help you A useful saying manner. 2-19). (Fig. ” Dominant hand My hand, Non-dominant My Light, My Patient,

LEFT-HANDED CLINICIAN 9781284456769_CH02_039_068.indd 56 © Jones & Bartlett Learning, LLC & Bartlett Learning, © Jones SALE OR DISTRIBUTION NOT FOR © Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, NOT FOR SALE OR DISTRIBUTION © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, NOT FOR SALE OR DISTRIBUTION LEFT-HANDED CLINICIAN 07/01/20 1:17 PM 57

or Ease of © Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, NOT FOR SALE OR DISTRIBUTION © Jones & Bartlett Learning, LLC © Jones & Bartlett OR DISTRIBUTION NOT FOR SALE osition When Working Working osition When Book P Position the Book f Position

© Jones & Bartlett Learning, LLC © Jones & Bartlett OR DISTRIBUTION NOT FOR SALE © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, NOT FOR SALE OR DISTRIBUTION © Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION Figure 2-21. Figure it the book so that Position Behind the Patient. behind the patient. view when seated is easy to Figure 2-20. Figure it is easy to the book so that Position Viewing. along step-by- view during skill Follow practice. in the book. shown with the steps step Clinician Position in Relation to the Treatment Area to the Treatment in Relation Position Clinician

© Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, NOT FOR SALE OR DISTRIBUTION © Jones & Bartlett Learning, LLC & Bartlett Learning, © Jones SALE OR DISTRIBUTION NOT FOR LLC © Jones & Bartlett Learning, NOT FOR SALE OR DISTRIBUTION Module 2 Module © Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, NOT FOR SALE OR DISTRIBUTION © Jones & Bartlett Learning, LLC © Jones & Bartlett OR DISTRIBUTION NOT FOR SALE © Jones & Bartlett Learning LLC, an Ascend Learning Company. NOT FOR SALE OR DISTRIBUTION. USE OF TEXTBOOK DURING SKILL PRACTICE SKILL DURING TEXTBOOK OF USE the reader step-by-step are designed to lead of each module Building sections The Skill ease of viewing the textbook for to position It is important each skill practice. through 2-20 and 2-21). (Figs. each skill practice throughout © Jones & Bartlett Learning, LLC © Jones & Bartlett OR DISTRIBUTION NOT FOR SALE © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, NOT FOR SALE OR DISTRIBUTION © Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION 9781284456769_CH02_039_068.indd 57 © Jones & Bartlett Learning, LLC & Bartlett Learning, © Jones SALE OR DISTRIBUTION NOT FOR © Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, NOT FOR SALE OR DISTRIBUTION © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, NOT FOR SALE OR DISTRIBUTION 07/01/20 1:17 PM © Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, NOT FOR SALE OR DISTRIBUTION © Jones & Bartlett Learning, LLC © Jones & Bartlett OR DISTRIBUTION NOT FOR SALE © Jones & Bartlett Learning, LLC © Jones & Bartlett OR DISTRIBUTION NOT FOR SALE © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, NOT FOR SALE OR DISTRIBUTION © Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION © Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, NOT FOR SALE OR DISTRIBUTION © Jones & Bartlett Learning, LLC & Bartlett Learning, © Jones SALE OR DISTRIBUTION NOT FOR LLC © Jones & Bartlett Learning, NOT FOR SALE OR DISTRIBUTION from the Left- from Away faces the Left-Handed Toward faces Sur Sur QUICK START GUIDE TO THE ANTERIOR SEXTANTS ANTERIOR THE TO GUIDE START QUICK © Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, NOT FOR SALE OR DISTRIBUTION © Jones & Bartlett Learning, LLC © Jones & Bartlett OR DISTRIBUTION NOT FOR SALE © Jones & Bartlett Learning LLC, an Ascend Learning Company. NOT FOR SALE OR DISTRIBUTION. Anterior Anterior Anterior Anterior

Fundamentals of Periodontal Instrumentation & Advanced Root Instrumentation Advanced & Instrumentation of Periodontal Fundamentals clock position for the anterior surfaces away clock position for the anterior surfaces toward

from the clinician ranges from 11 to 1 o’clock. The anterior surfaces shaded in purple on this drawing are called the anterior surfaces away from the clinician. The the clinician ranges from 3 to 4 o’clock. The The anterior tooth surfaces shaded in yellow The anterior tooth surfaces shaded on this drawing are called the anterior surfaces toward the clinician. © Jones & Bartlett Learning, LLC © Jones & Bartlett OR DISTRIBUTION NOT FOR SALE © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, NOT FOR SALE OR DISTRIBUTION © Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION

Handed Clinician. Figure 2-23. Figure • • Figure 2-22. Figure Clinician. • • There is no need to waste time memorizing the clock position for each treatment area. for each treatment area. time memorizing the clock position There is no need to waste Directions: for the to recognize the positioning pattern are easy to remember if you learn The clock positions each teeth, instrumentation of the anterior periodontal For 2-22 and 2-23). anterior teeth (Figs. half at the midline. tooth is divided in 58

LEFT-HANDED CLINICIAN 9781284456769_CH02_039_068.indd 58 © Jones & Bartlett Learning, LLC & Bartlett Learning, © Jones SALE OR DISTRIBUTION NOT FOR © Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, NOT FOR SALE OR DISTRIBUTION © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, NOT FOR SALE OR DISTRIBUTION LEFT-HANDED CLINICIAN 07/01/20 1:17 PM 59

© Jones & Bartlett Learning, LLC © Jones & Bartlett OR DISTRIBUTION NOT FOR SALE © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, NOT FOR SALE OR DISTRIBUTION © Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION Clinician Position in Relation to the Treatment Area to the Treatment in Relation Position Clinician

3 3 SKILL BUILDING SKILL Clock Positions for the Anterior Surfaces Toward for the Anterior Clock Positions 2 4 2 4 5 1 5 1 Maxillar A–D: Mandibular A A–D: © Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, NOT FOR SALE OR DISTRIBUTION © Jones & Bartlett Learning, LLC © Jones & Bartlett OR DISTRIBUTION NOT FOR SALE © Jones & Bartlett Learning LLC, an Ascend Learning Company. NOT FOR SALE OR DISTRIBUTION.

6 6 12 12 7 7 11 11 Clinician in the 3 to 4 o’clock position. the floor. Patient chin UP; place the maxillary occlusal plane perpendicular to to facilitate Patient head position ranges from neutral to turned to the right or left vision of the tooth surfaces. Clinician seated in the 3 to 4 o’clock position. Clinician seated in the 3 to 4 o’clock occlusal plane as parallel to the floor as Patient chin DOWN; place the mandibular possible. neutral to turned to the right or left to facilitate Patient head position ranges from vision of the tooth surfaces. 8 8

10 10 9 9 • • • Figure 2-25. Figure Figure 2-24. Figure • • • Practice the recommended clinician clock and patient head positions for the anterior head positions for the anterior clinician clock and patient Directions: Practice the recommended below in Figures 2-24 and 2-25. by following the illustrations shown TOWARD” “SURFACES

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nterior Surfaces, AWAY. nterior y Anterior Surfaces, AWAY. y Anterior

3 3 SKILL BUILDING SKILL Clock Positions for the Anterior Surfaces Away for the Anterior Clock Positions 2 2 4 4 © Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, NOT FOR SALE OR DISTRIBUTION © Jones & Bartlett Learning, LLC © Jones & Bartlett OR DISTRIBUTION NOT FOR SALE © Jones & Bartlett Learning LLC, an Ascend Learning Company. NOT FOR SALE OR DISTRIBUTION. 5 5 1 1 Maxillar A–D: Mandibular A A–D:

6 6 12 12 Fundamentals of Periodontal Instrumentation & Advanced Root Instrumentation Advanced & Instrumentation of Periodontal Fundamentals 7 7 11 11

Clinician seated in the 11 to 1 o’clock position. the floor. Patient chin UP; place the maxillary occlusal plane perpendicular to to the right or Patient head position ranges from a neutral position to turning the head left to facilitate vision of the tooth surfaces. Clinician seated in the 11 to 1 o’clock position. Clinician seated in the 11 to 1 o’clock occlusal plane as parallel to the floor as Patient chin DOWN; place the mandibular possible. a neutral position to turning the head to the right or Patient head position ranges from surfaces. left to facilitate vision of the tooth © Jones & Bartlett Learning, LLC © Jones & Bartlett OR DISTRIBUTION NOT FOR SALE © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, NOT FOR SALE OR DISTRIBUTION © Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION 8 8

10 10 9 9 Figure 2-27. Figure • • • Figure 2-26. Figure • • • Practice the recommended clinician clock and patient head positions for the anterior head positions for the anterior clinician clock and patient Directions: Practice the recommended 2-27. shown below in Figures 2-26 and by following the illustrations AWAY” “SURFACES 60

LEFT-HANDED CLINICIAN 9781284456769_CH02_039_068.indd 60 © Jones & Bartlett Learning, LLC & Bartlett Learning, © Jones SALE OR DISTRIBUTION NOT FOR © Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, NOT FOR SALE OR DISTRIBUTION © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, NOT FOR SALE OR DISTRIBUTION LEFT-HANDED CLINICIAN 07/01/20 1:17 PM 61

clock position for posterior aspects clock position for the posterior aspects The posterior surfaces shaded in blue on this drawing are called the posterior aspects facing away from the clinician. The away from the clinician ranges from 1 to 2 o’clock. The posterior surfaces shaded in yellow on The posterior surfaces shaded in yellow this drawing are called the posterior aspects facing toward the clinician. The toward the clinician is 3 o’clock.

from the Left-Handed Clinician. from Figure 2-29. Figure • • Figure 2-28. Figure the Left-Handed Clinician. • • There is no need to waste time memorizing the clock position for each posterior time memorizing the clock position There is no need to waste Directions: positioning if you learn to recognize the clock positions are easy to remember The treatment area. instrumentation each periodontal For and 2-29). 2-28 sextants (Figs. pattern for the posterior aspect of the aspect and (2) lingual facial is divided into two aspects: the (1) posterior sextant sextant.

osterior Aspects Facing TOWARD. Aspectsosterior Facing y Posterior Aspects Facing TOWARD. Aspects Facing y Posterior

3 3 2 4 2 SKILL BUILDING SKILL Clock Positions for the Posterior Sextants, Aspects Facing Toward Facing Toward Sextants, Aspects for the Posterior Clock Positions the Clinician 4 © Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, NOT FOR SALE OR DISTRIBUTION © Jones & Bartlett Learning, LLC © Jones & Bartlett OR DISTRIBUTION NOT FOR SALE © Jones & Bartlett Learning LLC, an Ascend Learning Company. NOT FOR SALE OR DISTRIBUTION. 5 1 5 1 Maxillar A–D: Mandibular P A–D:

6 6 12 12 Fundamentals of Periodontal Instrumentation & Advanced Root Instrumentation Advanced & Instrumentation of Periodontal Fundamentals 7 7 11 11

Clinician seated in the 3 o’clock position. Chin UP; place the maxillary occlusal plane perpendicular to the floor. slightly away Patient head position ranges from a neutral position to turning the head from the clinician. Clinician seated in the 3 o’clock position. occlusal plane as parallel to the floor as possible. Chin DOWN; place the mandibular a neutral position to turning the head slightly away Patient head position ranges from from the clinician. © Jones & Bartlett Learning, LLC © Jones & Bartlett OR DISTRIBUTION NOT FOR SALE © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, NOT FOR SALE OR DISTRIBUTION © Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION 8 8

10 10 9 9 Practice the recommended clinician clock and patient head positions for clinician clock and patient Directions: Practice the recommended the illustrations the clinician by following TOWARD” “FACING the posterior sextants 2-30 and 2-31. shown below in Figures 62 Figure 2-31. Figure • • • Figure 2-30. Figure • • •

LEFT-HANDED CLINICIAN 9781284456769_CH02_039_068.indd 62 © Jones & Bartlett Learning, LLC & Bartlett Learning, © Jones SALE OR DISTRIBUTION NOT FOR © Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, NOT FOR SALE OR DISTRIBUTION © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, NOT FOR SALE OR DISTRIBUTION LEFT-HANDED CLINICIAN 07/01/20 1:17 PM 63

Clinician Position in Relation to the Treatment Area to the Treatment in Relation Position Clinician

3 3 2 2 4 4 SKILL BUILDING SKILL Clock Positions for the Posterior Sextants, Aspects Facing Away From the Facing Away Sextants, Aspects for the Posterior Clock Positions Clinician 5 5 1 1 Maxillary Post Mandibular Posterior A Mandibular Posterior © Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, NOT FOR SALE OR DISTRIBUTION © Jones & Bartlett Learning, LLC © Jones & Bartlett OR DISTRIBUTION NOT FOR SALE © Jones & Bartlett Learning LLC, an Ascend Learning Company. NOT FOR SALE OR DISTRIBUTION.

6 6 12 12 7 7 11 11 Clinician seated in the 1 to 2 o’clock position. Chin UP; place the maxillary occlusal plane perpendicular to the floor. Patient head position is turned toward the clinician. Clinician seated in the 1 to 2 o’clock position. Clinician seated in the 1 to 2 o’clock occlusal plane as parallel to the floor as possible. Chin DOWN; place the mandibular the clinician. Patient head position is turned toward 8 8

10 10 9 9 • • • Figure 2-33. Figure Figure 2-32. Figure • • • Practice the recommended clinician clock and patient head positions for the clinician clock and patient Directions: Practice the recommended by following the illustrations the clinician FROM” AWAY “FACING posterior sextants 2-32 and 2-33. shown below in Figures

© Jones & Bartlett Learning, LLC © Jones & Bartlett OR DISTRIBUTION NOT FOR SALE © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, NOT FOR SALE OR DISTRIBUTION © Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION 9781284456769_CH02_039_068.indd 63 © Jones & Bartlett Learning, LLC & Bartlett Learning, © Jones SALE OR DISTRIBUTION NOT FOR © Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, NOT FOR SALE OR DISTRIBUTION © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, NOT FOR SALE OR DISTRIBUTION 07/01/20 1:17 PM ARY © Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, NOT FOR SALE OR DISTRIBUTION © Jones & Bartlett Learning, LLC © Jones & Bartlett OR DISTRIBUTION NOT FOR SALE © Jones & Bartlett Learning, LLC © Jones & Bartlett OR DISTRIBUTION NOT FOR SALE © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, NOT FOR SALE OR DISTRIBUTION © Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION Chin-down; neutral to turnedChin-down; right or left to neutral turned right or left to Chin-up: neutral Chin-down; neutral turned away slightly to Chin-up: neutral Chin-down; toward Chin-up; toward © Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, NOT FOR SALE OR DISTRIBUTION © Jones & Bartlett Learning, LLC & Bartlett Learning, © Jones SALE OR DISTRIBUTION NOT FOR LLC © Jones & Bartlett Learning, NOT FOR SALE OR DISTRIBUTION 3 3 3–4 3–4 1–2 1–2 11–111–1 Chin-down; turned right or leftto neutral turned right or left to Chin-up: neutral Clock Position Position Patient Head CLOCK POSITIONS—POSITIONING SUMM POSITIONS—POSITIONING CLOCK

© Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, NOT FOR SALE OR DISTRIBUTION © Jones & Bartlett Learning, LLC © Jones & Bartlett OR DISTRIBUTION NOT FOR SALE © Jones & Bartlett Learning LLC, an Ascend Learning Company. NOT FOR SALE OR DISTRIBUTION. TABLE 2-2. TABLE Fundamentals of Periodontal Instrumentation & Advanced Root Instrumentation Advanced & Instrumentation of Periodontal Fundamentals

Treatment Area surfacesMandibular arch—Anterior toward Maxillary surfaces arch—Anterior toward surfacesMandibular arch—Anterior away aspectsMaxillary arch—Posterior toward aspects Mandibular arch—Posterior away aspectsMaxillary away arch—Posterior Maxillary surfaces arch—Anterior away aspects Mandibular arch—Posterior toward © Jones & Bartlett Learning, LLC © Jones & Bartlett OR DISTRIBUTION NOT FOR SALE © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, NOT FOR SALE OR DISTRIBUTION © Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION REFERENCE SHEET: POSITION FOR THE LEFT-HANDED CLINICIAN LEFT-HANDED THE FOR POSITION SHEET: REFERENCE 64 Photocopy this clinician. for the left-handed the clock positions 2-2 summarizes Table Place the skills. practice your positioning reference as you use it for quick page and use. protector for longer in a plastic page reference sheet photocopied

LEFT-HANDED CLINICIAN 9781284456769_CH02_039_068.indd 64 © Jones & Bartlett Learning, LLC & Bartlett Learning, © Jones SALE OR DISTRIBUTION NOT FOR © Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, NOT FOR SALE OR DISTRIBUTION © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, NOT FOR SALE OR DISTRIBUTION Module 2 Clinician Position in Relation to the Treatment Area 65 © Jones & Bartlett Learning, LLC © Jones & BartlettSection Learning, 4 LLC NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION Modified Positioning: Working from a Standing Position

At times, it may be helpful for the clinician to use a standing, rather than a seated position, for ©periodontal Jones & instrumentation. Bartlett Learning, A standing LLC position can be used when© Jones there & Bartlett Learning, LLC is difficulty NOTaccessing FOR the SALE treatment OR area,DISTRIBUTION when the patient cannot be placedNOT in a supineFOR SALE OR DISTRIBUTION position due to medical or physical contraindications, or when working on mandibular treatment areas (Figs. 2-34 and 2-35).

© Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION Figure 2-34. A–B: Correct Standing Clinician Position. • A standing clinician position can be used to facilitate access to a treatment area or when a supine position is contraindicated for a patient due to medical or physical limitations. • Notice that the clinician’s shoulders are relaxed, the elbow of her dominant hand is a waist © Joneslevel, & herBartlett torso isLearning, in neutral position, LLC and she is not leaning© Jones over the & patient. Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION

© Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION NOT FOR SALEFigure 2-35.OR DISTRIBUTION Incorrect Standing Clinician Position. • This is an example of incorrect standing position. • Note that the clinician’s shoulders are © Jones & Bartlett Learning, LLC hunched, her torso© Jonesis tilted and& Bartlett twisted, Learning, LLC NOT FOR SALE OR DISTRIBUTION and her elbows areNOT raised. FOR SALE OR DISTRIBUTION

9781284456769_CH02_039_068.indd 65 07/01/20 1:18 PM 66 Fundamentals of Periodontal Instrumentation & Advanced Root Instrumentation © Jones & Bartlett Learning, LLC © Jones & SectionBartlett Learning, 5 LLC NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION Skill Application

Evaluate© Jones the photographs& Bartlett Learning,shown in Figures LLC 2-36 to 2-43: © Jones & Bartlett Learning, LLC (1)NOT Evaluate FOR the SALE clinician, OR patient,DISTRIBUTION and equipment position in eachNOT photograph. FOR SALE OR DISTRIBUTION (2) For each incorrect positioning element describe (a) what the problem is, (2) how the problem could be corrected, and (c) the musculoskeletal problems that could result from each positioning problem. © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION

Figure 2-36. Photo 1 © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION

9781284456769_CH02_039_068.indd 66 07/01/20 1:18 PM Module 2 Clinician Position in Relation to the Treatment Area 67 © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION

Figure 2-39. Photo 4 Figure 2-40. Photo 5 Figure 2-41. Photo 6 © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION

Figure 2-42. Photo 7 Figure 2-43. Photo 8 © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION

9781284456769_CH02_039_068.indd 67 07/01/20 1:18 PM 68 Fundamentals of Periodontal Instrumentation & Advanced Root Instrumentation © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC NOT FOR SALEStudent OR DISTRIBUTION Self Evaluation Module 2:NOT Positioning FOR SALE and OR ClockDISTRIBUTION Positions

Student: ______Area 1 = anterior sextant, facial aspect Area 2 = anterior sextant, lingual aspect Date: ______Area 3 right posterior sextant, facial aspect © Jones & Bartlett Learning, LLC = © Jones & Bartlett Learning, LLC Area 4 = right posterior sextant, lingual aspect NOT FOR SALE OR DISTRIBUTIONArea 5 = left posterior sextant,NOT facial FOR aspect SALE OR DISTRIBUTION Area 6 = left posterior sextant, lingual aspect DIRECTIONS: Self-evaluate your skill level in each treatment area as: S (satisfactory) or U (unsatisfactory).

Criteria:© Jones Mandibular & Bartlett Arch Learning, LLC © Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION Area NOTArea FOR Area SALE Area ORArea DISTRIBUTION Area Positioning/Ergonomics 1 2 3 4 5 6 Adjusts clinician chair correctly Reclines patient chair and assures that patient’s head is even with © Jones & Bartletttop of headrest Learning, LLC © Jones & Bartlett Learning, LLC Positions instrument tray within easy reach for front, side, or rear delivery as NOT FOR SALEappropriate OR forDISTRIBUTION operatory configuration NOT FOR SALE OR DISTRIBUTION Positions unit light at arm’s length or dons dental headlight and adjusts it for use Assumes the recommended clock position Positions backrest of patient chair for the specified arch and adjusts height of patient chair so that© clinician’s Jones elbows & Bartlettremain at waist Learning, level when LLC © Jones & Bartlett Learning, LLC accessing the specifiedNOT treatmen FORt area SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION Asks patient to assume the head position that facilitates the clinician’s view of the specified treatment area Maintains neutral position Directs light to illuminate the specified treatment area © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC NOTCriteria: FOR Maxillary SALE Arch OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION Area Area Area Area Area Area Positioning/Ergonomics 1 2 3 4 5 6 Adjusts clinician chair correctly Reclines patient chair and assures that patient’s head is even with top of © Jones & Bartlettheadrest Learning, LLC © Jones & Bartlett Learning, LLC NOT FOR SALEPositions OR instrument DISTRIBUTION tray within easy reach for front, side, or rear deliveryNOT asFOR SALE OR DISTRIBUTION appropriate for operatory configuration Positions unit light at arm’s length or dons dental headlight and adjusts it for use Assumes the recommended clock position Positions backrest of patient chair for the specified arch and adjusts height of patient chair so that© clinician’s Jones elbows & Bartlettremain at waist Learning, level when LLC © Jones & Bartlett Learning, LLC accessing the specifiedNOT treatmen FORt area SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION Asks patient to assume the head position that facilitates the clinician’s view of the specified treatment area Maintains neutral position ©Directs Jones light to &illuminate Bartlett the specified Learning, treatment LLC area © Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION

NOTE TO COURSE INSTRUCTORS: Module Evaluation forms—in both computerized and paper formats—are available online. © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION

9781284456769_CH02_039_068.indd 68 10/04/20 5:39 PM