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INSTRUMENTATION IN
OPERATIVE DENTISTRY
CONTENTS
HISTORY ROTARY CUTTING
GENERAL CLASSIFICATION INSTRUMENTS
HAND CUTTING INSTRUMENTS history
classification characteristics
materials design
parts dental burs
nomenclature & formulae dental abrasives
other design features
cutting mechanisms
instrument applications
NEWER
instrument grasps
DEVELOPMENTS
sharpening, sterilization
CONCLUSION
REFERENCES
INTRODUCTION
In order to perform the intricate and detailed
procedures associated with operative dentistry,
the dentist must have a complete knowledge of
the purpose, availability and application of the
many instruments required.
CLASSIFICATION OF
INSTRUMENTS
G.V. BLACK CLASSIFICATION
CUTTING INSTRUMENTS
CONDENSING INSTRUMENTS
PLASTIC INSTRUMENTS
FINISHING & POLISHING INSTRUMENTS
ISOLATION INSTRUMENTS
MISCELLANEOUS
1. Cutting instruments 3. Plastic instruments
• Hand - Spatulas
-Hatchets - Carvers
-Chisels - Burnishers
-Excavators - Packing instruments
-Others
• Rotary 4. Finishing and polishing instruments
- Burs - Hand
- Stones - Orange wood sticks
- Disks - Polishing points
- Others - Finishing strips
- Rotary
2. Condensing instruments - Finishing burs
Pluggers - Mounted brushes
- Hand - Mounted stones
- Mechanical - Rubber cups
- Impregnated disks and wheels
5. Isolation instruments
- Rubber dam frame
- Clamps, forceps, punch
- Saliva ejector
- Cotton roll holder
- Evacuating tips and
equipment
6. Miscellaneous instruments
- Mouth mirrors
- Explorers
- Probes
- Scissors
- Pliers
- Others
CLASSIFICATION
CLASSIFICATION BY MARZOUK
1. Straight explorer.
2. Right angled explorer
3. Arch explorer
4. Interproximal explorer.
RIGHT ANGLED
STRAIGHT
STRAIGHT RIGHT ANGLED
ARCH INTERPROXIML
INSTRUMENTATS FOR
RESTORATION
HAND CUTTING
INSTRUMENTS
CLASSIFICATION OF HAND
INSTRUMENTS
CUTTING NON-CUTTING
INSTRUMENTS INSTRUMENTS
Monel
Nichrome
Stellite
Tarno
HEAT TREATMENT
Hardening heat treatment
- The hardening heat treatment hardness the
alloy, but also makes it brittle, especially when the
carbon content is high.
- 1500°F (815°C)
Tempering
- The tempering heat treatment relieves
stains and increases toughness.
- 350°F (176°C)
PARTS OF HAND CUTTING
INSTRUMENTS
HANDLE
Small, medium, large
¼ inch diameter,
octagonal
CONE-SOCKET
INSTRUMENT
SHANK
Monoangled
Binagled
Tripleangled
BLADE/NIB
Cutting edge
Blade angle
Cutting edge angle
CONTRANGLED INSTRUMENTS
Suborder
Eg: binangle hatchet
Class push excavator
Subclass
Order: The order denotes the purpose or function of the
instrument. E.g. Excavator, scaler.
The class describes the form of the blade. Eg. Hatchets, chisel.
Boley gauge
Instrument motions
Chopping-- Using the instrument parallel
to the long axis of the blade
EXCAVATORS
CHISELS
SPECIAL FORM OF CHISELS
EXCAVATORS
Ordinary hatchet
Hoes
Angle formers
Spoon excavaters
ORDINARY HATCHET
FUNCTION:
• Single planed
instrument
FUNCTIONS:
Planing cavity walls
Refine line angles
Cl-III & Cl-IV
preparations for DFG
ANGLE FORMERS
FUNCTIONS:
Sharpening line angles
Retentive features
Beveling enamel margins
MOVEMENTS: 4 types
The instruments are made by grinding the bevel at an
angle of 80o with the shaft, thus forming an acute
angle with the long axis of the blade. This creates a
pointed and a linear cutting edge.
Circumferentially bevelled.
Straight
Binangled chisels
FUNCTIONS:
split/cleave undrmined
enamel in prox cavity
(buccal, lingual walls)
MOVEMENTS: 4
types
The hatchet shank has one or more angles. The
blade is in the same plane as this angle or angles
parallel with the shaft.
Paired instruments: right, left.
Single planed instruments.
Single bevelled instruments.
Bevel on the right side: right side instrument.
Bevel on the left side: left sided instrument.
Used with push stroke (planing or direct cutting
motion as well as lateral cutting motion).
OFFSET HATCHET
Blade :1/4th turn rotated
Set of 4
Is a Modified hatchet
WEDELSTAEDT CHISEL
• Straight chisel but with a slight
vertical curvature in its shank.
class-V restorations
margins.
INSTRUMENT GRASPS
MODIFIED
PEN GRASP
CORRECT INCORRECT
It is similar to that used in holding a pen but not identical.
Pads of the thumb, index and middle fingers contact the
instrument, while the tip of the ring finger or tips of the
ring and little finger is placed on a nearly tooth surface of
the same arch. The palm of the hand generally is facing
away from the operator. The pad of the middle finger is
placed near the top side of the instrument.
INVERTED PEN GRASP
The finger position of the inverted pen grasp are the
same as for the modified pen grasp, but the hand is
rotated so that the palm faces more towards the
operator.
This grasp is used mostly for cavity preparations utilizing
the lingual approach on anterior teeth.
The modified pen and inverted pen grasps are practically
universal.
PALM AND THUMB GRASP
The handle is placed in the palm of the hand and grasped
by all the fingers, while the thumb is free of the instrument
and the restoration is provided by supporting the tip of the
thumb on a nearby tooth of the same arch or on a firm,
stable structure. It may be useful on maxillary teeth
especially the right side when working from the right rear
position.
This form of grasp is usually necessary where the rest
support for the thumb is at some distance from the point of
operation, so that the thumb itself must be extended and
hence cannot be used for gripping.
MODIFIED PALM AND
THUMB GRASP
In this, the handle of the instrument is in contact
with the tips of the 4 fingers on one side,
opposed to which are contacts with the mesial
end of the 1st phalanx of the thumb. The hand is
only half closed instead of being fully closed.
The end of the thumb is used as a rest.
Rests:
A proper instrument grasp must include a firm rest to
steady the hand during operating procedures.
The closer the rest areas are to the operating area, the
more reliable they are.
In cases where it is impossible to establish a rest on tooth
structure then soft tissue may be used.
Three of these
Straight hand piece shank.
Latch type angle hand piece shank.
Friction grip angle hand piece shank. Are commonly
encountered.
Neck design:
The neck is the intermediate portion of
an instrument that connects the head
to the shank.
The main function of the neck is to
transmit rotational and translation
forces to the head.
Head design:
The head is the working part of the
instrument, the cutting edges or points
of which perform the derived shaping
of tooth structure
CHARACTERISTICS OF
ROTARY INSTRUMENTS
SPEED
By Sturdevant:
Low or slow speed-below 12,000 rpm
Medium /intermediate speed-12,000 to 2,00,000 rpm
High or ultra-high speed-above 2,00,000 rpm
By Marzouk:
Ultra low speed-300 to 3000 rpm
Low speed- 3000 to 6000 rpm
Medium high speed-20,000 to 45,000 rpm
High speed-45,000 to 1,00,000 rpm
Ultra-high speed-above 1,00,000 rpm
By Charbeneau:
Conventional/low speed-below 10,000 rpm
Increased or high speed- 10,000 to 1,50,000
rpm
Ultra-speed-above 1,50,000 rpm
LOW SPEED
Disadvantages:
Time consuming
Heavy force application
Heat & vibration
Bur rolls out
Carbide burs not useful
Uses
1. Removal of soft caries
2. Finishing of the cavity
HIGH SPEED:
Advantages:
Faster
Less pressure, vibration, heat
Smaller sizes-universal
Better control, ease
Instruments last longer
Patient is less apprehensive
Several teeth treatment
Uses
1. Cavity preparation
DENTAL BURS
HISTORY
Early burs-hand made
Machine made burs-1891-S.S.White
STEEL BURS
Dull at high speed
Finishing & polishing
VHN: 800
CARBIDE BURS
Used at high speed
Cavity preparation
VHN:1650-1700
BUR CLASSIFICATION
1. Material used
2. Size of head
3. Shape of head
4. Mode of attachment
5. According to motion
6. According to use
SHAPE OF BUR
Shape: contour/silhouette of head
Basic shapes
Round bur – is spherical. The shape has been used for
Initial entry into the tooth.
Preparation of retention potholes.
Caries removal.
Straight fissure:
A straight fissure bur is an elongated cylinder.
This shape is advocating some for amalgam
cavity preparation
Tapered fissure bur:
Is a portion of a slightly tapered cone with the
small end of the cone directed away from the
bur shank. This shape is useful for
Inlay and crown preparations where freedom
from undercuts is essential for successful
withdrawal of patterns and final seating of cast
restoration.
BUR BLADE DESIGN
Three important angles:
Rake angle (angle made between the rake face and
the line connecting the edge to the axis of the bur)
CLEARANCE ANGLE
Prevent friction
EDGE ANGLE
NO. OF BLADES
Less blades remove
more material
Less clogging
ADVANTAGES:
Longer life
Better cutting
effectiveness
Diamond instruments consist of 3 parts.
A metal blank,
powered diamond abrasive,
Metallic bonding material that hold the diamond powder
onto the blank.
& SIZES
Size:
coarse (125-150µm)
medium (88-125µm)
fine(60-74µm)
very fine(38-44µm)
finishing(10-38µm)
FACTORS INFLUENCING THE
CUTTING EFFICIENCY
Size of the abrasive particles
Shape of abrasive particles
Density of abrasive particles
Hardness of abrasive particles
Speed and pressure
OTHER ABRASSIVES
MOULDED INSTRUMENTS
Made by pressing uniform
mixture of abrasive and matrix
around end of shank
TYPES:
Hard & soft
MATERIALS
Silicon carbide (carborundum)
Aluminium oxide
MOUNTED STONES
FINISHERS
POLISHERS
COATED INSTRUMENTS
They are mostly discs that have a
thin layer of abrasives cemented to
a flexible backing.
FINISHING KIT
FOR COMPOSITES
ADVANTAGES OF ROTARY CUTTING
Most efficient for gross tooth removal
Diamond abrasives : enamel
Carbide burs : dentin
Less cumbersome
DISADVANTAGE:
In deep carious lesions-hand instruments preferable
HAZARDS
PULPAL HAZARD
EYE HAZARD
EAR HAZARD
INHALATION HAZARD