INSTRUMENTS

BY
Shams Waaz Amgad Ali
Dental Instrument
 It refers to a tool or a
device used for specific
type of work or
procedure.

 In Fixed Prosthodontic
work we use to cut and
reduce enamel
Dental Instrument
Classification
 According To Their Uses

Diagnostic Cutting Restoring

I-Diagnostic Instruments
Dental Mirror

Dental Probe

Dental Tweezer
Periodontal Probe
II-Cutting Instruments
 They are used to
cut, file, grind,
plane, or smoothen
dental structures.
 According To Their
Mode Of Cutting

Hand Rotary

Laser Other
1-Hand Cutting Instruments
 1-Hand Cutting Instruments

Hand powered
Blade

 Light in weight
Shank

Material of construction

a. Carbon steel

b. Stainless steel

c. Carbide
Handle
 As:
a. Excavators
(e.g. hatchets, hoes, angle former and
spoons).

b. Chisels
(e.g. straight chisel, curved chisel, enamel
hatchet and gingival marginal trimmers)

c. Other
(as knives, files, scalers and carvers)
 Instrument Design

a- Blade b-Shank c-Hand

2- Powered (Rotary) Cutting Instruments
 These are abrasive or cutting tools that is to
cut and reduce the tooth surface.

 They are divided in to three major groups :

1-Dental Burs ( cutting action)

2-Dental stones ( abrasion action)

3-Dental Abrasives Discs ( abrasion

action , slicing action)
  Head Design
It is classified (According to the mode of cutting) into:

Abrasive Burs Discs

 The rotary cutting instruments are held and
operated by removable shank called (Hand
piece)
 Hand pieces are classified:
1- According to the shape:
a. Straight b. Contra Angle
Fiber-optic hand piece
2-According to the Power Source
Air turbine Electric motor
 Rotary Speed Ranges
 The rotational speed of an instrument is
measured in revolution per minute (rpm)
 Three speed ranges are recognized:
1-Conventional or low speed 3000 to 10000
RPM
2-Intermediate or standard speed 10 000 to
40000 RPM.
3-Super high speed 40 000 to 100 000
RPM.
4-Ultra high speed 100 000 to 500 000
RPM.
 Uses of Low speed cutting instruments
Requires a relatively heavy force leading to heat
generation , vibration and discomfort of the patient
in addition to time consuming

 Preparation of grooves and pinholes

for partial coverage restoration.

 Cleaning of teeth ( scaling of calculus).

 Caries removal in deep cavities.

 Finishing and polishing .

 High &Ultra high speed instrument
Advantages:
 Faster and less pressure with less heat generation.
 Used in preparation of teeth and removal of old
restoration.
 Less patient discomfort.
 Several teeth in the oral cavity could be
performed in one visit.
 Common design

a. Head b. Neck c. Shank

Dental Burs
 Dental Burs

Cutting instruments
that have bladed
cutting heads
 Dental Burs Classification
according to

1-Material Of Construction

2-Shape of head

3-Shank
4-Flutes
5-Size
1-Material of construction
- Carbon steel.
-Tungsten Carbide.
- Diamond.

2-Shape
- Round. - Inverted cone.
- Fissure. - End cutting.
-Finishing
 3-Shank Design

Used with -With low speed contra- - With high speed

straight hand contra-angle hand
angle hand piece
piece piece
4- Flutes :
-Plain
-Cross Cut ( increase cutting efficiency)
5- Size : Number giving to the head diameter in
tenth of millimeter
Abrasive
 Abrasive Instruments
- Small, angular particles of a hard substance held in a matrix of
softer material
- It classified into:
- Diamond Instrument - Other Abrasives
Dental Stones
Dental Stones Classification
according to
1-Material Of Construction

2-Shape
3-Shank

4-Function

5-Particle Size
Material of construction
- Carbon steel.
- Carbide.
- Diamond.
- Ceramics
- Sand
 Shapes
a. wheel b. Flame shape c. Fine taper
d. Taper stone with round end e. Taper stone with flat end
 Dental stones

wheel
ball Inverted cone
Pear shape
barrel

Pointed end Round end Flat end cylindrical Tinker

  Ball Shaped: used to reduce
palatal and lingual surfaces of anterior
teeth.

 Wheel Stone: used to reduce

incisal edges in anterior teeth and
occlusal planes of cusps of posterior
teeth.
Wheel Stone may be with flat edge,
round edge, pointed edge.

 Barrel and Pear shaped

stone: used to reduce occlusal
surfaces of premolars and molars.
 Tinker Stone: used to
perform shoulder with bevel
finishing line for PFM
restorations.

 Tapered Stone as:

a. Tapered with round end used to
perform chamfer finish line for full
metal restoration.
b. Tapered with flat end used to
perform shoulder finish line for all
ceramic full coverage restoration.
c. Fine taper used to open the proximal
contact , knife edge finish line .
d. ‘Cylindrical stone.
 Function

End cutting bur or stone

used for sub gingival finish
line

Root Facer used in

preparation of post crown
Triple wheel (depth cuts) for
laminate veneer preparation

Tissue Trimmer
 Particle Size

Coarse, Medium, Fine, Very Fine

↑Particle Size →↓no. of abrasive particles
→↑pressure
→↑heat generation
Other Abrasive
Instruments
 Other Abrasive Instruments

Molded Abrasive Instrument

pressing or molding a uniform
mixture of abrasive particles and matrix
around roughened end of the shank
According to the matrix
rigid polymer or ceramic
flexible rubber

Coated Abrasive Instrument

Layer of thin abrasive cemented to
flexible backing
Molded Abrasive Instrument
1. Flexible Type
Molded Abrasive Instrument
2. Rigid Type
Coated Abrasive Instrument
 1.According to side of abrasive material
Safe sided, to prevent injury of adjacent teeth
Double side, when adjacent teeth are missing.
Safe sided cup shaped discs.
2.According to the shape
Flat shaped disc.
Cup shaped disc for distal surface of lower molars
due to the curve of Spee.
 3.According to Size ‘diameter’

Small--------- 3/8 inch

Medium-------- 5/8 inch
Large ------------ 7/8 inch
4.According to Material
Carborundum Stainless Steel
Diamond Sand paper
 Dental Rotary Instruments are supplied in
two categories:
1-Mounted type. Supplied with their mandrel firmly
attached to the working points.
Demounted type. These are mounted to shank
(mandrel), which carries a variety of
interchangeable demounted rotary points
Mandrel
 Abrasive Versus Burs

Mechanism of Cutting
a. Abrasives

- Abrading, or wearing

b. Burs
- Shearing
- Cutting primary from the
sides
of the instrument
 Abrasive Versus Burs

Cutting Efficiency

a. Diamonds
- More efficient
but
- Rough surfaces and irregular
finish lines

b. Carbide burs
- More slowly
but
- Smooth finish lines
- Internal features
3-Laser Equipment
 Laser Equipment

Lasers are devices that produce

beams very high intensity light

Uses:
Treatment of soft tissues.
Modification of hard tooth structure
4-Other Equipment
 Air Abrasive Cutting

Hard tooth structures are removed by rapid continuous air

driven abrasive action of aluminum oxide

Clinical problems
No tactile sense
Determination of cutting progress
Interfere visibility
Control inhalation

Uses:
Stain removal
De-pridment of pit and fissure prior to sealing
Micro-mechanical roughening
Mouth mirror with parallel lines
STERILIZATION
AND INFECTION
CONTROL

Why Infection Control Is Important
in Dentistry?
 Bothpatients and dental personnel can be
exposed to pathogens.

 Contact with blood, oral and respiratory

secretions, and contaminated equipment
occurs.

 Proper procedures can prevent transmission

of infections to patients and Dentist.
 Diseases Transmission in the Dental
Office
 Patient to Dental Team:
1. Direct contact.
2. Droplet infection.
3. Indirect contact.

 Dental Team to Patient.

 Patient to Patient.
 Dental office to community.
 Community to Dental office.
 Hand hygiene
 Themost important measure to preventing
disease transmission.
 Hands Need to be Cleaned
When!!!!
 Before and after patient
treatment (before glove
placement and after glove
removal)

 After touching contaminated

objects with bare hands

 Visibly dirty
 Hand Hygiene Definitions

 Hand washing
– Washing hands with plain soap and water

 Antiseptic hand-wash
– Washing hands with water and soap or other
detergents containing an antiseptic agent

 Alcohol-based hand rub

– Rubbing hands with an alcohol-containing
preparation
Instrument Sterilization and
Disinfection
Determining what should be sterilized,
Disinfected, or discarded

 Critical Instruments

 Semi-critical Instruments

 Non critical Instruments and Devices

 Single use items

Critical Instruments
 Penetrate mucous membranes or contact bone, the
bloodstream

 Cleaning followed by heat sterilization is required.

 Single use items must be discarded

 Examples include forceps, scalpel blades,

periodontal scalers, and surgical dental burs
Semi-critical Instruments

 Contact mucous membranes but do not penetrate

soft tissue.

 Heat sterilize or high-level disinfect.

 Examples: amalgam condensers, reusable

impression trays.
 AS A RULE !!!!!!

 All Critical and Semi-critical instruments

must be sterilized.

 Non critical instrument can be disinfected

 Sterilization

 A process that destroys all microbial

forms, including bacterial spores.

 All reusable items (critical and semi-

critical) instruments that come in contact
with the patient's blood, saliva or mucous
membranes must be heat-sterilized.
 Sterilization
 Can be achieved through the following:

(I) Physical ( heat based) sterilization:

1 - Steam under pressure (autoclaving):
2- Chemical vapor sterilization( chemiclave).
3 - Dry heat sterilization.

(II) Chemical sterilization (cold sterilization).

 (I) Physical ( heat based)
 Steam under pressure sterilization (autoclaving)
It’s the most effective for destroying the pathogenic
organisms and the vegetative forms
It’s achieved at 270° F at 27 PSI for at least 6 min.
2. Chemiclave (Unsaturated Chemical
Vapor)
 It’s effective for all metal instruments, but best for
carbon steel, because chemical vapor contains less
water……
 It’s achieved at 270°F 20-40 PSI for at least 20
min.
 3. Dry Heat Sterilization
 Sterilization is achieved when temperature of
the unit is maintained at 230° F for 2 hours.
 II) Chemical Sterilization

 Only for heat-sensitive semi-

critical devices.

 Method: Immersion, for several

hours

 Examples:
1. 2% to 3.4% Glutraldehyde
2. Ethylene oxide.
 Disinfection
A process that eliminates many or all
microorganisms except bacterial spores.

 Methods of Disinfection:
– A. Thermal disinfection: heating to a degree
below sterilizing temperature e.g boiling water

– B. Chemical disinfection : Their activity is

related to the following factors: concentration,
PH, Contact time, temperature.
Chemical Disinfection

High-level disinfection

Intermediate-level disinfection

Low-level disinfection
 High-level disinfection, e.g: . Glutaraldehydes
with phenol

 Intermediate disinfection, e.g: Sodium

hypochlorite, Iodophors, Phenolics

 Low-level disinfection, e.g: some phenolics,

some iodophors, and citric acid. They are
household level cleaner.
THANK YOU