Note: INTRUMENTS GRASP Remains bright in most conditions but quickly lose their edge

sharpness.

3. Carbide
Provide more sharp and durable cutting edges

PARTS OF HAND CUTTING INSTRUMENTS

1. Handle - used to hold the instrument; available in various sizes and
shapes o helpful for better grasping and developing pressure.

2. Shank - connects the handle with the working point or nib of the
instrument
- for better control, the working point should be near preferably
within 3mm of the center of the long axis of the handle.

3. Blade or nib – is the working point.

o blade for cutting instruments
- for cleaving and smoothening the enamel and dentin
o nib for non-cutting instruments
- for gold and amalgam condensation

Dr. G.V. Black classified the operative instruments according to their use and
function into six classes.

1. Cutting instruments
Note: HAND-CUTTING A. Hand cutting – hatchets, chisels, hoes, excavators, and others
B. Rotary cutting – burs, diamond abrasive points, stones, discs, and others
MATERIALS USED FOR MANUFACTURING
1. Carbon steel 2. Condensing instruments – pluggers (hand, mechanical)
Contains: Carbon (0.5-0.1) and Iron 3. Plastic instruments – spatulas, carvers, burnishers, packing instruments
Sharper than stainless steel but easily fractures and susceptible to 4. Finishing and polishing instruments
corrosion. A. Hand – orange wood sticks, polishing points, finishing strips
B. Rotary – finishing burs, mounted brushes, mounted stones, rubber cups,
2. Stainless steel impregnated disks and wheels
Contains: Iron (72-85%) Chromium (15-25%) and Carbon (1-2%)
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 and other

Note: TYPES of HAND-CUTTING INSTRUMENT

1. Chisels - used to fracture and cleave the hard tissues of tooth
o straight chisel
the cutting edge is perpendicular to the long axis of the handle o
used for gingival restoration of the anterior teeth
o angled chisel o the primary cutting edge is in a plane
perpendicular to the long axis of the shaft

2. Hoe - form of modified chisel in which the angle of the blade is

greater than 12.5 degree centigrade; is used with a pull motion

3. Hatchet - used in a chopping motion; to refine line and point

angles
4. Angle former - a type of excavator which is mono-angled with
the cutting edge sharpened at right and left angles to the long
axis of the blade; used with a push or pull motion for making
retentive forms in direct filling gold restoration

5. Spoon excavator - used to remove caries in a spooning or

scooping action from the carious teeth with large cavity
6. Gingival margin trimmer - used to give bevel in gingival enamel
margin of proximo-occlusal preparation
7. Cleoid and Discoid - used for removing caries and carving NOTES: ROTARY INSTRUMENT
amalgam or wax patterns; blades are claw like in cleoid and o instruments which rotate on an axis to do the work of
sharp circular in discoid
abrading and cutting on tooth structure.
8. Knives - are used for trimming excess filling material and
o Powered rotary cutting instruments (dental handpieces) are
contouring the surface of the restoration
the most commonly used instruments in contemporary
EXTRA NOTES: dentistry.

1. Air-driven handpiece
- less costly
- weigh less than the electric ones

2. Electric motor–driven handpiece
- are quieter than air-driven handpieces
- cutting is more precise
 Most useful instruments are rotated at either low speed or high
speed. Electric handpiece motors operate up to 40,000 rpm. This
speed is significantly less than the 400,000 rpm generated by air-
driven handpieces.
However, the electric handpiece motor has attachments with
multipliers that increase rotation in ratios of 5 to 1 or 4 to 1 -
enables rotational speeds effectively in the same range as air-driven
handpieces.
 Most handpieces require lubrication after sterilization, and excess
oil may be present during the startup operation and increase risk of
contamination of the preparation.
 It is recommended to run the handpiece for a few seconds before
initiating dental procedures in which the deposition of oil spray onto
tooth structure might interfere with processes such as dental
adhesion.
NOTES: BUR
 Burs and abrasive points are the two most commonly used means
for the removal of the tooth.
 All rotary cutting instruments that have bladed cutting heads come
under the term bur.
Two types of burs:
- carbon steel burs
- tungsten carbide burs
 The cuts made in the head of the bur make them effective cutting
instruments as there is very little build up in debris.
 Carbide burs
- leaves a much smoother finish than diamond burs
- removing metal-based restoration
- most commonly available as a friction grip shank
In abrasive instruments, in the matrix of soft materials, angular particles of
a hard substance are held. fine abrasives = smoothen rough abrasives =
reduce the tooth surface by grinding
Different types of abrasives:
1. Diamond
- hardest material available
- most commonly used with high speed handpieces
- used to grind away tooth tissue, usually enamel
- diamond burs are very effective when cutting away porcelain
restorative material
2. Carborundum Silicon Carbide
- used for finishing restorations and tooth structure
3. Aluminum Oxide
- white, fine textured and produces a fine surface
4. Pumice
- used as a polishing material in the laboratory and intraorally
5. Sand Paper Disks and Finishing Stones and Points
- used for final finishing and polishing
6. Crocus Discs
- After using the sand paper abrasives, the margins of the casting are
smoothed with crocus discs.
 Straight handpiece shank
- is a simple cylinder that is held in the handpiece by a metal
chuck.
 - rarely used for preparing teeth but are used for oral surgery - for initial entry into the tooth
extraction procedures - extension of the cavity preparation
- are commonly used however on low speed handpieces for - caries removal
external finishing and polishing indirect restorations
Inverted cone bur
- rapidly tapered cone with the apex of the cone directed toward the
 Right-angle latch-type shank bur shank
- are not retained in the handpiece by a chuck, but by a retaining - suitable for providing undercuts in tooth preparation
latch that slides into the groove found at the shank end of the
instrument. Pear-shaped bur
- used at low-speed and medium-speed ranges for caries excavation
- slightly tapered cone with the small end of the cone directed
and finishing procedure
toward the bur shank
- tooth cavity preparations for amalgam
 Friction grip shank - provides rounded line angles and point angles required for
- are used in conjunction with carbide and diamond head bur composite restorations
- used with high speed handpieces
Straight fissure bur
Many characteristics of the heads of rotary instruments could be used - is an elongated cylinder
for classification: - extension of cavity preparation
- Most important among these is the division into bladed instruments - for amalgam tooth preparation
and abrasive instruments.
- Bladed and abrasive instruments exhibit substantially different clinical Tapered fissure bur
performance, even when operated under nearly identical condition. - slightly tapered cone with the small end of the cone directed away
from the bur shank
Head/Bur Shapes - for tooth preparations for indirect restorations (inlay and crown
the basic head shapes are: preparations)
- round
- inverted cone
EXTRA NOTES:
- pear
- straight fissure
- tapered fissure

Round bur
- spherical
NOTES: SAS 19 TABLE (COMMON PROBLEMS: CAUSES AND POTENTIAL SOLUTIONS)
Problem: Poor Isolation of the Operating Area
EXTRA
CAUSES NOTES: SOLUTION
 No rubber dam or leaking  Better technique
rubber dam  Use of matrix to help isolation
 Inadequate cotton roll  Use of a nonbonded restorative
isolation material
 Careless technique  Repeat bonding procedures (if the
 Preparation so deep area is contaminated
gingivally it cannot
Problem: White Line or Halo Around Enamel Margin
CAUSES SOLUTION
 Traumatic contouring or  Re-etch, prime, and bond the area
finishing techniques  Conservatively remove the fault and re-
 Inadequate etching and restore
bonding of that area  Use atraumatic finishing techniques
 High-intensity light curing, (e.g., light intermittent pressure)
resulting in excessive  Use slow-start polymerization
polymerization stresses techniques
 Leave as is
Problem: Voids
CAUSES SOLUTION
 Mixing of self-cured  More careful technique
composites  Repair of marginal voids by preparing
 Spaces left between the area and re-restoring)
increments during insertion
 Tacky composite pulling away
from the preparation during
insertion
 Problem: Poor Retention
CAUSES
 Inadequate preparation form
 Contamination of operating area
 Poor bonding technique
 Intermingling of bonding
materials from different system
Problem: Incorrect Shade
CAUSES
 Inappropriate operator lighting
while selecting the shade
 Selecting the shade after the
tooth is dried
 Shade tab not matching the
actual composite shade
 Wrong shade selected
Problem: Contouring and Finishing Problems
CAUSES
 Injuring adjacent unprepared
tooth structure
 Overcontouring the restoration
 Undercontouring the restoration
 Ditching cementum
 Creating inadequate anatomic
tooth form
 Dealing with difficult-to-see
margins
SOLUTION
 Prepare the tooth with appropriate
bevels or flares and secondary retention
feature, when necessary
 Keep the area isolated while bond
SOLUTION
 Use natural light if possible
 Select the shade before isolating the
tooth
 Preoperatively place some of the
selected shade on the tooth and cure
(then remove)
 Do not shine operating light directly on
the area during shade selectio
SOLUTION
 Be careful with use of rotary instruments
to avoid adversely affecting adjacent
tooth structure or teeth
 Have a proper matrix with appropriate
axial and line angle contours
 Create embrasures to match the adjacent
tooth embrasure form
 Do not use rotary instruments that leave
roughened surfaces
 Use a properly shaped contouring
instrument for the area being contoured
 Remember the outline form of the
preparation
 View the restoration from all angles as it
is contoured