L5 Operative Dentistry

INSTRUMENTATION IN
OPERATIVE
DENTISTRY
Introduction
2
Modern high-speed equipment has

eliminated the need for many hand
instruments for tooth preparation.
Nevertheless, hand instruments
remain an essential part of the
armamentarium for restorative
dentistry.
Dr.Mahmood Alayham Abbas 15/4/2016

Introduction
3
Modern hand instruments, when

properly used, produce beneficial
results for the operator and the
patient. Some of these results can be
satisfactorily achieved only with hand
instruments and not with rotary
instruments.

4 Design

Basic Classification
5
The hand instruments used in the

dental operatory may be categorized
as cutting (excavators, chisels, and
others) or non-cutting (amalgam
condensers, mirrors, explorers,
probes).

Design
6
Most hand instruments, regardless of

use, are composed of three parts:
handle, shank, and blade
For many non-cutting instruments, the

part corresponding to the blade is
termed nib. The end of the nib, or
working surface, is known as face.

Design
7
Double-ended instrument illustrating three component parts of

hand instruments: blade (a), shank (b), and handle (c).

Handle
8
Handles are available in various sizes

and shapes.
In North America, most instrument

handles are small in diameter
(5.5 mm) and light. They are
commonly eight-sided and knurled to
facilitate control.
In Europe, the handles are often larger

in diameter and tapered.
Shank
9
Shanks, which serve to connect the

handles to the working ends of the
instruments, are normally smooth,
round, and tapered.
They often have one or more bends to

overcome the tendency of the
instrument to twist while in use when
force is applied. Black classified
instruments Dr.Mahmood
on Alayham
the Abbas
basis
15/4/2016
of the
number of shank angles as mon-angle
Blade or Nib
10
The blade or nib is the working end of

the instrument and is connected to the
handle by the shank. The blades are of
many designs and sizes, depending on
their functions.
Some instruments have a blade on

both ends of the handle and are
known as double-ended instruments.
Blade’s Cutting Edge
11
Most hand cutting instruments have

on the end of the blade a single bevel
that forms the primary cutting edge.
Two additional edges, called secondary
cutting edges, extend from the
primary edge for the length of the
blade.
Bi-beveled instruments such as

ordinary hatchets have two bevels
that form the cutting edge
Blade’s Cutting Edge
12
Chisel blade design showing primary and secondary

cutting edges.

13 Black’s System

Black’s System
14
Black classified all of the instruments

by name.
In addition, for hand-cutting

instruments, he developed a numeric
formula to characterize the dimensions
and angles of the working end

Black’s Classification by
15
Name
Black's classification system by
instrument name categorized
instruments by function (e.g., scaler,
excavator), manner of use (e.g., hand
condenser), design of the working end
(e.g., spoon excavator, sickle scaler),
or shape of the shank (e.g., mon-
angle, bin-angle, contra-angle).
These namesDr.Mahmood
wereAlayham
combined
Abbas 15/4/2016
to form
the complete description of the
Black’s Formula
16
Cutting instruments have formulas

describing the dimensions and angles
of the working end. These are placed
on the handle using a code of three or
four numbers separated by dashes or
spaces.

Black’s Formula
17
Instrument shank and blade design

(with primary cutting edge positioned
close to handle axis to produce
balance). The complete instrument
formula (four numbers) is expressed
as the blade width (1) in 0.1-mm
increments, cutting edge angle (2) in
centigrades, blade length (3) in
millimeters, and blade angle (4) in
degrees.

Black’s Formula: First
18
Number
(10–85–8–14)
(10–8–14)
The first number indicates

the width of the blade or
primary cutting edge in
tenths of a millimeter
(0.1 mm) (e.g., 10 = 1 mm).

Black’s Formula: Second
19
Number
(10–85–8–14)
The second number of a four-

number code indicates the
primary cutting edge angle,
measured from a line parallel
to the long axis of the
instrument handle in
clockwise centigrades.
Black’s Formula: Second
20
Number
The angle is expressed as a
percent of 360˚ (e.g., 85 =
85% × 360˚ = 306˚). The
instrument is positioned so
that this number always
exceeds 50.
If the edge is locally

perpendicular to the blade,
this number is normally
omitted, resulting in a three-
Black’s Formula: Third
21
Number
(10–85–8–14)
(10–8–14)
The third number (second

number of a three-number
code) indicates the blade
length in millimeters (e.g.,
8 = 8 mm).

Black’s Formula: Last
22
Number
(10–85–8–14)
(10–8–14)
The last number indicates

the blade angle, relative to
the long axis of the handle in
clockwise centigrade. The
angle is expressed as a
percent of 360˚(e.g., 14 =
14% × 360˚Dr.Mahmood
= 50˚). the
Alayham Abbas 15/4/2016
23 Diagnostic Instruments

Mouth Mirror
24
Mouth mirror is used for

indirect vision, retraction
of lips, cheeks, and
tongue, and illumination
of dark areas.

Explorer
25
Explorer is used for detection and

exploration of calculus, pockets,
furcations, restorations, pulp
chamber’s roof, root canal orifice
...etc.

Periodontal Probes
26
Probe is used to assess periodontal

pocket depths, attachment levels,
anatomy configurations and gingival
bleeding.
In operative dentistry it is used for

measurement and caries detection

Periodontal Probes
27
Williams Probe for CPITN Probe for caries

measurement detection
Pliers
28
Pliers are used to

grasp or transfer
materials in and out of
the oral cavity.

29
Instruments for Tooth
Preparation

Chisels
30
Chisels are used primarily for cutting

enamel
Chisels may be subdivided further into

straight chisels, curved chisels, bin-
angle chisels, enamel hatchets, and
gingival margin trimmers.

Straight, Curved & Bin-angle chisels
31
The straight chisel has a straight shank

and blade, with the bevel on only one
side. Its primary edge is perpendicular
to the axis of the handle. It is similar in
design to a carpenter's chisel.
The shank and blade of the chisel also

may be slightly curved (Wedelstaedt
design) or may be bin-angled. The
force used with all these chisels is
essentially a straight thrust.
Straight, Curved & Bin-
32
angle chisels
Examples of hand instruments called chisels (with corresponding

instrument formulas). A, Straight (12–7–0). B, Wedelstaedt (11.5–
15–3). C, Bin-angle (10–7–8).
Straight, Curved & Bin-
33
angle chisels
straight curved chisel bin-angle chisel

chisel

Enamel Hatchet
34
The enamel hatchet is a chisel similar

in design to the ordinary hatchet
except that the blade is larger,
heavier, and beveled on only one side.
It has its cutting edges in a plane that

is parallel with the axis of the handle.
It is used with a planning or direct
cutting motion and a lateral cutting
motion for cutting enamel.
Gingival Margin Trimmer
35
The gingival margin trimmer is similar

in design to the enamel hatchet except
the blade is curved, and the primary
cutting edge is at an angle (other than
perpendicular) to the axis of the blade.
It is designed to produce a proper

bevel on gingival enamel margins of
proximo-occlusal preparations and
rounding or beveling of the axiopulpal
line angle of two-surface preparations
36
Examples of hand instruments called chisels (with corresponding

instrument formulas). A, Enamel hatchet (10–7–14). B, Gingival
margin trimmer (12.5–100–7–14). C, Gingival margin trimmer (12.5–
100–7–14). Dr.Mahmood Alayham Abbas 15/4/2016
37
Enamel hatchet Gingival margin trimmer

Excavators
38
Excavators are used for removal of

caries and refinement of the internal
parts of the preparation.
Excavators may be subdivided further

into ordinary hatchets, hoes, angle
formers, and spoons.

Spoon Excavator
39
Spoon excavators are used for

removing caries and carving amalgam
or direct wax patterns.
The blades are slightly curved, and the

cutting edges are either circular or
claw-like. The shanks may be bin-
angled or triple-angled to facilitate
accessibility.
40
Examples of hand instruments called spoon excavators (with

corresponding instrument formulas). A, Bin-angle spoon (13–7–14).
B, Triple-angle spoon (13–7–14).
Dr.MahmoodC, Spoon
Alayham (15–7–14).
Abbas 15/4/2016
Spoon Excavator
41
spoon excavators
Ordinary Hatchet
42
An ordinary hatchet excavator has the

cutting edge of the blade directed in
the same plane as that of the long
axis of the handle and is bi-beveled.
These instruments are used primarily

on anterior teeth for preparing
retentive areas and sharpening
internal line angles, particularly in
preparations Dr.Mahmood
for direct
Alayham Abbas 15/4/2016
gold
restorations.
Hoe
43
The hoe excavator has the primary

cutting edge of the blade
perpendicular to the axis of the
handle.
This type of instrument is used for

planing tooth preparation walls and for
forming line angles. It is commonly
used in Class III and V preparations for
direct gold restorations.
Angle Former
44
the angle-former is used primarily for

sharpening line angles and creating
retentive features in dentin in
preparation for gold restorations. It
also may be used in placing a bevel on
enamel margins.
It is mon-angled and has the primary

cutting edge at an angle (other than
90˚) to the blade.
45
Examples of hand instruments called excavators (with corresponding

instrument formulas). A, Bi-beveled ordinary hatchet (3–2–28). B,
Hoe (4.5–1.5–22). C, Angle former (12–85–5–8).
46
Hoe Angle former

Right beveled or Left
47
beveled
Certain single-beveled instruments
such as spoon excavators, gingival
margin trimmers and enamel hatchets
must be made in pairs, with the
bevels on opposite sides of the blade.
Such instruments are designated as
right beveled or left beveled.
One instrument is suited for work on

one side of the preparation, and the
other is suited for the opposite side of
Right beveled or Left
48
beveled
To determine whether the instrument
has a right or left bevel, the primary
cutting edge is held down and
pointing away, and if the bevel
appears on the right side of the blade,
it is the right instrument of the pair.
The opposite holds true for the left

instrument of the pair.
Mesial bevel or Distal bevel
49
Instruments having the cutting edge

perpendicular to the axis of the handle
such as bin-angle chisels, instruments
with a slight blade curvature
(Wedelstaedt chisels), and hoes, are
single-beveled and not designated as
rights or lefts but as having a mesial
bevel or a distal bevel.

Mesial bevel or Distal bevel
50
If when one observes the inside of the

blade curvature (or the inside of the
angle at the junction of the blade and
shank) the primary bevel is not visible,
the instrument has a distal bevel.
Conversely, if the primary bevel can

be seen (from the same viewpoint),
the instrument has a mesial or reverse
bevel. Dr.Mahmood Alayham Abbas 15/4/2016
51
Instruments for
Restoration

Amalgam Carrier
52
Amalgam Carrier is used to carry and

dispense amalgam restorative
materials.

Plugger
53
Plugger (condenser) used to pack

filling materials into cavity
preparations

Plastic (Composite) Filling
54
Instrument
Highly polished stainless steel
instruments used for composite
placement and contouring.

Dycal Applicator
55
Calcium hydroxide or glass ionomer

base/liner placement instrument. Also
useful as a small burnisher.

Carver
56
Carvers are used to carve anatomical

features and trim excess materials.
Hollenback
carver
Carver
57
Discoid-Cleoid
Carver
Burnisher
58
The Burnisher is designed to smooth

and polish amalgam.
Ball Burnisher
59 Grasps

Modified Pen Grasp
60
The grasp that permits the greatest

delicacy of touch. It is similar, but not
identical, to that used in holding a
pen.
The pads of the thumb and of the

index and middle fingers contact the
instrument, while the tip of the ring
finger (or tips of the ring and little
fingers) is placed on a nearby tooth
surface of the same arch as a rest.
Modified Pen Grasp
61
The palm of the hand generally is

facing away from the operator. The
pad of the middle finger is placed
near the topside of the instrument.
The instrument should not be allowed

to rest on or near the first joint of the
middle finger as in the conventional
pen grasp. Although this latter
position may appear to be more
comfortable, it limits the application
Modified Pen Grasp
62
conventional pen grasp

Modified Pen Grasp
63
modified pen grasp

Inverted Pen Grasp
64
The finger positions of the inverted

pen grasp are the same as for the
modified pen grasp. The hand is
rotated, however, so that the palm
faces more toward the operator. This
grasp is used mostly for tooth
preparations employing the lingual
approach on anterior teeth.

Inverted Pen Grasp
65
inverted pen grasp

Palm-and-thumb grasp
66
The palm-and-thumb grasp is similar

to that used for holding a knife while
paring an apple.
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 rest is provided by
supporting the tip of the thumb on a
nearby toothDr.Mahmood
of theAlayham
same arch or on a
Abbas 15/4/2016
firm, stable structure. For suitable
palm-and-thumb grasp
67
palm-and-thumb grasp
Modified palm-and-thumb
68
grasp
The modified palm-and-thumb grasp
may be used when it is feasible to rest
the thumb on the tooth being prepared
or the adjacent tooth.
The handle of the instrument is held by

all four fingers, whose pads press the
handle against the distal area of the
palm and the pad and first joint of the
thumb. Grasping the handle under the
first joints of the ring finger and little
Modified palm-and-thumb
69
grasp
modified palm-and-thumb grasp

References
70
Sturdevant's Art and Science of

Operative Dentistry, 6th Edition;
Heymann, Swift and Ritter
https://www.hu-friedy.com

L5 Operative Dentistry

Uploaded by

Document Information

Original Description:

Original Title

Copyright

Available Formats

Share this document

Share or Embed Document

Sharing Options

Did you find this document useful?

Is this content inappropriate?

Copyright:

Available Formats

L5 Operative Dentistry

Uploaded by

Copyright:

Available Formats

INSTRUMENTATION IN

Modern high-speed equipment has

Dr.Mahmood Alayham Abbas 15/4/2016

Modern hand instruments, when

Dr.Mahmood Alayham Abbas 15/4/2016

Dr.Mahmood Alayham Abbas 15/4/2016

The hand instruments used in the

Dr.Mahmood Alayham Abbas 15/4/2016

Most hand instruments, regardless of

For many non-cutting instruments, the

Dr.Mahmood Alayham Abbas 15/4/2016

Double-ended instrument illustrating three component parts of

Dr.Mahmood Alayham Abbas 15/4/2016

Handles are available in various sizes

In North America, most instrument

In Europe, the handles are often larger

Shanks, which serve to connect the

They often have one or more bends to

The blade or nib is the working end of

Some instruments have a blade on

Most hand cutting instruments have

Bi-beveled instruments such as

Chisel blade design showing primary and secondary

Dr.Mahmood Alayham Abbas 15/4/2016

Dr.Mahmood Alayham Abbas 15/4/2016

Black classified all of the instruments

In addition, for hand-cutting

Dr.Mahmood Alayham Abbas 15/4/2016

Cutting instruments have formulas

Dr.Mahmood Alayham Abbas 15/4/2016

Instrument shank and blade design

Dr.Mahmood Alayham Abbas 15/4/2016

The first number indicates

Dr.Mahmood Alayham Abbas 15/4/2016

The second number of a four-

If the edge is locally

The third number (second

Dr.Mahmood Alayham Abbas 15/4/2016

The last number indicates

Dr.Mahmood Alayham Abbas 15/4/2016

Mouth mirror is used for

Dr.Mahmood Alayham Abbas 15/4/2016

Explorer is used for detection and

Dr.Mahmood Alayham Abbas 15/4/2016

Probe is used to assess periodontal

In operative dentistry it is used for

Dr.Mahmood Alayham Abbas 15/4/2016

Williams Probe for CPITN Probe for caries

Pliers are used to

Dr.Mahmood Alayham Abbas 15/4/2016

Dr.Mahmood Alayham Abbas 15/4/2016

Chisels are used primarily for cutting

Chisels may be subdivided further into

Dr.Mahmood Alayham Abbas 15/4/2016

The straight chisel has a straight shank

The shank and blade of the chisel also

Examples of hand instruments called chisels (with corresponding

straight curved chisel bin-angle chisel

Dr.Mahmood Alayham Abbas 15/4/2016

The enamel hatchet is a chisel similar

It has its cutting edges in a plane that

The gingival margin trimmer is similar