Professional Documents
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IN OPERATIVE DENTISTRY
CONTENTS
•
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Introduction
• Materials used in manufacturing hand instruments
• Instrument design
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INTRODUCTION
• The term “Instrument” refers to a tool or a device used for
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specific purpose or work.
• Instruments used in dentistry varied from the time they
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• Earlier, Removal and shaping of tooth structure was an
essential part of restorative dentistry, was difficult and time
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consuming accomplished entirely by the use of hand
instruments.
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MATERIALS
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• Hand cutting instruments are manufactured from two main
materials:
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• Stainless steel : iron
chromium :12-30%
carbon :0.15%
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• Chromic oxide – prevents corrosion..
• Loses keen edge during use much more quickly than does
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• Hardening heat treatment hardens the alloy, also making it
brittle, if the C content is high.
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• Tempering heat treatment relieves strains and increases
toughness.
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INSTRUMENT DESIGN
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Consists of 3 parts
Handle
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SHAFT/HANDLE
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serrated to increase friction for hand gripping.
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LONG HANDLES AND CONE
SOCKETS
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• Instruments are known as “long handled”,if the handle,
shank and the blade are all made from single piece of steel.
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THE SHANK
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blade or working end of the
instrument.It may have one or
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BALANCE AND CONTRANGLING
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• Enamel and dentin are hard substances to cut and require the
generation of substantial forces at the tip of the instrument.
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• The shanks of instruments have
multiple angles to keep the working
end of the instrument within 2 to
3mm of the long axis of the handle.
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• A)The working end of the
instrument is not close to the long
axis of the handle and hence it is not
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quadrangled.
• The length of the blade
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• It is that part of the instrument
bearing the cutting edge. It
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CUTTING EDGE
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• It is the working end of the instrument. It is usually in the
form of a bevel with different shapes.
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• It is defined as an angle between
the margin of the cutting edge and
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THE BLADE
ANGLE
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• It is defined as the angle
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NOMENCLATURE
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Dr. Black gave 4 classes in establishing a nomenclature for hand
instruments.
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• Naming the instrument usually moves from subclass to
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order.(4-1)
Eg: Binangle hatchet push excavator
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INSTRUMENT FORMULA
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• Cutting instruments have formulas describing the
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• The third number indicates the blade angle.
• 15- 8-12 binangle hatchet
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Presented by: Dr. Pragya Tripathi
blade width1.5mm
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12/08/21 Presented by: Dr. Pragya Tripathi
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• When the primary cutting edge is at an angle other than
90°to the long axis of the blade,a 4th unit is added to the
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basic 3 unit formula.
• This number ,the cutting edge angle,represents the angle
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SINGLE PLANE AND DOUBLE PLANE
INSTRUMENT
• An instrument with the shank and the blade in
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the same plane is called as a single planed
instrument. Even if they have 2 or 3 angles in
the shank all are in the same plane.
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DIRECT CUTTING AND LATERAL
CUTTING INSTRUMENTS
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Direct cutting Lateral cutting
Force is applied in same Force is applied at right
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• The principle of cutting instrument is to concentrate forces
on a very thin cross section at the cutting edge. Thinner the
cross section, at the bevel, more pressure that is
Bibeveled
Circumferentially beveled
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SINGLE BEVELED INSTRUMENT
• Instruments have a bevel on one side of
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the instrument.
• The instrument is held with the blade
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angle of 12° or less, they are used in push (direct
cutting)motion and scraping motions(beveled to non
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BIBEVELED INSTRUMENTS
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• The blade of a bibeveled instrument has
2 bevels of equal dimension on the
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TRIPLE BEVELED INSTRUMENTS
• Beveling the blade laterally, together with
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the end, forms three distinct cutting edges.
Other than the 1°cutting edge, two
additional cutting edges called the
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CIRCUMFERENTIALLY BEVELLED
INSTRUMENTS
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• The blade of the cutting instrument
is beveled at all peripheries and is
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RIGHT AND LEFT INSTRUMENTS
• Direct cutting instruments are made
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either right or left by placing a bevel on
one side of the blade.
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• Lateral cutting instruments are made
left and right by having the curve or
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angle, which is at right angle to the
principal plane(shaft plane),either on
the right or on the left.
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• Identifying rings on the shaft, identifies Right of the pair.
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Presented by: Dr. Pragya Tripathi
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SINGLE AND DOUBLE ENDED
INSTRUMENTS
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• Instruments are available with blades and shanks on both
ends of the handle.
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CLASSIFICATION
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According to Marzouk: Instruments for operative
dentistry procedures can be generally classified as
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I. Those used for exploration
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A) Dry the area on the tooth:
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B) Illuminate the area : A source of light could be either
an overhead fixture supplying non-reflecting light or an
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C) To retract the soft tissues:
The hand mirror is used to move the tongue and cheek
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12/08/21 Presented by: Dr. Pragya Tripathi
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D) To probe the potential lesion:
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Explorers are used for this purpose.
These are 4 types of explorers.
Arch explorer
Interproximal explorer.
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II) Those used for tooth structure removal:
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III) Those used for restoring:
– Mixing instruments
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– Spatulas
– Plastic instruments
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According to Charbeneau: Operative instruments can
be conveniently classified into 6 categories.
I. Cutting instruments
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– Hand
Hatchets
Excavators
Others
– Rotary
Burs
Stones
Disks
Others
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II. Condensing instruments
- Pluggers
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Hand
Mechanical
Carvers
Burnishers
Packing instruments
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IV. Finishing and polishing instruments
• Hand
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Orange wood sticks
Polishing points
• Rotary
Finishing burs
Mounted brushes
Mounted stones
Rubber cups
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V. Isolation instruments
• Rubber dam frame
• Clamps, forceps, punch
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• Saliva ejector
• Cotton roll holder
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the shaping of internal parts of cavity preparation.
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B). Hoe Excavator 4½ -1½ - 22
• Single planed instrument
• Primary cutting edge perpendicular to
axis of handle
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• 4 possible movements: vertical,
push(pull), right & left
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• Curve of the blade makes it lateral cutting
instrument
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Spoon excavators
• Triple angled discoid
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spoon
• Binangle spoon or regular
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D) Discoid Excavator(disc like)10-2-12
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movements
• Blade is disc shaped, with the cutting edge extending
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E) Cleoid Excavator(claw like) 20-2-12
• Double planed with lateral cutting movements
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• Blade resembles claw, hence the name “CLEOID”
Uses:
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CHISELS
• Chisels are instruments designed for planning or cleaving enamel &
dentin
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• Characterized by a blade that terminates in a cutting edge formed by
one sided bevel.
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STRAIGHT CHISEL:12 – 7- 0
-straight blade in line with the shank & blade,
-bevel on one side
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-primary edge is perpendicular to axis of handle
-single planed instrument
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MONOANGLED CHISEL: 10 – 7- 8
• single planed,
• single angle in the shank,
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• mesially or distally bevelled.
BINANGLED CHISEL:
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• Beveled on one side.
• If bevel is on the side toward the curvature of shank- mesially
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SPECIAL FORMS OF CHISELS
Enamel hatchet 10-7-14
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• Hatchet is different from chisel with the cutting edge
parallel or in the same plane as the shaft.
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• Certain hatchets are “bi-bevelled”. The blade has two
bevels of equal dimension placing the cutting edge in the
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centre. This type of hatchet is single ended.
• Used to refine line and point angles in varied forms of
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GINGIVAL MARGIN TRIMMER
• GMT is a modified hatchet.
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• The cutting edge makes an angle other right angle with the
axis of the blade.
• Blade of GMT is curved & is a double planed instrument with
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• They are double ended, paired instruments.
• A Mesial and a distal GMT,each with a
Right and Left blade at their ends.
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• If the acute angle of the cutting edge is
nearer to the shaft,it is a mesial GMT and
vise versa.
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• 100 & 75 pairs are used for inlay/onlay
preparations with steep gingival bevels.
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• 12-85-5-8 ; 8-80-3-9
• The cutting edge is sharpened at an
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USES:
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internal outline form in cavities for
cohesive gold to establish retention form.
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OFFSET HATCHET
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• Similar to regular hatchet except that the whole blade is
rotated quarter turn forward or backward around its long
axis.
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TRIANGULAR CHISEL
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• Blade is triangular in shape with the base of the blade
away from the shaft.
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MOUTH MRROR
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• Clear & distinct vision
• Quite unique
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USES OF THE MOUTH MIRROR
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• INDIRECT VISION – when the operator uses a mirror
to view area of the oral cavity not seen with direct
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image a “ghost image” as the light
reflects from the glass and the silver
layer.
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12/08/21 Presented by: Dr. Pragya Tripathi
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12/08/21 Presented by: Dr. Pragya Tripathi
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12/08/21 Presented by: Dr. Pragya Tripathi
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INSTRUMENT GRASPS
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• A proper instrument grasp is essential for performing
operative procedures.
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MODIFIED PEN GRASP
• Pads of the thumb,index, and the
middle fingers contact the instrument.
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• The tip of the ring finger and the little
finger rest on the nearby tooth surface
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INVERTED PEN GRASP
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• The finger positions are the same as for
the modified pen grasp. However, the
hand is rotated so that the palm faces
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PALM AND THUMB GRASP
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• 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
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MODIFIED PALM AND THUMB
GRASP
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• The handle of the instrument
is held between the pads of the
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RESTS
• Finger rest or fulcrum is essential for the
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controlled movement of an instrument.
• It is the point of support from which the hand
moves to activate the instrument and also
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• Modified pen grasp and inverted pen grasp:
ring and little finger on tooth/teeth of same
arch
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• Palm and thumb grasp:
Tip of thumb on the same tooth/adjacent
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SHARPENING HAND
INSTRUMENTS
• “No man has ever yet become a good and efficient dentist
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until after he has learned to keep his cutting instruments
sharp”—G.V.Black
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• Sharpening is done by reducing the bulk of the metal at the
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cutting edge, following the original configuration of the
bevel.
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PRINCIPLES OF
SHARPENING
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1)Sharpen instruments only after they have
been cleaned and sterilized.
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6) Lightly hone the unbeveled side of the blade after
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• Sterilization can be accomplished by autoclaving, dry heat
procedures, ethylene oxide equipment and chemical vapor
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CONCLUSION
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• Modern hand instruments, when used, produce beneficial
results for both the operator and the patient. It should be
noted that some of these results can be satisfactorily
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REFERENCE
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• Operative dentistry: Modern theory and practice – MA
Marzouk, I Edition.
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12/08/21 Presented by: Dr. Pragya Tripathi
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