INTRUDUCTION

 The removal and shaping of tooth

structure are essential aspects of
restorative dentistry

 Initially this was a difficult process

accomplishing entirely by the use of hand
instruments.

 The introduction of rotary, powered cutting

equipment was one of the truly major
advances in dentistry
MATERIALS

a) Carbon steel

b) Stainless steel

c) nickel, cobalt, chromium

Heat treatment
 Hardening heat treatment :
1500° F (815°C)

 Tempering heat treatment:

350°F (176° C)
Hand cutting instruments
 Excavators
Ordinary hatchet
Hoes
Spoon excavators  Special chisels
Discoid excavators Enamel hatchet
Cleoid excavators Gingival marginal
trimmer
 Chisels Angle formers
Straight chisels Wedelstaedt design
Monoangle chisels Off-set hatchets
Binangle chisels Triangular chisels
Triple angle chisels Hoe chisels
Powered cutting instruments
 Rotary instruments

 Air abrasion

 Ultrasonic

 Lasers
CLASSIFICATION
 Cutting instruments

a. Hand cutting instruments

b. Powered cutting instruments

 Non cutting instruments

a. Exploring instruments
b. Restoring instruments
c. Miscellaneous instruments
Instrument design
 Direct cutting & lateral cutting
instruments

 Contrangling

 Right and left instruments

 Double ended & Single ended

instruments
Single bevelled

Bibevelled

Triple bevelled

Circumferentially bevelled
 Nomenclature
G.V. BLACK categorized
instruments into
 1. order purpose or function of
instruments
e.g.. Scalar, excavator
 2. sub order position or
manner of use e.g. push or pull motion (hatchet)
 3.class form of working end
e.g. spoon excavator, sickle scalar
 4. sub class shape of the
shank e.g. Bin angle, mono angle
 PARTS OF THE HAND
CUTTING INSTRUMENTS

 HANDLE (SHAFT)

 SHANK

 WORKING END
BLADE
CUTTING EDGE
 Instrument formula for Angled
instruments
 1st number : width of
the blade in 1/10 mm

 2nd number :
primary cutting edge
angle (this angle
expressed in % of 360°)

 3rdnumber : length of
the blade in mm

 4th number : blade

angle relative to long axis
of the handle in clockwise
centigrade
 Instrument formula for Non
angulated instruments

 1st number : width of the blade in 1/10 mm

 2nd number : length of the blade in mm

 3rd number : blade angle relative to long

axis of the handle in clockwise centigrade
Excavators
Mainly used for removal of caries and
refinement of the internal parts of the
preparation

Four subdivisions of excavators are

 1. Ordinary hatchet
 2. Hoes
 3. Spoon excavators
 4. Discoid excavators
 5. Cleoid excavators
 Ordinary hatchet excavator
 Cutting edge of the blade
is parallel to the long axis
of the handle

 Bibevelled

 Uses :preparing the

retentive areas in the
anterior teeth and
sharpening the internal
line angles

 FOURMULA : 3–2-28.
 Hoe excavator
 Primary cutting edge of
the blade is perpendicular
to the long axis of the
handle
 Mesially and distally
bevelled

 Uses : for planning the

tooth preparation walls
and forming line angles

FORUMLA : 4 ½-1 ½-22 .

Spoon excavators

 Blades are slightly

curved and the cutting
edges are either
circular (discoid) or
claw like (Cleoid)

 FORMULA ;
 spoon ( 15 – 7 -14 )
 bi & tri angle ( 13 – 7 –
14 ).
 Discoid excavators:

Circular blade

 Cleoid excavators:

Circular blade with a

point
chisels
 They are intended mainly for cutting
enamel and maybe grouped as

Straight chisels
Monoangle chisels
Binangle chisels
Triple angle chisels

Formula : 12 – 7 – 0 ( Straight). 10 – 7 – 8
(Curved)

FORCE USED : FORWARD or STRAIGHT THRUST

 Straight chisel:
cutting edge is
perpendicular to the
shaft

 Monoangled
chisel:
distal bevel or mesial
bevel

 Bin angle chisel

 Triple angle chisel

Special chisels

1) Enamel hatchet
2) Gingival marginal trimmer
3) Angle formers
4) Wedelstaedt design
5) Off-set hatchets
6) Triangular chisels
7) Hoe chisels
ENAMEL HATCHET

. CUTTING EDGE IS IN A
PLANE THAT IS
PARALLEL WITH THE
AXIS OF THE HANDLE.

. AVAILABLE AS
RIGHT/LEFT.

. USED FOR REMOVING

HARD CARIES,
PREPARATION OF
RETENTIVE AREAS, &
INTERNAL LINE ANGLES.

FORMULA : 10 – 7 – 14
 GINGIVAL MARGINAL TRIMMER
 USED TO PROVIDE
PROPER BEVEL ON
GINGIVAL CAVO SURFACE
MARGINS OF THE
PROXIMO OCCLUSAL
CAVITIES.

AVILABLE AS RIGHT AND

LEFT WITH BOTH SIDES
( MESIAL & DISTAL )
FORMULA FOR GMT :
DISTAL . > 12 ½ - 100 – 7
– 14

MESIAL. > 12 ½ - 75 – 7
– 14 .

MESIAL. > 85 TO 75
DISTAL. > 90 TO 100
 Angle former

 Primary cutting edge

is at an angle (other
than 90°) to the
blade

 Right and left

bevelled

 FORMULA :12 – 85 -5– 8

Wedelstaedt chisels
 It has a slight
vertical
curvature in its
shank

Mesially and distally

bevelled
 Uses: cleaving the
undermined enamel
Shaping the walls
Off-set hatchet
 Whole blade is rotated
90 of turn forward or
back ward around its
long axis

 Right and left bevelled

 Uses: They are useful

to create & shape
specific angulations
for cavity walls in
inaccessible areas
 Triangular chisel

 Hoe chisel
 INSTRUMENT GRASPS


1.PEN GRASP,

2.MODIFIED PEN GRASP.

3.PALM AND THUMB GRASP .

4.MODIFIED PALM AND THUMB.

 Modified pen and inverted pen grasps are used

practically and universally
Modified pen grasp
 It permits the delicacy
of touch
 Pads of the thumb,
index, and middle
fingers contact the
instrument
 Palm of the hand is
facing away from the
operator
 Pad of the middle
finger placed near the
top side of the
instrument
Inverted pen grasp
 Same as for the
modified pen grasp
but the hand is
rotated so that the
palm of the hand
faces more towards
the operator

 Mainly used for tooth

preparation utilizing
the lingual approach
on anterior teeth
Palm and thumb grasp

 It is similar to that of
holding a knife while
paring the skin from an
apple

 Handle is placed in the

palm of the hand and
grasped by all the fingers

 It is mainly used for

providing incisal retention
for class III on a
maxillary incisor
Modified pen and thumb grasp

 Handle of
instrument is held
by all four fingers
whose pads press
the handle against
the distal area of
the palm as well as
the pad and first
joint of the thumb
Sharpening of hand instruments
 Stationary sharpening stones

 Mechanical sharpeners

 Hand piece sharpening stones

Stationary sharpening stones
 They are often called as oil stones

 course, medium and fine grits

 These also available in

1. flat
2. Grooved
3. Cylindrical
4. tapered
 Sharpening stones are made
with

1. Arkansas stone

2. Silicon carbide

3. Aluminum oxide

4. Diamond
 Mechanical sharpening : Rx honing
machine

This instrument moves a hone in a reciprocating

motion at low speed

Instrument is held at the appropriate

angulations and supported by a rest

 Hand piece sharpening :

mounted silicon carbide and aluminum oxide

stones are used for sharpening of instruments
Sharpness test
 Sharpness of the instrument can be
tested by lightly resting the cutting
edge on a hard plastic surface, if
the cutting edge digs in during an
attempt to slide the instrument
forward over the surface, the
instrument is sharp, if it slides the
instrument is dull
Noncutting instruments

a. Exploring instruments

b. Restoring instruments

c. Miscellaneous instruments
Exploring instruments
 Dry : Air syringes, tweezers

 Illuminate : battery operated lights, lights

attached to dental units, mouth mirrors

 Retract the soft tissues : mouth mirrors,

cheek retractors, Tongue depressors-retractors

 Probes : Straight, Right angled, Arch explorer,

Interproximal explorer

 Separators : Slow separators, Quick

separators
 Probes
 Straight

 Right angled

 Arch explorer

 Interproximal
explorer
 Restoring instruments
 Mixing instruments
 Plastic instruments
 Condensing instruments
 Burnishing instruments
 Carvers
 Files
 Knives
Plastic instruments
Condensing instruments
and Burnishing instruments
Carvers

 There blades are

either bevelled or
knife edged

 Hollenback carvers
 KNIVES & FILES
 Knives: They are
designed with a
thin blade made of
various sizes &
shapes.
 Files :The blade of
files have serrations
(or) teeth up to
half
Movement given is
basically PUSH

(OR) PULL.
Miscellaneous instruments

 Rubber dam kit

 Saliva ejectors
 Scissors
 Cotton holders
 Needles & Suture materials
 Matrix bands & Retainers
 BP handles & Blades
 Evacuating tips
POWERED CUTTING EQUIPMENT
Evaluation of rotary cutting equipment
 1st rotary instrument: “bur
drills”-300 rpm

 Scranton drill

 1846- “Drill Ring”-J. Foster

Flaggs

 1850-Chevalier’s Drill Stock

 1850-Early Angle Hand Drill

 1858 to 1862-1st drill with

flexible cable arm, 1st angle
hand piece- Charles Merry
 First electrical
dental engine
containing the
motor and
handpiece
 1871-foot engine-
Morrison-700 rpm
 1870 to 1874-electric
dental motor-S.S.White-
1000rpm
 1914-electric dental
engine incorporated into
dental unit-5000 rpm
 1935/1942-diamond
cutting instruments-5000
rpm
 1946-tungsten carbide
burs-10,000 rpm
 1953-ball bearing
handpiece-25,000 rpm

 1955:Water-turbine
handpiece-50,000 rpm

 1955-Page-Chayes
handpiece-multiplying
internal belt drives-
1,50,000 rpm
 1957-Air-turbine
handpiece (Bordon
Air Rotor)-2,50,000
rpm

 1961-Air-turbine
straight handpiece-
25,000 rpm

 1963- Air bearing

handpiece-8,00,000
rpm

 1994-contemporary
handpiece-3,00,000
rpm
Ultrasonic instruments

1.Ultrasonic generator

2.Magnetostrictive
transducer

3.Working point

Mainly used for calculus

and stain removal
Air abrasion
In this kinetic energy
from a stream of
powder particles
will transfer on the
surface and produce
fracture of tooth
structure or
restoration

 Abrasive dust is used

for cutting of the tooth
structure
 Particle size – 350 µm
 The energy transfer is
effected by
1. Air pressure (20-55
psi)
2. Water flow rate
3. Powder flow rate
4. Particle size (25 – 250
µm)
5. Particle type and
hardness
6. Angulation (60°-90°)
7. Surface composition
8. Clearance angle
9. Distance (3-5 mm)
 Disadvantages :
1. No tactile sense for operator
2. Abrasive dust interference with the visibility of
the cutting site
3. Mechanically etch the surface of the mirror
4. Patient inhale the abrasive dust

 Uses :
1. Stain removal
2. Debriding the pits and fissures prior to sealing
3. Micromechanical roughening of surfaces
(enamel, cast metal alloys, porcelain )to be
bonded
Lasers
 It is a coherent and
high intensity light

 Laser is as an acronym
for light amplification
by stimulated emission
of radiation

 A crystal or gas is
exited to emit light
photons of
characteristic
wavelength that are
amplified and filtered
to make a coherent
light beam
 Lasers available as infrared, visible, and
ultraviolet rays
 Co2 Nd:YAG, and Er:YAG lasers are
mostly used
 Collimated beam is directed by a flexible
fiber optic light pipe or mirror train to the
point of application where it is normally
focused by a lens to a focal area near the
tip
 Exposure dose is depends on the
 ED =(W) (t)/A
 W =power (watts) emitted from the
light guide
 t= time of exposure
 A = area
 1. Photo thermal effects (dental)
 2. Photo chemical effects
 <100°c – denatures the proteins
and produce hemolysis
,coagulation and shrinkage
 >100°c – water in soft and hard
tissues boil and produces
explosive expansion
 >400°c – carbonization of
organic material
 400°c -1400°c –inorganic
constituents change in chemistry
(they may melt or recrystalize or
vapor)
 When laser and tissue are matched
energy will be absorbed quickly
 Infrared lasers –high energy densites –
enamel
 Low energy densites – dentin
 Nd:YAG-λ= 1.064µm
 Er:YAG- λ= 2.94µm
 Co2- λ= 10.6µm
 Uses :
 Soft tissue applications
 Surface modifications in hard tissues
 Ho:YAG used for tooth preparation in
primary teeth
Characteristics of rotary
instruments

 Speed

 Pressure

 Heat production

 Vibration
 CHARACTERISTICS OF ROTARY
INSTRUMENTS
 Speed
By Sturdevant:
Low or slow speed -12,000
Medium speed-12,000 to 2,00,000 By Charbeneau:
High or ultra-high speed-2,00,000 Conventional/low speed-below
By Marzouk: 10,000 rpm

Ultra low speed-300 to 3000 rpm Increased or high speed-

10,000 to 1,50,000 rpm
Low speed- 3000 to 6000 rpm
Ultra-speed-above 1,50,000
Medium high speed-20,000 to
rpm
45,000 rpm
High speed-45,000 to 1,00,000 rpm
Ultra-high speed-above 1,00,000
 LOW SPEED
Disadvantages:
 Time consuming
 Heavy force application
 Heat & vibration
 Bur rolls out
 Carbide burs not useful
Uses
 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
 pressure:
Force/Area
Low speed -2-5pounds
High speed -1pound
Ultra high speed-1-4 ounces
 Heat production :
It is related to 1.pressure
2.RPM
3.area of tooth in contact with tool
130°F –pulpal damage
113 F –pulpal inflammation
 Vibration:
The deleterious effects of vibration are two fold in origin
1.Amplitude
2.Undesirable modulating frequencies
Rotary instrument design

 Handpiece

 Cutting tool
 HANDPIECE DESIGN
 (Sturdevant’s)
 Hand piece is a device for
holding rotating instruments,
transmitting power to them,
and for positioning them
intraorally.

Gear driven
Water driven
Belt driven
Air driven
Criteria for evaluating the
handpiece
 Friction

 Torque

 Vibration
 Dental bur
 Defination :
(sturdevant)
 The term bur is applied to all rotary cutting
instruments that have bladed cutting heads. This
includes instruments intended for such purposes
as finishing metal restorations and surgical
removal of bone, as well as those primarily
intended for tooth preparation.

(Mc Gehee).
 The bur is a form of drill for use in the hand piece
of the dental engine, intended for rapid cutting of
tooth structure during the opening and preparation
of cavities.
DENTAL BURS

 HISTORY
 CLASSIFICATION
 BUR BLADE DESIGN
 ADDITIONAL FEATURES IN HEAD DESIGN
 MODIFICATIONS OF BLADE DESIGN
 FACTORS AFFECTING CUTTING EFFECIENCY
 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
 Combination burs
 Carbide heads are attached to steel
shank and neck by welding or
brazing
 Baker curson bur: this bur
consists of tungsten carbide blank
sintered on to the steel shank
 No blades are visible
macroscopically but microscopic
blades are cut into the surface by
stroking the tungsten carbide
longitudinally with a diamond stone
 Parts of the bur
 Head

 Neck

 Shank or Attachment part

BUR CLASSIFICATION
 Bladed or Abrasive
 Material used
 Size of head
 Shape of head
 Mode of attachment
 Length of head
 According to motion
 According to use
 Bur sizes

 Numbers are designated for bur sizes

 This numbering system was originated by the S.S

White Dental Manufacturing Company in 1891 for
their first machine made burs

 The original numbering system contains 9shapes

and 11 sizes the ½ and ¼ designations were
added later when smaller instruments were
included in the system
Size of bur
Original bur head size -1891 to 1954
Standard bur head sizes: 1955 to present
 Basic head shapes are

1. Round

2. Inverted cone

3. Pear shaped

4. Straight fissure

5. Tapered fissure
 Round bur
 Spherical in shape
 Number : ¼,½,1,2 to 10
 Uses :
 Initial tooth preparation
 Placement of retentive
grooves
 Caries removal
 Inverted Cone bur
 Number : 33¼, 33½,
34, 35 to 39
 Uses :
1. cavity extension
2. Establishing wall
angulations and
retention formation
 Plain cylindrical fissure
bur
 Number : 55 to 59
 Bur teeth are cut parallel to
the long axis of the bur
 Used mainly for tooth
preparation for amalgam
restoration

 Plain tapered fissure bur

 Number : 168,169 to 172
 It is a portion of slightly
tapered cone with the small
end is directed away from
the bur shank
 Uses: Tooth preparation for
indirect restorations
Pear shaped bur
 A bur with slight tapering cone
directed towards the bur shank
It is used in class I cavity
preparations for gold foil
 Long length burs are used
mainly advocated for cavity
preparations in amalgam

Wheel bur
 Number : 14 & 15

 They are used to place grooves

and for removal of tooth
structure
End cutting burs
 Number :900 to 904
 These are cylindrical
in shape with only
end carrying the
blades
 Uses : apical
extension
preparations without
axial reduction
 Twelve blade
carbide burs
(finishing burs):
 Available in various
shapes and sizes
 Used for beveling and
smoothing enamel
edges
 Special cutters:
these are used for
special purposes these
are twist drills, Peso
reamers and Gates
glidden drills
 Mode of attachment to the
handpiece
1. Latch type 2. Friction grip
3. Straight handpiece bur
 Bur tooth
Bur blade design
 Rake angle

 Land

 Clearance angle

 Tooth angle

 Flute or chip space

 Bur tooth :it has two
surfaces 1.Tooth face

2.back or flank

 Rake angle : it is the

angle of the face of the bur
tooth makes with the radial
line from the center of the
bur to the blade
Rake angle can be positive,
zero, or negative

 Land : the plane surface

immediately following the
cutting edge
Rake angle
Clearance angle : it is the
angle between the back of
the tooth and its work
Primary clearance angle
Secondary clearance angle

Tooth angle : it is the angle

between the face and back
(face & land)

Flute or chip space: space

between two successive
teeth
Generally 6-8 teeth are present
MODIFICATIONS
IN BUR DESIGN
 Reduced use of cross
cuts

 Extended head lengths

 Rounding of the sharp

tip corners

 Reduced use of large

diameter burs
Factors influencing the cutting
efficiency

 Rake angle
 Clearance angle
 Number of teeth or blades and their distribution
 Run out
 Finish of flutes
 Heat treatment
 Bur diameter
 Depth of cutting
 Influence of load
 Influence of speed
 RAKE ANGLE
Radial angle >
negative rake
angle
Positive angle -
more clogging

 CLEARANCE
ANGLE
Prevent friction
Less rapid dulling
 NO. OF BLADES
 Less blades remove
more material
 Less clogging
 Straight flutes-less
temp rise-larger
chips

12 BLADE BUR 40 BLADE BUR BAKER-CURSON BUR

 Run out
It is a dynamic test

It refers to the
maximum displacement
of the bur head from its
axis of rotation while
the bur turns

Clinically acceptable
run out is 0.023mm

It mainly depends on
the
1.Eccentricity of the
bur
2.Precision of the
handpiece
3.length of the bur
shank
Finish of flutes
 1st cut – flute is
roughly formed
 2nd cut – cutting
edge on the bur
flute
 Next cuts –
roughness on the
flutes will be
removed
Design of flute ends
 Revelation type:
flutes come together
at two junctions near
a diametrical cutting
edge

 Star cut :
flutes come together
in a common junction
at the axis of the bur
 Heat treatment :

 Used to harden the soft stainless steel burs


 This treatment is not used in tungsten carbide burs

 Influence of load :

Low speed – 1000 grams (2 pounds ) to 1500 grams

High speed – 60 to 120 grams (2 to 4 Ounces)

 Influence of speed :
Rate of cutting increases with rotational speed but it is
not directly proportional
Abrasive instruments

 Diamond abrasive instruments

 Other abrasive instruments

 DIAMOND ABRASIVES
 1st introduced in USA-1945
 Small angular particles in
softer matrix
 Larger no. of cutting points
 ADVANTAGES:
Longer life
Better cutting effectiveness
 Diamond abrasive instruments

 3 parts
 1.Metal blank
a) Head
b) Neck
c) Shank
 2.Powder diamond abrasive

 3.Metallic bonding material

 Diamond particles :
Natural and synthetic
Shape and size of the particles
will effect the cutting efficiency
and durability of the
instruments

 Metallic bonding
material:
Diamonds attached to blank by
electroplating method
Electro deposition stages

 1st stage : Shank portion is coated

with inert material

 2nd stage : stainless steel blanks are

then flash-plated or strike–plated
with a thin coating of nickel

 3rd stage : It is performed in nickel

–plating solution commonly nickel
sulfamate solution
Alternative attachment methods

 Microbrazing –technique :heat and

vacuum are used for attachment

 Sintering :mixture of diamond chips

and powdered matrix and metal (gold or
copper alloy) are hot or cold compressed
on to the blank then it is heated
 CLASSIFICATION

SHAPES & SIZES

 Size:
 Coarse(125-150µm),
 medium(88-125µm),
fine (60-74µm),
very fine(38-44µm),
finishing (10-38µm)

 Shape

 Hardness of the
particles

 Spacing

 Exposure

 Bonding of particles
 Disposable burs

 Multiuse burs
Other abrasive instruments
 They are restricted to shaping,
finishing and polishing the
restorations in the clinic and lab

1. Molded instruments

2. Coated instruments
 Abrasive particles are bonded to
metal shank through a binder

 1. Sintering

 2. Vitreous bonded abrasives are mixed

with a glass or ceramic matrix material ,
cold-pressed to the instrument shape ,
and fired to fuse the binder

 3. Resin bonded abrasives are cold

pressed or hot pressed and then heated
to cure the resin

 4. Rubber bonded abrasives are made in

a manner similar to that resin bonded
 MOLDED INSTRUMENTS

 Made by pressing uniform

mixture of abrasive and
matrix around end of
shank
 Wearing causes
regeneration of particles
 TYPES:
Mounted & unmounted
stones, points
Hard & soft
 MATERIALS
Silicon carbide
(carborundum)
Aluminium oxide
Mounted stones Mounted stones

FINISHERS

POLISHERS
Unmounted stones
 COATED INSTRUMENTS
 Thin layer of abrasive is
cemented to a flexible blank

 They are softer & less wear

resistance

 Used for finishing and

smoothing procedures in
indirect restorations

 MATRIX :
 Phenolic resins
 Rubber

 ABRASIVE MATERIALS :
Garnet
Quartz
Flint (sand)
Crocus
emery
Cuttlefish-polishing
Evaluation of cutting
 Cutting effectiveness :
 it is the rate of tooth structure removal
(mm/min or mg/sec)
 Cutting efficiency :
 It is the percentage of energy actually
producing the cutting
 it is possible to increase the effectiveness
by reducing the efficiency e.g. Dull bur
cutting
 Cutting mechanism
Bladed cutting Abrasive cutting

Ductile material

Brittle material
ADVANTAGES OF ROTARY CUTTING

 Most efficient for gross tooth

removal
Diamond abrasives : enamel
Carbide burs : dentin

 Disadvantage:
In deep carious lesions-hand
instruments preferable
 Hazards
 PULPAL PRECAUTIONS
remaining dentin thickness
Coolants

 SOFT TISSUE
PRECAUTIONS

 EYE PRECAUTIONS
Glasses with side shields
High volume evacuation

 EAR PRECAUTIONS
85 Decibels-protection
Sound proofing
Ear plugs

 INHALATION PRECAUTIONS
Masks
Rubber dam
References
 Art and science of operative dentistry
Sturdevant’s
 Operative dentistry marzouk
 Text book of Operative dentistry
Baum-Philips-Lund
 Principles and practice of Operative dentistry
Charbeneau
 Text book of Operative dentistry
Vimal sikri
 Oprative dentistry Mc Gehee
 Operative dentistry Mc cabe
 www.ADA history .com
THANK YOU