INSTRUMENTS

Dental suite

Should be in a separate area away from surgical procedures

Needs good lighting

Magnification should be available

Tables

Consider ergonomic chairs or stools

Tables

Should be designed to allow personnel to sit for procedures

Adjustable height is ideal

Loupes

Many different types

Recommended for dentistry = 2.5x

Length aerosolized bacteria can stay in the air

8-12 hours

Dental Unit

All have a water component

Air-driven

Motor Driven units

Water Component

Helps rid debris and prevent thermal damage

use demineralized water

Air-Driven

The compressor delivers pressurized air to the handpiece

Monitor oil levels

Drain air daily!

Motor driven units

Not as efficient as Air-Driven

Small, Portable, less expensive

Highspeed handpiece

FOR CUTTING BONE OR TEETH

Never run without a bur

Store bur in place

Most are Autoclavable

Burs

Most are disposable

• throw away after every procedure

• exception is the diamond bur

• if not replaced, will cause turbine failure

Crosscut fissure bur for sectioning

Round burs for alveoloplasty, endodontic procedure

Low Speed handpiece

Usually for polishing

Prophy angle for polishing

Polish

Polish

fine grit

decrease RPM

2 types of Ultrasonic Scaler

Magnetostrictive and Piezoelectric

Magnetostrictive

• Working end vibrates in figure 8 motion

• Needs replaced if light shines through the stacked end

• If stacked tips are used, fill with water before attaching tip

Piezoelectric

Linear vibrations

Have small metal tips that screw into the handpiece

Contains crystals that are active when electrified

• distal 3mm of the tip

3 Ultrasonic tips

Periodontal tip, Universal tip, Beaver tip

Periodontal tip

For SUBgingival cleaning

Universal tip

Can be used on crown or subgingival

Not efficient at either

Beaver tip

For SUPRAgingival use only

More efficient at removing calculus

Ultrasonic Scaling

Piezio units should come with wear card

• efficiency is lost over time

• Use card to know when to replace

Grasp lightly with modified pen grasp

• let the instrument do the work

• Keep tip moving in constant contact with tooth

• No more that 10 sec (REALLY 5-7) per tooth at one time

Time you can leave the ultrasonic scaler on the tooth

5-7 seconds

Assessment Instruments

Periodontal probe, Dental explorer, mirror

Periodontal Probe

For assessing pocket depth and attachment level

Each line represents 1mm

Different styles exist; make sure you are comfortable reading!

Normal canine pocket depth

1-3mm

Normal feline pocket depth

<1mm

Dental Explorer

Almost always on opposite end of probe

Allows for assessment of enamel and pulp exposure

Mirror

Underutilized, but very helpful

Calculus removing forceps

Used to remove large amounts of calculus build-up

Used to help with leverage

• can cause enamel damage if used too roughly

You can accidently extract loose teeth

Not recommended in cats

Morphology of hand instruments

Working end, Terminal shank, Functional shank

Working end

• Functional part that comes in contact with tooth surface

• Has sharp blade(s)

  • must be shrp to function correctly

Terminal Shank

Part just before it attaches to the working end

Functional Shank

Part that allows adaption of working end to each tooth

Curette

Rounded edges

For SUBGINGIVAL use

• removing calculus

• Curettage (periodontal debridement)

Scaler

2 Sharp sides and sharp tip

SUPRAGINGIVAL ONLY (crown)

Always pull toward yourself

• away from gumline

What is this?

Curette

What is this?

Scaler

Universal Curette

2 sharp edges

for lighter treatment

Gracey Curette

Only 1 cutting edge

Slightly “tilted”

Can be area specific

Have a mini version better for cats

Elevators

Winged or regular

Used for rupturing the periodontal ligament

Using rotational and prying forces

Luxators

Very similar to elevators

thinner profile for cutting the ligament

No rotating or prying against bone

Periosteal Elevators

Separate periosteal tissue connecting attached gingiva

• gingival flaps

Surgical instruments

Elevators, Luxators, Periosteal elevators, Scalpel blade and handle, needle holders, 4-0 or 5-0 suture, Minnesota retractor

Sharpening

Not all practices follow proper sharpening

It is very easy to mess up an instrument from sharpening

• when possible, major sharpening should be done by professionals familiar with dental instruments

Sharpening Materials

Fine-grit Arkansas flat and Conical stones

Honing Oil

Plastic test stick

After every cleaning and before autoclaving

How often sharpening should occur

PPE

Cap, Goggles/Visor, Lab jacket, Gloves, Chlorhex Spray on mouth before starting scaling, Dosimeter during radiographs