Lecture 6

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Operative Instruments

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63 Terms

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Operative Instruments
Wide variety of dental instruments are used in dental procedures.
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CARBON STEEL

STAINLESS STEEL

CARBIDE STEEL
Types of steel used to manufacture hand instruments
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Carbon Steel
Hardness and sharpness

Susceptibility to corrosion and fracture
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Stainless steel (Material of choice)
Bright in appearance

Does not corrode

Tends to lose their sharpness with repeated use

Can be sterilized by steam or dry heat
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Carbide Steel
Hard and wear resistant

Brittle
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Handle/Shaft

Shank

Blade/NIB
Handle/Shaft

Shank

Blade/NIB
Parts of Hand Instruments
Parts of Hand Instruments
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Handle or Shaft
Handle or Shaft
Where the instrument is held by the operator

Available in various sizes and shapes (Small,,medium or large, smooth or serrated)
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Shank
Shank
Part of the instrument that connects the blade to the handle; may be STRAIGHT or ANGLED

Black classified instruments on the basis of the number of shank angle as:

STRAIGHT → Having no angle

MON - ANGLE → One angle

BIN - ANGLE → two angles

TRIPLE - ANGLE → Three angles
Part of the instrument that connects the blade to the handle; may be STRAIGHT or ANGLED 

Black classified instruments on the basis of the number of shank angle as: 

STRAIGHT → Having no angle 

MON - ANGLE → One angle 

BIN - ANGLE → two angles 

TRIPLE - ANGLE → Three angles
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Blade or NIB
Blade or NIB
Working end of instrument

Connected to the handle by the shank;

Designed for a specific function
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NIB
Part corresponding to the blade in a non-cutting instrument
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Tip of the blade
Primary cutting edge (known as working end)
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Side of the blade
Secondary cutting edges; cut tooth structures; bevels
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Face
End of the nib or working surface
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Cutting instruments

Non-cutting instruments
Categories of Hand Instruments

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Cutting Instruments
Used to ASSIST IN THE DESIGN of the cavity preparation

REFINE AND DEFINE the cavity walls and margins
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Non-cutting instruments
Include basic examination instruments used to insert and finish amalgam and composite restorative materials.
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Cutting Instruments (CHISEL family)
CHAD

Chisel, Hoes, Angle formers, Discoid and Cleoid
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Cutting Instruments (HATCHET family)
HEG

Hatchet, Excavators, Gingival trimmer
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Chisel
Chisel
Used to SHAPE AND PLANE (make surface flat or level) enamel and dentin walls of the cavity preparation

COMMON TYPES:

STRAIGHT CHISELS

BIN-ANGLE CHISEL

WEDELSTAEDT CHISELS

ANGLE-FORMED CHISELS
Used to SHAPE AND PLANE (make surface flat or level) enamel and dentin walls of the cavity preparation 

COMMON TYPES:  

STRAIGHT CHISELS  

BIN-ANGLE CHISEL

WEDELSTAEDT CHISELS 

ANGLE-FORMED CHISELS
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Hatchet
Hatchet
Sometimes called enamel hatchet

To cut, clean and smooth walls in cavity preparation

To REMOVE ENAMEL NOT SUPPORTED BY DENTIN
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Hoes
Hoes
To clean and smooth floor and walls in cavity preparation with a push-pull action.
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Gingival Margin Trimmers
Gingival Margin Trimmers
To ELIMINATE UNSUPPORTED ENAMEL on gingival walls of proximal preparations; bevel the margin wall of the cavity preparation

SIMILAR IN DESIGN TO THE ENAMEL HATCHET except the blade is curved and the primary cutting edge is at an angle to the axis of the blade

DOUBLE-ENDED AND PAIRED INSTRUMENT; one end curves toward the left and the other end curves toward the right
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Angle Formers
Angle Formers
Used in a DOWNWARD PUSHING MOTION to form and define point angles and to sharpen line angles

SIMILAR TO THE HOE except the cutting edge is angled liked the gingival margin trimmer
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Excavators
Excavators
Also known as SPOON EXCAVATOR

Used to REMOVE CARIOUS MATERIAL AND DEBRIS from the teeth

Working end that is CIRCULAR OR ELONGATED
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Cleoid - Discoid
Cleoid - Discoid
It is MODIFIED CHISEL with different shape of cutting edges

In cleoid, it is CLAW-LIKE in discoid it is DISK-LIKE and the edge is rounded

Used for REMOVING CARIES and CARVING AMALGAM OR WAX PATTERN
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What are non-cutting instruments?
Basic Instruments: Mouth Mirror, Explorer, Cotton

Burnishers

Carriers

Carvers

Composite Instrument

Condensers

Files

Finishing knives

Plastic filling Instruments
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Non-cutting instruments
AMALGAM CONDENSER

MIRRORS

EXPLORERS

PROBES
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Other cutting instruments
KNOVES

FILES

SCALERS

CARVERS
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Rotary instruments
Operated in hand-piece
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Nomenclature for the instruments
ORDER

SUBORDER

CLASS

SUBCLASS
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Order
FUNCTION OR PURPOSE of the instrument

example:

EXCAVATOR

CONDENSER
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Suborder
POSITION, mode or manner of use

example:

PUSH

PULL
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Class
Design or form of the working end

example:

HATCHET

SPOON EXCAVATOR
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Subclass
Shape of the shank

example:

BINDANGLE

CONTRA – ANGLE
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Instrument Formula #3 FORMULA
Instrument Formula #3 FORMULA
Used instruments in which cutting edge is at right angle to the long axis of the blade.

1st # Width of the blade or primary cutting edge in mm

2nd # Length of the blade in mm

3rd # Angle of the blade against long axis of handle
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Instrument Formula #4 FORMULA
Instrument Formula #4 FORMULA
Used for the instruments in which primary cutting edge is not at right angle to the long axis of the blade.

1st # Width of the in tenths of mm

2nd # Cutting edge angle

3rd # Length of the blade in mm

4th # Angle of the blade against long axis of the handle
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EXAMINATION

HAND CUTTING (manual)

RESTORATIVE

ACCESSORY
Classification of General Dental Instruments
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Examination Instruments
Allow the operator to thoroughly examine the health status of the oral cavity
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Hand (Manual) Cutting Instruments
Allow the operator to remove decay manually and to smooth, finish, and prepare the tooth structure for its final restoration
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Restorative Instruments
Allow the operator to “RESTORE” a tooth by placing, condensing, and carving a dental material to the original anatomy of the tooth structure.
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Accessory Instruments
Are miscellaneous instruments and items that are used to compete a procedure.
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Used for examining the teeth but are also common to all tray set-ups.

Mouth Mirror

Explorer

Cotton Pliers

Periodontal Probe - optional
Basic Examination Instruments
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INDIRECT VISION

LIGHT REFLECTION

RETRACTION

TISSUE PROTECTION
Use for the mouth mirror

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Restorative Instruments
Used to place, condense, and carve the restorative dental materials back to normal anatomy of the tooth.

AMALGAM CARRIER

CONDENSER

BURNISHER

CARVERS

AMALGAM KNIFE

COMPOSITE-PLACEMENT INSTRUMENTS
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Amalgam Carrier
Amalgam Carrier
To carry & dispense amalgam into the cavity preparation
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Condenser
Condenser
Also known as PLUGGER

Used to condense (pack down) freshly placed amalgam into the preparation
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Burnisher
Burnisher
Used to smooth rough margins of the restoration and to shape metal matrix bands
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Carvers
Carvers
Used to remove access restorative material and to carve tooth anatomy in the restoration before the material hardens.
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Amalgam Knife
Amalgam Knife
For the removal of excess restorative material along the margin where the material and the tooth structure meet
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Composite Placement Instruments
For the placement of composite restorative materials

Made from anodized aluminum or Teflon.

These materials prevent the composite material from being scratched
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CEMENT SPATULA

SCISSORS

AMALGAM WELL

HOE PLIERS

ARTICULATING PAPER HOLDER
Accessory Instruments
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AMALGAM CARRIER

CONDENSER

BURNISHERS

AMALGAM CARVERS

˃ HOLLENBACK (Contour carver)

˃ DISCOID – CLEOID

˃ INTERPROXIMAL (Class II preparations)
Hand Instruments for Amalgam Restorations
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Amalgam Carriers
Transfers amalgam to cavity preparation.

Aids in dispensing and placement of amalgam into cavity preparation.

Can be used to begin condensation of amalgam
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Amalgam Condensers
Used to condense amalgam into all areas of preparation

Types:

ROUND

ELLIPTICAL
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Burnishers
Conforms amalgam to margins

Aids initial shaping of restorations

Types:

ACORN

ROUND

FOOTBAL
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Carvers
Used to place distinguished grooves and fossae into amalgam restoration types:

DISCOID – CLEOID

HOLLENBACK (contour carvers)

INTERPROXIMAL (for Class II preparations)
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MODIFIED PEN Grasps

INVERTED PEN Grasps

PALM and THUMB Grasps

MODIFIED PALM and THUMB Grasps
Instrument Grasps
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Modified Pen Grasps
Provides four (4) points of support

Allows considerable force to be applied to instrument

Provides more control of measurement
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Invented Pen Grasps
This grasps is used mostly for tooth preparations utilizing the lingual approach on anterior teeth.
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Palm and Thumb Grasps
This grasps has limited use, such as preparing incisal retention in a class III preparation on a maxillary incisor.
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CONVENTIONAL PEN GRASPS

MODIFIED PEN GRASPS
Grasping Instruments
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Conventional Pen Grasps
Used for writing
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Modified Pen Grasps
Used in dentistry