Instruments, Handpieces, and Accessories

The method in which an instrument is managed and skillfully used

Manipulated

Restorative instruments can be assigned to one of four categories

1. Examination instrument
2. Hand (manual) cutting instruments
3. Restorative instruments
4. Accessory instruments

An instrument used during restorative procedures, which allows the dentist to examine the health status of the teeth and oral cavity

Examination instrument

An instrument used during restorative procedures that allows the dentist to remove decay manually and to smooth, finish, and prepare the tooth structure to be restored to its normal function in preparation for receiving a temporary or permanent restoration

Hand (manual) cutting instruments

An instrument used during restorative procedures, which allows the dentist to place, condense, and carve a temporary or permanent restorative material to the original anatomy of the tooth structure / Used for amalgam and composite resin procedures

Restorative instruments

Instruments used during restorative procedures. They are multipurpose instruments added to the setup of many procedures. Used in preparing the setup, in carrying things to the mouth, or in the application or placement of a dental material

Accessory instruments

Explorers are included in the setup of every procedure. They are

Multifunctional instrument

An examination instrument used to measure the sulcus or pocket depth of the periodontium of each tooth. This measurement indicates the overall gingival health of that area. The working end of the instrument has calibrated markings in millimeters

Periodontal probe

The tooth preparation instrument is one of the most versatile instruments on the restorative tray setup. Have a working end that is circular or elongated

Excavator

Used for the removal of soft denting, debris, and decay from the tooth

Spoon excavator

A procedure tray is set up in sequential order (based on the order in which the instruments are transferred and used throughout a dental procedure) from left to right, starting with

Examination instrument, followed by hand-cutting instrument, restorative instruments, and finally accessory instruments and items

A tooth preparation instrument that has a straight or angled shank and a single-beveled cutting edge. Used most often to break down the enamel margin of the tooth preparation, to form sharp lines and point angles, and to place retention grooves

Chisel

Tooth preparation instruments that are similar in appearance to wood hatchets. The cutting edge is parallel to the long axis of the handle. Used to cut enamel and to smooth the walls and floors of the tooth preparation

Hatchets

Tooth preparation instrument, which is a type of chisel that has been modified so that the blade is curved slightly doe mesial or distal access during preparation. Used to cut enamel and to place bevels along the gingival enamel margins of the preparation

Gingival margin trimmer

Instruments that are an essential part of restorative dentistry. The setup includes the dental handpiece and revolving mechanisms, which include cutting and finishing burs, polishing tips and points, and abrasive discs and stones that fit into the handpiece

Rotary

Many patients identify this instrument as "the drill". This instrument provides power and rotary motion, whereas the dental bur, which is securely held in the ____

Handpiece

The two most commonly used handpieces are the

Low-speed handpiece and high-speed handpiece

Often referred to as the straight handpiece because of its straight-line design, and is the most versatile handpiece in dentistry

Low-speed handpiece

A restorative instrument that is a double-ended instrument designed with wells on either end, which is used to pack freshly mixed amalgam and carry it to the prepared tooth. Most are designed to hold a large increment of amalgam at one end and a smaller increment at the opposite end

Amalgam carrier

Restorative instruments that have a flat working end that can be smooth or serrated; they come in varying sizes to accommodate the size of the preparation. To enable the operator to reach all areas of the preparation, the shank of the instrument is angled. The amalgam condenser, also known as a plugger, is used to condense (pack down) freshly placed amalgam into the preparation

Condensers

A restorative instrument with a smooth working end. The rounded working end is available in many shapes to accomplish different tasks. Routinely used to smooth the surface of a freshly placed amalgam restoration

Burnisher

A restorative instrument designed with a sharp edge on the working end to remove excess material, to contour surfaces, and to carve anatomy back into the amalgam or intermediate restoration before it hardens. Various styles are available

Carvers

Restorative instrument. Designed with a sharp edge for the removal of excess restorative material along the margin where the material and the tooth structure meet. The knife has several angles in the shank and working end that enable the operator to reach specific areas of a tooth, most often interproximal areas

Amalgam knife carver

Restorative instrument. Designed specifically for the placement of composite restorative materials, Composite placement instruments are made from anodized aluminum or Teflon. These materials prevent the composite material from being scratched. The instruments do not discolor the composite material, as do stainless steel instruments

Composite placement instrument

Restorative instrument. A double-ended instrument that is made from hard plastic or stainless steel. One end is a "paddle" that is used for carrying dental materials to the prepared tooth structure. The other end is a nib, which resembles a condenser

Woodson (FP-1)

Restorative instrument. Used for most procedures in which a dental material is involved. Flexible mixing spatula is single-ended, made of stainless steel, comes in two sizes (#15, #24), and is used to mix liners, bases, and cements

Spatulas

Restorative instruments most often associated with restorative dental procedures are crown and bridge scissors, which are available with curved or straight blades. They are useful for many tasks, such as cutting dental dam material, retraction cord, and stainless steel crowns

Scissors

Accessory instruments. Made of metal and is weighted with a nonskid base. The newly mixed amalgam is placed in the well; it is then picked up in the carrier for transfer to the dentist

Amalgam well

Accessory instruments. Versatile pliers that can be used in many procedures for many tasks. Their design is straight and includes beaks that have a flat, rounded end, making them useful for holding items. Useful for carrying cotton products to and from the oral cavity, for removing the matrix band, and for placing and removing the wedge

Howe pilers or 110 pilers

Accessory instruments. Used to hold and carry articulating paper to the mouth. This carbon paper material varies in thickness and color and is used to check a patient's "bite" following placement of a new restoration, crown, bridge, or denture. This mark must appear equal in distribution across the occlusal surface of the tooth. If one area appears lighter or darker, the patient's bite is incorrect and will need to be adjusted.

Articulating paper holder

A variety of attachments (sleeves) are adapted to fit onto the low-speed handpiece. The ______ is locked into place and holds larger burs for procedure completed outside the mouth, such as denture adjustments and preparation of temporary crowns

Straight-line attachment

Available in both the latch-type and friction-grip varieties. Latch-type angle mechanically holds the bur in place by grasping a small notch on the end of the shank of the bur. The friction-grip angle holds the bur in place by grasping the shank of the bur with a friction chuck in the head of the contra-angle attachment

Contra-angle attachments

Used to hold polishing cups and brushes

Prophy angles or prophylaxis angles

High-speed handpieces are equipped with a ____ mounted in the head to deliver the proper amount of light directly onto the site

Fiberoptic light

To protect the tooth against frictional heat caused by the extremely high speed of the bur, high-speed handpieces are equipped with

Water-spray devices

Designed for the dental laboratory and not for the mouth. This type of handpiece operates at speeds up to 20,000 rpm and uses laboratory burs of various shapes and sizes

Laboratory handpiece

The laboratory handpiece provides greater ___ (turning power of the instrument when pressure is applied during the cutting procedure) than the intraoral handpiece

Torque

Works by converting high-frequency electrical current into mechanical vibrations for the removal of calculus from the tooth surface. Vibration at the tip of this scale ranges from 29,000 to 40,000 cycles per second. Water is needed to cool the friction created between the tip and the tooth surface

Ultrasonic handpiece

Small version of a sandblaster and is most effective when used for sealant preparation, stain removal, class I and VI preparations, endodontic access, preparation of crown margins, and preparation of a tooth surface for cementation of a cast restoration

Air abrasion handpiece

Uses the laser light beam instead of a rotary instrument. Used for various procedures, from soft tissue procedures to the removal of decay from tooth structure. Pain-free

Laser handpiece

Before cleaning a contaminated bur they should be placed in a ____ to prevent damgage to the blades from rubbing or vibrating agains each other or again any hard surface during cleaning

Bur block or holder

Have bits of industrial diamonds incorporated into their working surface. Many dentists use them as an important part of restorative dentistry because of their cutting ability, which shortens preparation time and increases productivity

Diamond accessories or diamond burs, or diamond stones

Similar in appearance to carbide burs, but the blades or bevels on the burs are significantly sharper and closer together. These instruments are preferred for finishing a composite-resin restoration. Available only in the XF (super finisher) designation

Trimming and finishing burs

Makes the initial entry into the tooth structure. Extends the preparation. Provides retention. Removes decay

Round bur

Removes decay. Establishes retentive grooves

Inverted cone bur

Makes the initial entry into the tooth. Forms the internal walls of the preparation

Straight fissure plain cut bur

Provides angles to the walls of the prepared tooth

Tapered fissure cross-cut bur

Tapered fissure plain-cut bur

Makes the initial entry into the tooth structure. Extends the preparation

Pear bur

Makes the initial entry into the tooth structure. Creates a shoulder for the margin of a crown preparation

End cutting bur

The most varied of the rotary instruments. Polishing discs and wheels are abrasive on a metal or paper backing. Used during a restoration, polishing discs are available in four grits: coarse, medium, fine, and super fine. Coarse discs are used to remove excess filling material from the margins of a restoration. Finer discs are used to smooth and polish the completed restoration

Abrasive rotary instruments

Abrasive discs and wheels are attached to a metal shaft, also known as

Mandrel

Used when maximum abrasion is needed during a procedure, as for adjusting the occlusion on an amalgam restoration or gold crown

Stones

Embossed with a polishing agent and are used to polish the anatomic groves of metallic restoration

Rubber points