ITC PART 2: DENTAL INSTRUMENTS

what instruments are in a basic examination kit and what are their functions

• dental mirror - allows indirect vision and retraction of soft tissues

• dental probes

  • sharp: checking restoration margins and assessing roughness of tooth and restoration surfaces

  • blunt: WHO/ Williams/ UNC15 are used for periodontal examination, straight

• college tweezers - to place cotton wool rolls and remove large pieces of intraoral debris

WHO probe/ BPE probe

• has a 0.5mm ball at the end

• markings at 3.5, 5.5, 8.5 and 11.5mm

• used in BPE

Williams probe

• grooves/ markings at 1, 2, 3, 5, 7, 8, 9, 10mm (4 and 6mm markings are missing to avoid confusion when reading)

• commonly used to measure periodontal pocket depths

UNC15 probe

• slightly thicker than Williams probe

• assesses periodontal pocket depth

• 15mm probe with 1mm markings from 1-15mm

• 4-5mm, 9-10mm, 14-15mm markings are shaded

what instrument is this and what is its function

excavators

• sharpened cutting edge on a discoid/ ovoid blade

• removes caries and temporary restorations

• can also be used to carve amalgam restorations

• available in different sizes

• usually double ended

chisels, hatchets and hoes function

chisels, hatchets and hoes

• used to remove unsupported enamel at the cavity margins (cavity preparation)

• seldom used now

chisels VS hatchets

• chisel: the cutting edge is perpendicular to the instrument handle

• hatchet: the cutting edge is parallel (or close to parallel) to the instrument handle

what instrument is this and what is its function

gingival marginal trimmer

• used to remove unsupported enamel margins (cavity preparation)

• comes as a set of two instruments with curved blades

what is the design of hand instruments

• most are stainless steel or carbon steel

• may have tungsten carbide tips on cutting edge to retain sharpness for longer

• 3 parts: blade, shank, handle

• primary cutting edge is at the end of the blade

• instruments have a number of bends in the shank to allow access to different areas of mouth

• handle may be serrated to enhance grip

what instrument is this and what is its function

amalgam carrier

• convey mixed amalgam alloy to express into prepared cavity

what instrument is this and what is its function

amalgam condensers

• also known as pluggers/ packers

• instrument for packing plastic restorative materials into cavities under pressure and eliminating voids

what instrument is this and what is its function

carvers

• semi-sharp blades

• carve the shape of a restoration by a scraping action

• different patterns e.g. Wards, Frahm, Hollenback

what instrument is this and what is its function

flat plastic

• used for conveying, placing and shaping plastic materials not requiring heavy pressure

• usually made of stainless steel, may be Teflon-coated for composite placement

what instrument is this and what is its function

burnishers

• round ended smooth surfaces for using straight after a filling to bring mercury rich amalgam to the surface

• also used to place and shape composite restorations

state types of rotary instruments

• burs

• files

• stones

• discs

ALL ROTATED IN HANDPIECES

how can rotary instruments be powered

1. compressed air

2. electric motor

what are the types of handpieces

• high speed: air rotor

• low speed: contra-angle or straight

what instruments are these and what is its function

dental burs

• used with high and slow speed hand pieces

• cut, shape and polish hard tissues - prep. for restorative work

what instruments are these and what is its function

dental discs

• used with slow speed hand pieces

• removing hard tissues during procedures like crown preparation

• finishing and polishing restorations

what instrument is this and what is its function

dental polishing cup

• used with low speed hand piece

• remove surface stains, plaque and smooth tooth surfaces

what instruments are these and what is their function

dental (polishing) stones

• used with slow and high speed hand pieces

• used to shape, contour and polish dental restorations

• different colours are used for different material restorations

what instruments are used in oral surgery

oral surgery: extractions

• elevators or luxators are often used first to loosen the tooth in its socket

• elevators pry teeth out of their sockets

• luxators separate teeth from surrounding soft tissues

• extraction forceps come in various shapes and sizes depending on the tooth being extracted

sign on disposable instruments

give examples of disposable instruments

• matrix bands

• files

• reamers - shape root canals

• aspirators

• 3-in-1 plastic syringe tips

• impression trays

• mouthwash cups

• absorbent patient bibs

• rubber prophylaxis cup

what is the procedure if a dental instrument breaks

• check oral cavity

• try to retrieve the broken instrument with tweezers or suction

• senior nurse and supervising tutor must be informed

• if you suspect the patient may have aspirated or swallowed it a chest X-ray is required

• inform the patient of the situation and document it in their records

• fill in a Datix form

fractured endodontic instruments during a root canal treatment

• if a file fractures you must always inform the patient and document it in their notes

• it is recommended that an X-ray of the tooth be taken to verify the location of the file within the root canal

• depending on where the file is it may be better to monitor the tooth

• other times it may be necessary to remove the file or refer the patient to a specialist endodontist

needle breakage during administration of local anaesthesia

• it is possible for an anaesthetic needle to break particularly if it has been bent

• inform the patient of what has occurred

• document it in the patient’s notes

• unless the needle is sticking out of the tissue an oral and maxillofacial surgeon must be contacted to have the patient seen immediately for its removal