CHAPTER 1 Manual Operative

8/10/2019 CHAPTER 1 Manual Operative

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CHAPTER 1

Introduction to Instruments and

Dental Materials in Operative

Dentistry



Chapter 1: Introduction to Instruments and Dental Materials in Operative Dentistry

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1.1 BASIC DENTAL INSTRUMENTS

Mouth Mirror

FUNCTION To provide indirect visionTo retract lips, cheeks and tongueTo reflect light into the mouth

CHARACTERISTICS Front surface mirrors – Accurate, distortion-free imageFlat surface mirrors – Used in disposable modelsConcave mirrors – Magnify image

Double sided mirrors – used to retract tongue or cheek and view intraoralcavity simultaneouslyRange of sizes (commonly used sizes: No. 4 and No. 5)Single endedDifferent mirror handles availableUsed with most tray set-ups

Explorers

FUNCTION To examine teeth for decay (caries), calculus, furcations or otherabnormalities

CHARACTERISTICS Pointed tips; sharp, thin, flexibleSingle or double endedUsed with most tray set-upsVariety of sizes and types

Periodontal Probe

FUNCTION To measure the depth of the periodontal pocket in millimeter increments

CHARACTERISTICS Flat or rounded endsDouble-ended style available with probe on one end, explorer on the otherUsed with most tray set-upsVariety of types




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Tweezer

FUNCTION To grasp material and/or transfer it into and out of the oral cavity

CHARACTERISTICS Plain or serrated tipsPointed or rounded tipsRanges sizes availableMetal or plasticUsed with most tray set-ups

Tray

FUNCTION For basic instruments placement

CHARACTERISTICS Range of sizes available




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1.2 HAND INSTRUMENTS

Parts of an instrument:

• Handle – grasping end of instrument; variety of sizes and styles

• Shank – connects handle to working end of instrument, may be straight or may have one ormore angles to accommodate specific areas of the mouth

• Working end – may have cutting edge, bevel, point, nib or beaks

Spoon Excavators

FUNCTION To remove carious dentin

CHARACTERISTICS Spoon-shaped with cutting edgeSingle or double endedRange of sizes; small to larger

Enamel Hatchet

FUNCTION To clean and smooth walls in cavity preparationTo remove enamel not supported by dentin

CHARACTERISTICS Cutting edge on same plane as handleUsed with push motion

Single or double ended

Handle

Shank

Working end




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Enamel Hoe

FUNCTION To clean and smooth floor and walls in cavity preparationTo form or accentuate line angles in cavity preparation

CHARACTERISTICS Cutting edge or blade almost perpendicular to the handleUsed with pulling motion

Chisel

FUNCTION To plane and cleave enamel in cavity preparation

CHARACTERISTICS Used with push motionSingle or double ended Variety of types of cutting edge

Gingival Margin Trimmer

FUNCTION To bevel cervical walls of mesial/distal retention areas

CHARACTERISTICS Curve bladeCutting edge at angle to bladeDouble ended






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1.4 DENTAL HANDPIECES

Parts:

High-Speed Handpieces

FUNCTION To use with bur to cut tooth with decay or other dental anomaliesTo use with bur for adjusting crowns and bridges for final fit

CHARACTERISTICS Handpiece is run by air pressure at a maximum speed of 450,000 rotationsper minuteOn high-speed handpiece, bur generates extreme amount of heatInstruments spray water/air on bur for cooling purposes to prevent damage topulpHandpiece attaches to tubing on dental chairDifferent attaches (coupling) to tubing on dental chair

Low-Speed Handpieces

FUNCTION To use with burs for intraoral and extraoral procedures:To remove decay

To refine cavity preparationsTo adjust occlusal restorationsTo polish amalgam restorationsTo adjust provisional and permanent crowns and bridgesTo adjust dentures

CHARACTERISTICS Llow-speed handpiece and motor-attaches to tubing on unitTypes:Latch type – latch type bur or latch-type prophylaxis polishing cup or brushFriction grip –friction-grip bur

HeadShank




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1.5 ROTARY INSTRUMENTS

Parts:

Shank

Neck – connects the shank to the head

Head – cutting portion of the bur which come in many different shapes

and sizes which are made of different materials

Low speed burs. Name all the burs at your own time.

High speed burs. Name all the burs at your own time.




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Round Bur

FUNCTION To use during initial access into the toothTo remove caries from tooth structure

CHARACTERISTICS Available in stainless steel for caries removal in low speed

handpieces or diamond for cutting and polishing tooth colouredrestorationRange of sizes

From left: Low speed SS round bur, high speed diamond round bur

(Note the differences between the two heads.)

Pear-shaped Bur

FUNCTION To open tooth for access cavity

CHARACTERISTICS Has rounded cutting ends Also available as tungsten carbide friction grip burs

Range of sizes

Inverted Cone Bur

FUNCTION To remove cariesTo establish retention in tooth for cavity preparation

CHARACTERISTICS The shape of this bur provides undercut/s in the cavitypreparationRange of sizes

Straight Fissure Bur

FUNCTION To cut cavity preparationTo form inner walls of cavity preparationTo place retention grooves in walls of cavity preparation

CHARACTERISTICS Elongated, cylindrical bur- small surface area for cutting on theendRange of sizes

Flame Bur

FUNCTION To polish tooth coloured restorationTo use during cavity preparation

CHARACTERISTICS Available in diamond or tungsten carbide

Tapered Fissure Bur

FUNCTION To cut cavity preparationTo form angles in walls of cavity preparationTo place retention grooves in walls of cavity preparation

CHARACTERISTICS Cutting part of bur – has tapered sidesRange of sizes

Football Bur

FUNCTION To polish tooth coloured restoration on palatal area (anterior)

CHARACTERISTICS Available in diamond or tungsten carbide




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1.6 RUBBER DAM INSTRUMENTS

Rubber Dam Sheet

FUNCTION To isolate teeth for dental procedures

CHARACTERISTICS Varies colour- gray, green, blueGauge or thickness – thin, medium, heavyLatex free available

Rubber Dam Punch

FUNCTION To punch holes in rubber dam sheet for each individual tooth

CHARACTERISTICS Designated hole size for each tooth

Rubber Dam Forceps

FUNCTION To place clamp on tooth and to remove clamp after procedures

CHARACTERISTICS Beaks on forceps fit into clamp

Forceps open with spring motion




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Parts of clamp:

Bow

Holes

Prongs

Winged clamps

• Bow – placed toward distal part of tooth

• Jaws – have four prongs that secure clamp on tooth

• Holes – on jaws, designated for beaks on forceps to place clamp on tooth

• Prongs – designated to secure clamp on cervical part of tooth, beyond the height of

contour

• Winged clamps – have extension of metal on jaws to hold dental dam away for better

visibility

Clamp

FUNCTION To anchor and stabilize rubber dam

CHARACTERISTICS Clamp used determined by tooth size (anterior, premolar, molar)Range of sizesVariety of styles – wingless clamp, winged clamp

Rubber Dam Frame FUNCTION To hold rubber dam

CHARACTERISTICS Metal or plastic




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Floss

FUNCTION to ligate the clamp

CHARACTERISTICS Waxed and non-waxed

Wedjets

FUNCTION To stabilize rubber dam at the interproximal area

CHARACTERISTICS Place in gingival embrasure areaVariety of sizes and shapes available to accommodate embrasure area




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1.7 AMALGAM INSTRUMENTS

Parts:

Guide slots

Diagonal slots Spindle - holds matrix band in retainer

Spindle pin - stabilizes band in holder Inner knob - adjusts size or loop ofmatrix band to fit around tooth andloosens band for removal

Outer knob - positioned atend of spindle that tightensor loosens matrix band inretainer band for removal

Matrix Band Retainer

FUNCTION To maintain stability of matrix band during condensation of restorativematerials for class II preparations

CHARACTERISTICS Double ended – Ends protrude at different anglesVaries type : Tofflemire, Siqveland

Matrix Bands

FUNCTION To replace missing proximal wall or walls of cavity preparation for condensingof restorative material

CHARACTERISTICS Bands designed for specific teethVariety of sizes, shapes and thicknessDisposable (single use)

Siqveland Narrow

Tofflemire




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Wedges

FUNCTION To hold matrix band in place along gingival margin of Class II

CHARACTERISTICS Wood or plasticTriangular, round or anatomical shapesPlaced in gingival embrasure areaVariety of sizes and shapes available to accommodate embrasure area

Dycal Applicator

FUNCTION To place calcium hydroxide or glass ionomer in cavity preparation

CHARACTERISTICS Short or long handle

Dappen Glass

FUNCTION To hold amalgam before it is placed in preparationTo hold amalgam while loading amalgam carrier

CHARACTERISTICS Metal, plastic or glass

Amalgam Carrier

FUNCTION To carry and dispense amalgam for cavity preparation

CHARACTERISTICS Metal, plastic




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Amalgam Plugger

FUNCTION To pack and condense amalgam into cavity preparation

CHARACTERISTICS Single or double endedRange of sizes

Ball Burnisher

FUNCTION To smooth amalgam after condensingTo contour matrix band before placement

CHARACTERISTICS Single or double ended

Carver

FUNCTION To contour and carve occlusal and interproximal anatomy in amalgamrestorations

CHARACTERISTICS Double ended – Ends protrude at different anglesVaries type : Hollenbach, cleoid-discoid




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Amalgamator

FUNCTION To mix alloy and mercury and other restorative materialsTo mix cements

CHARACTERISTICS Preloaded capsules contain alloy, mercury and pestle to aid mixing




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1.8 TOOTH COLOURED INSTRUMENT

Mylar/ Celluloid Strip

FUNCTION To mould tooth coloured restoration

CHARACTERISTICS Plastic, clearDisposable (single use)

Plastic Flat

FUNCTION To carry tooth coloured material for cavity preparationTo place and condense composite material in cavity preparationTo shape tooth coloured material in cavity preparation

CHARACTERISTICS Double endedVariety of sizes, shapes and anglesMetal or plastic

Microbrush Applicator

FUNCTION To apply etchant, conditioner, primer and bonding material to cavitypreparation

CHARACTERISTICS DisposableVariety of sizes




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Mixing Well

FUNCTION To hold material: etchant, bonding and composite

CHARACTERISTICS Variety of design, plastic

Curing Light

FUNCTION To start polymerization of light-cured materials: bonding agent, composite,sealants

CHARACTERISTICS Various styles available – electric or battery operated, Quartz-tungsten, LED

Metal Cervical Matrices

FUNCTION To mould tooth coloured restoration (Class V)

CHARACTERISTICS Variety of shapes and sizes




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Clear Cervical Matrix and its Holder

FUNCTION To mould tooth coloured restoration (Class V)

CHARACTERISTICS Variety of shapes and sizes

Abrasive Finishing Str ips

FUNCTION To finish and smooth interproximal surface of restoration

CHARACTERISTICS Abrasive texturesDifferent grit consistencies (fine, medium, coarse)




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1.9 FINISHING AND POLISHING SYSTEMS

From left: flame, pear and round shape

Multifluted Finishing Bur

FUNCTION To finish restoration to the exact tooth anatomy

To adjust occlusion

CHARACTERISTICS Ranges of shapes and sizes (round, flame,pear)Stainless steel

Diamond Finishing bur

FUNCTION To finish tooth coloured restoration to the exact tooth anatomyTo adjust occlusion

CHARACTERISTICS Range of shapes, sizes and degree of coarsenessDiamond

White Stone

FUNCTION To produce a smoother finish tooth coloured restoration

CHARACTERISTICS Aluminium oxide, finer texture, less porousVariety of shape, use with water spray on high speed handpiece




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Green Stone

FUNCTION To remove overhang/excess amalgam

CHARACTERISTICS Variety of shape

Amalgam Polishing Ki ts

FUNCTION To polish amalgam

CHARACTERISTICS Variety of shape (pointy, cup)Range of coarseness (brown, green, super greenie)Variety of shanks available for all types of rubber points ; friction frip and latchtype

From left: bristle brush, rubber cup

Bristle Brushes

FUNCTION To use with an abrasive/pumice paste and prophylaxis pasteUse with light intermittent pressure to polish teeth in final polishing ofamalgam




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Rubber Cups

FUNCTION To use with a whitening, pumice paste and prophylaxis pasteUse with light intermittent pressure to polish teeth in final polishing ofamalgam

Upper: Soflex dics. Lower: Mandrel screw-on

Soflex Disc

FUNCTION To contour and polish tooth coloured restorations

CHARACTERISTICS Range of grit –from coarse to extra fine (colour coding)Grit: Aluminium oxide coating

Mandrel–Screw On

FUNCTION To attach discs to mandrel for finishing and polishing inside or outside

CHARACTERISTICS Shank types:

Long shank – for straight slow –speed handpieceShort latch-type shank –for contra-angleFriction grip shank – for high speed handpiece

Polishing System (Ivoclar vivadent)

FUNCTION Politip – F (Finish) : for removal of excess material and pre-polishingPolitip – P (Polish) : for polishing restorations surfaces especially microfilledcomposite

CHARACTERISTICS Range of shape (large flame, large cup, small cup)




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1.10 MISCELLANEOUS

Scissor

FUNCTION To cut (e.g. retraction cord etc.)

CHARACTERISTICS Variety of shapes and sizesVariety of uses

Metal spatula and mixing glass slab Plastic spatula and mixing pad

Spatula FUNCTION To mix

CHARACTERISTICS Metal – mainly for dental cements (e.g. zinc oxide eugenol)Plastic – for GIC

Mixing Glass Slab/Mixing Pad

FUNCTION To hold materials (e.g. cements)

CHARACTERISTICS Variety – glass, laminated mixing pad

Articulating Paper

FUNCTION To check occlusion

CHARACTERISTICS Articulating paper is blue or redPaper varies in thickness






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CHAPTER 1 Manual Operative

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