Chapter 34 Dental Hand Instruments Copyright 2003, Elsevier Science (USA) All rights reserved. No part of this product may be reproduced or transmitted in any form or by any means, electronic or mechanical, including input into or storage in any information system, without permission in writing from the publisher. PowerPoint® presentation slides may be displayed and may be reproduced in print form for instructional purposes only, provided a proper copyright notice appears on the last page of each print-out. Produced in the United States of America ISBN 0-7216-9770-4 Copyright 2003, Elsevier Science (USA). All rights reserved. Introduction A wide variety of dental instruments are used in dentistry today. Copyright 2003, Elsevier Science (USA). All rights reserved. Identifying Hand Instruments Referred to by: • Name • Assigned number Black’s instrument formula • Describes the angulation. • Describes the dimensions. Copyright 2003, Elsevier Science (USA). All rights reserved. Hand Instrument Design Handle • Portion of the instrument where the operator grasps. Shank • Part of the instrument that attaches the working end to the handle. Working end • Portion of the instrument with a specific function. Copyright 2003, Elsevier Science (USA). All rights reserved. Classification of Instruments Four categories • • • • Examination Hand-cutting Restorative Accessory Copyright 2003, Elsevier Science (USA). All rights reserved. Examination Instruments Allow the operator to thoroughly examine the health status of the oral cavity. Mouth mirror • Indirect vision • Light reflection • Retraction • Tissue protection Copyright 2003, Elsevier Science (USA). All rights reserved. Examination Instruments- cont’d Explorer • Distinguish areas of calculus. • Distinguish decay. • Distinguish areas of discrepancies on teeth. Cotton Pliers • Carry, retrieve and place small objects. • Locking • Non-locking Copyright 2003, Elsevier Science (USA). All rights reserved. Examination Instruments- cont’d Periodontal probe • Measure the sulcus or pocket depth of the periodontium. Articulating paper and holder • Carbon paper held in place by a holder used to check a patient’s “bite.” Copyright 2003, Elsevier Science (USA). All rights reserved. Handcutting Instruments Allow the operator to manually remove decay, as well as smooth, finish, and prepare tooth structure to be restored back to its normal function. Excavator is used for the removal of soft dentin, debris, and decay from the tooth. • Spoon excavator • Black spoon Copyright 2003, Elsevier Science (USA). All rights reserved. Handcutting Instruments- cont’d Hoe • Used to plane the walls and floors of the tooth preparation. Chisel • Used to cut the enamel margin of the tooth preparation, form sharp lines, point angles, and place retention grooves. • Straight chisel • Bin-angle chisel • Wedelstaedt chisel • Angle former Copyright 2003, Elsevier Science (USA). All rights reserved. Handcutting Instruments- cont’d Hatchet • Used for cutting enamel, and to smooth the walls and floors of the tooth preparation. Gingival margin trimmer • Used to cut enamel and place bevels along the gingival enamel margins of the preparation. Copyright 2003, Elsevier Science (USA). All rights reserved. Restorative Instruments Allow the operator to place, condense, and carve a dental material to the original anatomy of the tooth structure. Amalgam carrier • A double-ended instrument designed with wells on either end to pack the freshly mixed amalgam in and carry it to the prepared tooth. Copyright 2003, Elsevier Science (USA). All rights reserved. Restorative Instruments- cont’d Condenser • Used to condense the freshly placed amalgam into the preparation. • Smooth • Serrated Burnisher • Used to smooth the surface of the freshly placed amalgam restoration. • Egg-shaped • Football • T-shaped • Beaver tail Copyright 2003, Elsevier Science (USA). All rights reserved. Restorative Instruments- cont’d Carvers • Used to remove excess material, contour surfaces, and carve anatomy back into the amalgam or intermediate restoration before it hardens. • Discoid/Cleoid • Hollenback Amalgam knife • Used for the removal of excess restorative material along the margin where the material and tooth structure meet; most commonly interproximal. Copyright 2003, Elsevier Science (USA). All rights reserved. Restorative Instruments- cont’d Composite placement instrument • Designed specifically for the placement of composite restorative materials. • Anodized aluminum • Teflon Plastic instrument • Instrument with a paddle shape that is used for carrying dental materials to the prepared tooth structure; on the other end is a nib, which resembles a condenser. Copyright 2003, Elsevier Science (USA). All rights reserved. Accessory Instruments Miscellaneous instruments that may be needed for many uses to complete a procedure. Spatulas • Used for most every procedure when a dental material is involved. • Cement spatulas • Impression material spatulas Copyright 2003, Elsevier Science (USA). All rights reserved. Accessory Instruments- cont’d Scissors • Used for cutting dental dam material, retraction cord, and stainless steel crowns. • Crown and bridge scissors Dappen Dish • Hold certain liquid dental materials during a procedure. Copyright 2003, Elsevier Science (USA). All rights reserved. Accessory Instruments- cont’d Amalgam well • Where the newly mixed amalgam is placed and retrieved from. Howe Pliers • Also referred to as 110 pliers. Useful for holding items, for carrying cotton products to and from the oral cavity, removing the matrix band, and placing and removing the wedge. Copyright 2003, Elsevier Science (USA). All rights reserved. Preset Cassettes Hand instruments and related accessories for a given procedure are prepared, stored, and transported together. Exam Amalgam Composite Crown and Bridge Endodontic Surgical Copyright 2003, Elsevier Science (USA). All rights reserved. Instrument Sequence on a Tray Criteria Instruments set-up from left to right • • • • • Basic set-up Additional examination instruments Handcutting instruments Restorative instruments Accessory items Copyright 2003, Elsevier Science (USA). All rights reserved. Color Coding of Instruments Organization • Instruments with bands of same color. • Tray of the same color. • Tub with dental materials of the same color. Copyright 2003, Elsevier Science (USA). All rights reserved.