Diagnostic Instruments and Aids
- Used by the dentist to help diagnose dental conditions
- The basic diagnostic set up (BDS) is used in most dental procedures
BDS
Mouth mirror, explorer, probe, and cotton forceps
Mouth Mirror
Small, rounded mirror with a detachable handle
The dentist uses the mouth mirror to...
- View the oral area
- Reflect light into the oral cavity
- Retract the tongue and oral tissues
- Protect the oral mucosa from injury
Explorer
- Often created as a double ended instrument with a probe on the opposite end
- It is a hook-like instrument with a sharp, pointed working end
- It is used to detect breaks in the enamel of the tooth and the integrity of tooth and restorative margins
- Wi
Probe
- Double ended instrument with an explorer on the opposite end
- Long, blunt working end
- Several varieties
- Common type is the PSR (Periodontal Screening and Recording
- Working end is marked in millimeter increments from 1-10 millimeters.
- It is used
Cotton forceps
- Tweezer like instruments
- Used to place cotton pellets, medications, and dressings in the oral cavity
- Can transport small items such as wedges, to and from the mouth
Diagnostic aids
- Other aids not included in the BDS that can be used to diagnose dental conditions
Digital images/radiographs
- Used to detect dental conditions that may not be directly visible in the PT's mouth
- Resemble small photo negatives
Electric pulp tester
- AKA vitalometer
- Uses variable controlled electrical charges to measure the vitality of the pulp
- Helpful in diagnosing for root canal therapy in endodontics
Hand cutting instruments
- Dentist will use these as "rotary" instruments interchangeably during a procedure
Spoon excavator
- Hand cutting instrument
- Used to remove dentin, debris, and caries from the tooth
Chisel
- Hand cutting instrument
- Used to smooth the enamel margin of the cavity preps on anterior teeth
Gingival margin trimmers (GMT)
- Hand cutting instrument
- Used to place a bevel along the gingival margin of cavity prep
- Even numbered types are used on the distal surface of the tooth.
- Odd numbered types are used on the mesial surface of the tooth,
- Remember the acronym DEMO (di
Amalgam
Silver colored restorative material that is used on the posterior teeth
What are the steps associated with amalgam restoration?
- Bring the material to the oral cavity
- Pack it into the cavity preparation
- Carve it into the tooth anatomy
- Smooth off the rough edges
Tofflemire retainer
- Holds the stainless steel matrix together
- Its different parts are used to hold the matrix and tighten and secure the matrix to the tooth
Celluloid strip or mylar strip
- Another type of matrix
- Made of clear plastic that holds resin material on anterior teeth
Matrices (Matrix)
-Disposable accessory that forms a wall or box around a tooth to hold the filling material until it sets
- Stainless steel type is used on posterior teeth with amalgam restorations
- Held together with a tofflemire retainer
- An auto type is used when the
Wedges
- Triangular disposable accessories used with a matrix
- Made of wood or plastic
- Help contour the matrix to the tooth anatomy
- Help to reduce gingival irritation due to overhangs/excessive restorative material projecting over the cavity margin
Amalgam carrier
Used to carry amalgam to the cavity prep
Amalgam condenser
- Flat working end
- Packs the amalgam into the cavity preparation
Amalgam well
- Made of metal and has a non-skid base
- Newly mixed amalgam is placed into this instrument and then picked up by the amalgam carrier for transfer
Amalgam retention pins
- Provide retention for teeth that may not have enough natural tooth structure to retain filling material
- Have deep threads that grip the dentin when screwed into the tooth structure
- The other end of it grips the restorative material
Carvers
- Used to "carve" or recreate the tooth anatomy on amalgam restoration
Interproximal Carver (IPC)
- Carver
- Has thin, rounded working ends
- Used on mesial, distal, facial, and lingual surfaces
- "Thinner than a stellite
Discoid/Cleoid
- Carver
- Used to carve occlusal surfaces
- One end is disc shaped, and the other end is shaped like a spade
- "Tanner 5's little brother
Hollenback
- Carver
- Used on mesial, distal, facial, and lingual surfaces
- Has thin working ends that are pointed
- "Surfboard; Backstabber
Walls carver
- Carver
- Carves occlusal surfaces
- Square on one end, and rounded on the other end
- "Square end looks like a....
Tanner-5 (T-5)
- Carver
- Carves occlusal surfaces
- "Discoid/cleoid's big brother
Burnishers
Used to smooth or buff (roughly polish) amalgam restorations
Small ball or large ball
- Burnisher
- Used to smooth occlusal surfaces
Ovoid
- Burnisher
- Used on occlusal surfaces
- "Football
Anatomical burnisher
- Burnisher
- Used to refine pits and fissures
- "Acorn
Which carvers are used on mesial, distal, facial, and lingual surfaces?
- Interproximal carver (IPC)
- Hollenback
Which carvers are used on occlusal surfaces?
- Discoid/cleoid
- Walls carver
- Tanner 5 (T-5)
What are the composite instruments?
- Stellite
- Woodson
- Ladmore
What are composite instruments constructed of?
Chrome or Teflon (which do not stain resin material)
Finishing Aids (Dental Instruments)
- Used to smooth the restoration
Stellite
- Composite instrument made of chrome/Teflon
- Used to place resin into anterior cavity preparations
- Used to invert the dental dam facially and lingually when a dental dam material is placed in the mouth
- "Thicker IPC
Types of finishing aids (dental instruments)
- Abrasive discs
- Abrasive strips
- Abrasive stones
Abrasive discs
- Finishing aid (dental instruments)
- Attach to the mandrel of a low speed handpiece
- Small sandpaper discs that can shape or smooth facial and lingual surfaces of resin filling materials in anterior teeth
Abrasive strips
- Finishing aid (dental instruments)
- Narrow sandpaper strips
- Used to reduce resin restorations on mesial and distal surfaces
Aspirating syringe
- Used for administering local anesthetic
- Type ensures anesthetic is not injected into the blood stream
- The gauge refers to the thickness of the needle
- Long needles are used for mandibular injections; short needles for maxillary injections
Abrasive stones
- Finishing aid (dental instruments)
- Attached to a low speed bur
- Can polish and smooth restorations
Anesthetic carpule
- Glass cartridge containing the anesthetic
- Placed into the barrel of the aspirating syringe
Sharp's container
- Needles, carpules, and any other potentially sharp disposables must be discarded into this container
- Must be puncture resistant, closable, leak proof, color-coded and labeled w/ the biohazard symbol
Dental dam
- Thin rubber like square sheet that comes in light, medium, or heavy degrees of thickness
- Commonly made of latex, but also available in latex free material
- Used to isolate the tooth or teeth being worked on from the rest of the mouth
- Helps to incre
Dental dam punch
- Used to punch different size holes in the rubber dam material
- Sizing of the holes conforms to tooth size
Dental dam frame
- Dental dam material is placed on U-shaped rubber dam instrument
-Holds the dental dam in place
Dental dam clamps
- Primary means of anchoring and stabilizing the dental dam to the arch
- Sizes and shapes vary according to the arch and type of tooth posterior to the treatment site
- Placed and removed with dental dam clamp forceps
Dental dam clamp forceps
Places and removes dental dam clamps on and from tooth
Ligature
- For safety
- Made of dental floss
- Attached to the dental dam clamp in the event the clamp flies off or is swallowed
- Dentist or DA can grab the clamp via this instrument
- Floss: can be used to move the dental dam material mesially and distally when
Round-tip scissors
Used to cut dental dam material at the interproximal areas upon removal
Woodson
- Composite instrument made of chrome/Teflon
- Does not stain
- Used on anterior resins
- "Golf club; horse hoof; Tiger Woods
Ladmore
- Composite instrument made of chrome/Teflon
- Rounded ends
- Used to smooth and shape composite materials
- "Tear drop
Cotton-tipped applicator
- Other miscellaneous instrument
- Used to take topical anesthetic from the container
- Used to apply topical anesthetic to the oral mucosa
Patient napkin
- Other miscellaneous instrument
- Held in place around the patient's neck w/ a towel chain
Dappen dish
- Other miscellaneous instrument
- Multipurpose glass container
- Can be used to hold medications, burs, cotton pellets, etc.
Spatula
- Other miscellaneous instrument
- Made of stainless steel or plastic
-Used to mix/triturate materials
Articulating paper
- Other miscellaneous instrument
- Carbon paper that can be used to check PT's "bite" on the occlusal surface for high spots
- Can check for high spots in restorations, sealants, crowns, fixed partial dentures (bridges), or full dentures
Articulating paper forceps
- Other miscellaneous instrument
- Used to hold the paper in place as it is used in the PT's mouth
Visible light cured (VLC) shade guide
- Other miscellaneous instrument
- Dentist can compare the PT's natural tooth color to this instrument in order to choose the correct color of restorative material for anterior tooth
Dycal instrument
- Other miscellaneous instrument
- Used to mix/triturate
- Used to place dycal (pulp protector) in the cavity
High volume excavator (HVE)
- Other miscellaneous instrument
- Suction tip (sterile, disposable) used to remove debris in oral cavity and preparation
Rotary instruments
Used in cavity preparations, finishing restorations, trimming dentures, and polishing teeth
What are the types of rotary instruments?
- Burs
-Stones
- Wheels
- Discs
Bur types
- Friction grip (high speed hand piece)
- Latch angle (slow speed hand piece)
Bur parts
- Head: working or cutting
- Neck: narrow; connects head to shank
- Shank: fits into hand piece
Round burs
- Head shape: round
- Bur number: 1/4, 1/2, 2, 4, 6, 8
- Removes caries from tooth surface
- Opens tooth for endodontic treatment
- Places retention in cavity preparation
Pear shaped burs
- Head shape: pear
- Bur number: 330
- Opens tooth for restoration
- Removes caries
Inverted cone burs
- Head shape: inverted cone
- Bur number: 33 1/2, 35, 37, 39
- Removes caries
- Establishes retention in tooth for cavity preparation
Straight plain fissure
- Head shape: straight plain
- Bur number: 56, 57
- Cuts cavity preparation
- Forms inner walls of cavity preparations
- Places retention grooves in walls of cavity preparation
Tapered plain fissure
- Head shape: Tapered plan
- Bur number: 169, 170
- Cuts cavity preparation
- Forms angles in walls of cavity preparation
- Places retention grooves in walls of cavity preparation
Straight fissure
- Head shape: tapered
- Bur number: 556, 557, 558
- Cuts cavity preparation
- Forms walls of cavity preparation
- Places retention grooves in walls of cavity preparation
Finishing burs
Head shape: straight, tapered, round, flame
- Finishes composite restoration
- Finishes restoration by restoring anatomy in tooth
- Adjusts occlusion
- Used to shave down high spots
Finishing aids (dental rotary instruments)
- Stones
- Wheels
- Discs
- Mandrel
Stones
- Finishing aid (dental rotary instruments)
- abrasive, diamond shaped
- rotary instrument for polishing
Wheels
- Finishing aid (dental rotary instruments)
- abrasive, round shaped
- rotary instrument for final finishing and polishing
Discs
- Finishing aid (dental rotary instruments)
- abrasive, round shaped
- produces a coarse to medium finish for restorations
Mandrels
- Finishing aid (dental rotary instruments)
- miniature attachment device for discs and wheels in slow speed hand pieces
Dental handpieces
- Air system in main power source
- Air rotates air turbine or vane drive, and fiber optic light
- Used in cavity prep and cleanings
- Classified according to revolutions per minute(RPMs) as slow and high speed
High speed handpiece functions
- Use with bur to cut tooth with decay or other dental abnormalities
- Use with bur for adjusting crowns and bridges for final fit
High speed handpiece characteristics
- Run by air pressure at a maximum speed of 450,000 RPM.
- Bur generates extreme amounts of heat
- Instrument sprays water/air or air on bur for cooling purposes to prevent damage to pulp
High speed handpiece styles of securing bur
- Power lever chuck
- Push button chuck
- Conventional chuck (need to secure bur and loosing bur in handpiece)
Fiber optic high speed handpiece functions
- Illuminate tooth during preparation for restoration
- Provide light intraorally during use of handpiece
- Use with bur to cut tooth with decay or other dental anomalies
- Use with bur for adjusting crowns and bridges for final fit
Fiber optic high speed handpiece characteristics
- Light at head of handpiece
- Lights up working area while handpiece rotates
- Same characteristics as a high speed handpiece
Slow speed motor w/ straight hand piece attachment functions
- Use with slow speed attachments
- Use straight attachment w/ long shank straight bur
Slow speed motor w/ straight hand piece attachment characteristics
- Maximum speed of 30,000 RPM
- Used as adjunct to a high speed handpiece
- Usually used outside oral cavity
- Handpiece needs to be engaged in forward or reverse
Slow speed motor w/ contra-angle hand piece attachment functions
- Use with burs for intraoral and extraoral procedures
- Remove decay, polish amalgam restorations, refined cavity preparation, adjust provisional and permanent crowns and bridges, adjust occlusal restorations, adjust partials and dentures
Slow speed motor w/ contra-angle hand piece attachment characteristics
Attaches to straight handpiece or to slow speed motor
Types of contra-angle attachments
- Latch type
- Friction grip
Latch type
- Contra-angle attachment for slow speed motor with contra-angle handpiece
- Type of bur
- Prophylaxis polishing cup or brush
- Bur is secured by swivel of device in back of handpiece
Friction grip
- Contra-angle attachment for slow speed motor with contra-angle handpiece
- Type of bur
- Bur is secured by pushing back of the handpiece