What are some materials that hand instruments can be made of?
stainless steel, carbon steel, plastic or a specialized metal
what are the three parts of a hand instrument?
handle, shank, working end
handle - part of hand instrument
function: to hold (grasp) instrument
-portion of the instrument that the operator grasps
-variety of shapes and styles
Characteristics of Instrument Handles
-single or double ended
-removable working ends (replaceable and interchangeable) attach to handle
-nonremovable working ends available (commonly used)
-larger diameter models: help tighten grasp and maximize control
-alternating diameter models: less str
shank - part of hand instrument
-part of instrument that attaches/connects the working end to the handle
-may be straight or may have one or more angles; the bends or angles are designed so that instrument can reach specific areas of the mouth/tooth
instruments used _____ have more angles in their shank.
instruments used _____ tend to have a straighter shank
-interproximally
-on the facial or buccal surface of a tooth
working end - part of hand instrument
-portion of instrument with specific function
-may have cutting edge, blade, bevel, point, beaks, or nib (area may be smooth or serrated)
hand instruments can have what kind of working end?
can be single or double ended/sided
double-ended hand instrument
-has a shank and working end at both ends of the handle
-often, are mirror images (reverse angles) of each other, allowing adaptation to all surfaces of the tooth. these are referred to as left and right instruments
multipurpose double-ended instrument
is designed to have two working ends that would be needed for the same procedure
is a perio-probe an example of a single-ended and/or double-ended hand instrument?
yes.
a perio probe is an instrument used to detect for periodontal disease.
Instruments used in restorative dental procedures are classified into four categories, what are they?
1) Examination instruments
2) Hand (manual) cutting instruments
3) Restorative instruments
4) Accessory Instruments & Items
Examination instruments allow what?
allow for the operator to thoroughly examine the health status of the oral cavity.
Hand (manual) cutting instruments allow what?
allow the operator to remove decay manually and to smooth, finish, and prepare the tooth structure for its final restoration.
Restorative instruments allow what?
allow the operator to "restore" a tooth by placing, condensing, and carving a dental material to the original anatomy of the tooth structure.
Accessory instruments are what?
are miscellaneous instruments and items that are used to complete a procedure.
instrument sequence
-a procedure tray is set up from left to right
-sequencing based on how instruments are transferred and used throughout a dental procedure
what hand does a clinical assistant use when transferring instruments?
left hand
where should most frequently used instruments be placed for ready availability?
placed closer to the dentist
Define examination instruments (tab
-are the most frequently used on the tray
-range of uses:
--checking a specific problem
--providing a thorough examination
--evaluating a restored tooth
what are some general types of examination instruments part of basic set up?
-explorer
-mouth mirror
-cotton forceps (pliers)
Basic Setup
-are instruments set out for ever procedure
-when tray is set up from left to right, they're the first 3 instruments
how should the explorer and mouth mirror be transferred?
simultaneously, with the use of a two-handed transfer
what is the best tray positioning/set up to prevent crossover of your hands when transferring the two instruments?
1st the explorer
2nd the mouth mirror
explorer (examination instrument, part of basic set up)
-multifunctional instrument
-available in many shapes
-all have a thin, flexible, wire-like working end with a sharp point at the tip.
-variety of sizes & types
what does the tip of an explorer-instrument enable?
enables the operator to use tactile sensitivity to distinguish areas of calculus or decay from discrepancies on the surface of teeth
what are general common types of explorer instruments?
-orban
-pigtail
-shepherd's hook
explorers function- examination instrument part of basic setup
to examine teeth for decay (caries), calculus, furications, or other abnormalities
explorers characteristics - examination instrument part of basic setup
-pointed tips; sharp, thin, flexible
-single or double ended
-variety of sizes and types
double-ended instruments
may have the same style working ends or different styles of working ends; may also have a explorer on one end and a periodontal probe on the other end
1) orban explorer
2) pigtail explorer
3) shepherd's hook explorer
are types of explorers
instrument category: examination
pg.p4
identify the category, type and specific names of the instruments
mouth mirror - examination instrument part of basic set up
p.477
-designed to have different handles available
--straight handle, slight angle to shank & working end with a round metal disk & a mirror on one or both sides
-can have a flat or concave (indented) surface
-when face of mirror gets scratched it can be repla
what are the four uses/purposes of a mouth mirror?
-indirect vision
-light reflection (reflecting of light on a surface)
-retraction & tissue protection (retraction of tongue & soft tissues, such as cheek and lips)
mouth mirror functions - examination instrument part of basic setup pg.p3
-to provide indirect vision
-to retract lips, cheeks, and tongue and protect soft tissues
-to reflect light into mouth
mouth mirror characteristics - examination instrument part of basic setup pg.p3
-1) front surface mirrors: accurate, distortion-free image
-2)double-sided mirrors: used to retract tongue or cheek and view intraoral cavity
-flat surface mirrors - used in disposable mirrors
-concave mirrors: magnify image
-commonly used sizes: 4 & 5; r
what are alternative names for cotton forceps?
-cotton pliers
-"pickups
cotton forceps - examination instrument part of basic setup p.477
-used to carry, place, and retrieve small objects
-with nonlocking version: the handles must be held closed with fingers
-with locking version: the handles can be locked in a closed position, & the tips do not open until the lock is released
-the tips of
cotton forceps (pliers) function - examination instrument, part of basic set up pg.p7
-to grasp or transfer items and/or material into and out of the oral cavity
cotton forceps (pliers) characteristics - examination instrument, part of basic set up pg.p7
-plain or serrated tips
-pointed or round tips
-thin or thick tips
-locking forceps (see ch11, pg.p289)
-range of sizes available
hand (manual) cutting instruments
-these instruments allow the dentist to manually remove decayed tooth structure, to smooth cavity walls and floors of the tooth preparation, and to place any bevels or retention grooves to hold the dental material within the tooth
-dentist will have a spe
what are some general types of hand (manual) cutting instruments?
-excavator, hoe, chisel, hatchet, and gingival margin trimmer
enamel hatchet functions - hand (manual) cutting instrument pg.p20-21
-to clean, cut, and smooth walls in cavity preparation
-to remove enamel not supported by dentin
enamel hatchet characteristics - hand (manual) cutting instrument pg.p20-21
-used with push motion
-cutting edge on same plane as handle
-single-or double ended
-is a three numbered instrument
examples of instrument numbers for enamel hatchet
20-9-14
15-8-14
15-12
enamel hoe functions - hand (manual) cutting instrument pg.p22-23
to clean and smooth floor and walls in cavity preparation
enamel hoe characteristics - hand (manual) cutting instrument pg.p23
-used with pulling motion
-cutting edge or blade nearly perpendicular to handle
-is a three numbered instrument
examples of instrument numbers for enamel hoe
10-4-8
10-4-14
chisel - hand (manual) cutting instrument p.477
-has a straight or angled shank & a single-beveled cutting edge
-uses: used to break down the enamel margin of the tooth preparation; to form sharplines; to place retention/retentive grooves
general common types of chisels - hand (manual) cutting instrument
-straight chisel
-wedelstaedt chisel
-binangle chisel
-angle former / angle-formed chisel
straight chisel functions - pg.p24&25
to plane and cleave enamel in cavity preparation
straight chisel characteristics - pg.p24&25
-used with push motion
-single-bevel cutting edge
-single or double ended
-examples of instrument numbers: 15 ; 20
Wedelstaedt Chisel function - pg.p26&27
to plane and cleave enamel in cavity preparation
Wedelstaedt Chisel characteristics - pg.p26&27
-used with push motion
-curved blade on working end
-single-bevel cutting edge
-single or double ended
-is a three numbered instrument
examples of instrument numbers for Wedelstaedt Chisel
15-15-3
11.5-15-3
Binangle Chisel function - pg.p28&29
to plane and cleave enamel in cavity preparation
Binangle Chisel characteristics - pg.p28&29
-used with push motion
-two angles in the shank
-single or double ended
-is an example of three-numbered instrument
Example numbers for binangle chisel
20-9-8
15-8-8
Angle formed chisel / angle former function - pg.p30&31
to accentuate line and point angles in internal outline and retention in cavity preparation
Angle formed chisel / angle former characteristics - pg.p30&31
-cutting edge at angle
-single or double ended
-is a four numbered instrument
examples of instrument numbers for angle former / angle formed chisel
20-80-5-8
9-80-4-8
Gingival Margin Trimmer - mesial and distal function - pg.p32&33
to bevel cervical walls of mesial and distal retention areas
Gingival Margin Trimmer - mesial and distal characteristics - pg.p32&33
1) mesial: to create bevels on the mesial cervical margin of the preparation
2) distal: to create bevels on the distal cervical margin of the preparation
-curved blade: cutting edge at angle to blade
-double ended: one end curves to the right; the other t
example of instrument numbers for Gingival Margin Trimmer - pg.p32 & 33
mesial:
13-80-8-14
15-80-8-12
distal:
13-95-8-14
15-95-8-12
hoe - hand (manual) cutting instrument p.477
-the blade is perpendicular to the handle
-used to prepare the tooth and plae the walls and floors of the tooth preparation with a push-pull action
hatchet - hand (manual) cutting instrument p.477
-the cutting edge is parallel to the long axis of the handle
-used to cut enamel and smooth the walls and floors of the tooth preparation
excavator p.477
-one of the most versatile instruments on the tray setup
-have a working end that is "spoon" shaped and circular or elongated
-two most used versions are: spoon and blackspoon
excavator functions - hand (manual) cutting instrument pg.p34&35
-to remove carious dentin
secondary functions:
-to remove temporary crowns
-to remove temporary ement in temporary restoration
-to remove permanent crown during tray-in
excavator characteristics - hand (manual) cutting instrument pg.p34&35
1) large: curved blade - "Black Spoon"
2) small: round blade
single or double ended
black spoon excavator pg.p34/35
large: curved blade
-has a flat appearance but is used for removal of soft dentin, debris, and decay from tooth (#1 in image)
spoon excavator - pg.p34/35
small: round blade
-used for removal of soft dentin, debris, and decay from tooth
(#2 in image)
Restorative Instruments - p.476
-used to place, condense, & carve the restorative dental materials to reflect the normal anatomy of a tooth
-most dentists use these instruments in a specific sequence b/c precise application of the dental material is necessary
-instruments selected for t
types of restorative instruments p.476, 479
-amalgam carrier
-condensers; "pluggers"
-burnishers,
-carvers
Amalgam Carrier function (restorative instrument) pg.p207
to carry and dispense amalgam into cavity preparation
Amalgam Carrier characteristics (restorative instrument) pg.p207
-single or double ended:
1) double ended: one small and and one large end.
2) single ended: plunger style.
-the inside of the hollow tubes is coated with metal or teflon
Amalgam Carrier notes (restorative instrument) pg.p207
amalgam is packed in hollow tubes and then transferred to the cavity preparation.
amalgam sticks in the carrier if it is not released immediately after the tubes are filled.
amalgam carrier is used exclusively on amalgam trays.
amalgam carrier p.479-481
-restorative instrument
-double-sided instrument designed with wells on either side
-used to pack freshly packed amalgam and carry it to the prepared tooth.
-most versions are designed to hold a large increment of amalgam at one end and a smaller incremen
condensers/pluggers functions (restorative instrument) pg.p209
(smooth and serrated versions)
-to pack and condense amalgam into cavity preparation
-to pack and condense other restorative materials
-to pack and condense temporary filling material
condensers/pluggers characteristics (restorative instrument) pg.p209
1) small smooth end.
2) large smooth end.
-round, flat, diamond shaped or serrated ends available
-double ended: one small end and one large end.
-back action condenser available with right-angle working ends, accommodates difficult areas
-range of sides
condensers/pluggers p.479-481
-restorative instrument
-have a flat working end that is either smooth or serrated
-various sizes available, to accommodate the size of the preparation
-the shank is angled to allow the operator to reach all areas of the preparation
-used to pack down ama
Composite Condenser p.479-481
is often Teflon coated to prevent sticking and discoloration of the restorative material
Amalgam Condenser p.479-481
is used to condense (pack down) freshly placed amalgam into the preparation
Burnishers p.480
-restorative instrument
-has a smooth working send
-routinely used to smooth the surface of a restorative material by directing the material against the cavity wall and margin and for final contouring
-the working end is available in many different shapes
Burnishers- Football, Ball, and Acorn functions p.480; pg.p212-213
-to smooth amalgam after condensing;
-to contour matrix band before placement;
-to perform initial carving of amalgam;
-to burnish other restorative material;
-to burnish temporary filling material
Burnishers- Football, Ball, and Acorn characteristics p.480; pg.p212-213
1) football burnisher
2) ball burnisher
3) acorn burnisher
T-ball burnisher functions p.480; pg.p215
-to smooth amalgam after condensing;
-to contour matrix band before placement;
-to begin shaping of amalgam;
-to burning restorative materials;
-to burnish temporary filling material
T-ball burnisher characteristic p.480; pg.p215
single ended
Beavertail Burnisher functions p.480; pg.p217
-to smooth amalgam after condensing;
-to perform initial shaping and/or carving of amalgam
-to invert dental dam
-to burnish restorative materials
-to burnish temporary filling material
Beavertail Burnisher characteristics p.480; pg.p217
single or double-ended
Carver p.480
-restorative instrument
-designed with a sharp edge on the working end to remove excess material to contour surfaces, and to carve anatomy back into restorative material or intermediate restoration before it hardens
Discoid-Cleoid Carver (suggested Quizlet definitions)
(suggested Quizlet definitions)
Used to carve occlusal anatomy in amalgam restorations.
Used to carve occlusal surfaces. Double ended. Discoid end is disc shaped, and Cleoid end is like a spade.
To carve occlusal anatomy into amalgam restorations
Discoid-Cleoid Carver functions p480; pg.p221
-to carve occlusal anatomy into amalgam restorations
-to carve occlusal anatomy in other restorative and temporary filling materials
-useful for carving the restorative material on the occlusal surfaces
A discoid-cleoid is a double ended variety of a
Carver
Discoid-Cleoid Carver characteristics p480; pg.p221
-double-ended, two ends shaped differently
-disc end and claw-like end
-1) discoid end: disc shaped.
-2) cleoid end: pointed.
(ends shaped differently from those of Tanner Carver)
Hollenback and Half-Hollenback Carvers functions p.480; pg.p223
To contour and carve occlusal and interproximal anatomy in amalgam restorations
Half-Hollenback Carver
is half size of Hollenback carver
Hollenback Carver functions p.480; pg.p223
-restorative instrument
-to contour and carve occlusal and interproximal anatomy in amalgam restorations
-to contour and carve occlusal and interproximal anatomy in other restorative and temporary filling materials
Hollenback and Half-Hollenback Carvers characteristics p.480; pg.p223
-has a flat tapered working end to contour or remove excess restorative material interproximally
1) Hollenback
2) Half-Hollenback
-double ended: working ends protrude at different angles
Amalgam Knife Carver p.480
-restorative instrument
-has a flat angled working end with a sharp end for the removal of excess restorative material along the margin where the material & the tooth structure meet
-the knife has several angles in the shank & the working end that enable
Gold Carving Knife functions pg.p224-225
-restorative instrument
-to trim interproximal amalgam restoration, recreating contour of proximal walls
-to trim interproximal restorations with other restorative materials, recreating contour of proximal walls
-to remove flash composite material from in
Gold Carving Knife characteristics pg.p224-225
-single or double ended
-variety of designs
-Interproximal carving knife: different designs available
Composite placement instrument
(quizlet suggested definitions)
is 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.
What do doctors commonly refer Composite Placement Instruments as? (ch34, slide 28)
PFI
Composite Placement Instruments p.481
-restorative instrument
-designed specifically for the placement of composite restorative materials
-made from anodized aluminum of Teflon. These materials prevent the composite material from being scratched.
-these instruments do not discolor the composi
Composite Placement Instrument functions pg.p239
-to carry composite material to the cavity preparation
-to place, condense, and carve composite material in the cavity preparation
Composite Placement Instrument characteristics pg.p239
1) plastic composite instrument: plastic that can be sterilized
2) metal composite instruments: Titanium nitride coating
-double ended
-different angles on ends
-ends shaped differently, one to accommodate initial placement of material (paddle end) and th
Woodson (FP-1) p.481
-restorative instrument
-double ended instrument: one end is paddle end, other end is nib/plugger end
-range of sizes available
paddle end of Woodson (FP-1) (#2, green)
-used to carry and place dental material/restorative material for cavity preparation to the prepared tooth structure/surface
-available in different angles and sizes
nib/plugger end of Woodson (PF-1) (#1, red)
-to condense restorative material
-to condense a base
-nib end, resembles a condenser
-available in a variety of sizes.
Woodson (FP-1) functions pg.p201
-to carry and place temporary restorative material for cavity preparation (paddle end)
-to condense restorative material (plugger end)
-to carry (paddle end) and condense a base (plugger end)
Accessory Instruments & Items p.481
-are items not necessarily included in the tray set up, but can be "pulled" from the dental cabinets or tubs to be used for many procedures.
When accessory instruments and items are used, remember... p.481
when additional items are used for a procedure, you must follow proper infection control guidelines regarding disinfection, or sterilization of the item before/after it is used AND before it is placed back into the cabinet.
articulating paper holder p.482, pg.p227
-can be metal or plastic (disposable)
-is used to hold & carry articulating paper (for the mouth) in place
articulating paper p.482, pg.p227
-carbon paper/material varies in thickness/thin & colors available
-is used to check the patient's "bite" after placement of a new restoration, crown, bridge, or denture
--> marks the occlusal surface to check patient's bite.
-the mark must appear equal i
amalgam well (slide 32)
well for composite material; used to hold dental material
dappin dish (slide 32?)
Glass dish to hold liquid or powder
scissors
...
scissors as accessory instrument/item p.482
-most often associated with restorative dental procedures are termed "crown & bridge" scissors, & are made available with curved or straight blades
-are useful for many tasks, such as: cutting, dental dam material, retraction cord, & stainless steel crown
crown and bridge scissors functions pg.p263
-to trim aluminum temporary crowns on gingival side
-to trim custom temporary crowns
-to cut gingival retraction cord
-to cut matrix bands
-to cut dental dam septum
crown and bridge scissors characteristics pg.p263
-short cutting edges: can be straight or curved, narrow or wide
-variety of sizes
short-blade scissors pg.p390-391
-to precisely cut material especially for whitening trays
-characteristic: fine cutting blade
-note: used on whitening tray set up and on other operative tray setups
Tissue Scissors pg.p488-489
-function: to cut tissue
-characteristics: straight or curved; variety of shapes and sizes; variety of uses
Suture scissors pg.p504-505
-function: to cut sutures
-characteristics: cutting edges: straight or angled; may have notch on end of cutting edge (see image); range of sizes
Spatula p.482
are used in procedures in which mixing of a dental material is needed
flexible alginate (irreversible Hydrocolloid) Spatula functions pg.p629
-to mix powder and a liquid in a flexible bowl
-to mix impression material such as irreversible hydrocolloid, alginate
-to load material into tray
-to mix laboratory plaster, stone, and die stone for models
flexible alginate (irreversible Hydrocolloid) Spatula characteristics pg.p629
-spatula is flexible to manipulate material
-is used with the flexible rubber bowl
a flexible mixing spatula p.482
is a single ended, made of stainless steel, comes in two sizes (#15, #24), & is used to mix liners, bases, & cement
laboratory spatula pg.p651
-functions: to mix powder and a liquid in a flexible bowl
-to mis and shape laboratory plaster, stone, and die stone for models
-characteristics: spatula straight to help manipulate material; available in a range of sizes
-note: is used with vibrator to m
Flexible mixing spatula pg.p661
function: to mix dental materials.
characteristics: -flexible metal spatula allows for proper manipulation of material; -range of sizes available.
amalgam well function pg.p205
-to hold amalgam before it in placed in preparation;
-to hold amalgam while loading amalgam carrier
amalgam well characteristic pg.p205
metal (shown in picture), plastic, or glass
amalgam well p.482
-is made of metal and is weighted with nonskid base
-newly mixed amalgam is placed in the well; then the amalgam is picked up from the 'amalgam well' with the 'amalgam carrier' for transfer to the dentist or to the tooth preparation
How (or Howe) Pliers; "110 pliers" pg.p431
functions: To place/remove arch wires and check for loose bands
characteristics: all-purpose pliers for orthodontic procedures; serrated tips for better grip on wire; straight or curved beaks
Howe Pliers (110 Pliers) p.482
-are versatile pliers that can be used in many different procedures, for many tasks.
-their design is straight and include beaks that have flat, rounded ends, making them useful for holding items.
-used for carrying cotton procuts to and from the oral cav
cassette trays
used to contain instrument setups that travel from operatory use to the ultrasonic cleaning, rinsing, and wrapping for sterilizing and storage until the next use; are marked and dated and can be color-coded to signify which operatory, procedure, operator,
cassette tray setup"; "preventive procedure"; preset cassettes (trays) (ch 34, slide 36) p.481
-is a method to maintain organization and be prepared for a procedure is to have instruments in a preset cassette.
A dental practice will have sterilized cassettes arranged for most procedures, for example: p.581 (ch 34, slide 36)
procedure examples: examination, hygiene, restorative, crown & bridge, & surgical
preset cassettes (trays) (ch34, slide36) p.481
-the sterile cassette is taken to the treatment area for preparation before the patient is seated.
-if the instruments are kept separate in either a sterile pouch or package, they will need to be removed from their packaging, set out and arranged on an in
Storage tubs (ch 34, slide 37) p.483
Supplies and dental materials for specific procedures can be stored in a covered plastic tub within each operatory
The combination is known as the tub and tray system.
Important consideration: remember not to have items used in a dental procedure left out
Color-Coding Systems function (ch 34, slide 38) p.483
one of the most convenient and efficient ways to organize instruments and supplies for specific procedures.
Color-Coding Systems (ch 34, slide 38) p.483
the instrument tray and the tub for related materials can be used to indicate the procedure.
-instruments with bands of the same color
-tray of the same color
-tub with dental materials of the same color