OPERATIVE
INSTRUMENTS
z PRESENTED BY – 15. DHANANJAY SONI
24. JALAJ GARG
z
INTRODUCTION
Removal and shaping of tooth structures
are essential aspects of restorative
dentistry.
The early hand-operated instruments—
with their large, heavy handles and
inferior metal alloys in the blades—were
cumbersome, awkward to use and
ineffective in many situations.
With advancement of knowledge,
improved quality of materials and
z
introduction of rotary-powered
cutting equipment, tremendous
strides have
been made in the mechanical
alteration of tooth structure
and in the ease with which teeth
may be restored.
It allowed dentists all over the
world to work efficiently and treat
their patients with extreme
accuracy.
z
HAND INSTRUMENTS FOR CUTTING
z
CLASSIFICATION
Commercial manufacture of hand
instruments increased and dentists
began to express ideas about tooth
preparation, it became apparent
that some scheme for identifying
these instruments was necessary.
G.V. Black is credited with the first
acceptable nomenclature for and
classification of hand instruments.
z
DESIGN
BLADE
The blade is the working end of the instrument and is connected to the
handle by the shank.
Shank
Connect the handles to the working ends of the instruments.
Handle
They are commonly eight-sided and knurled to facilitate control.
z
Balance
Balance is an attribute that allows for the concentration of force
onto the blade without causing rotation of the instrument in the
operator’s grasp.
Black’s classification system by
z
instrument name
I. Function (scaler and excavator)
II. Manner of use (hand condenser)
III. Design of the working end (spoon excavator)
IV. Shape of the shank (mon-angle, bin-angle, contra-angle)
Formulas
z
First number: The first number indicates the width of the blade or primary
cutting edge
Second number: The second number of a four-number code indicates
the primary cutting edge angle, measured from a line parallel to the long
axis of the instrument handle
Third number: The third number indicates the blade length
Fourth number: The fourth number indicates the blade angle, relative to
the long axis of the handle.
(in mm)
z THREE NUMBER FORMULAS
It is used for the instruments in which cutting edge is at its right angle to the long
axis of the blade.
E.g 15 – 8 – 14
15 represent width of the blade intense of a mm, i.e. 1.5 mm.
8 represents the length of the base in mm i.e 8 mm.
14 represents the angle which blade forms with the axis of handling.
It is expressed in the hundredths of a circle. It means 14% of a circle. A circle is
360 degree. To convert 14% into circle degrees means 14/100 x 360 = 50 degree.
z
Bevels
Most hand-cutting instruments have a single bevel on the end of the blade that forms
the primary cutting edge. (Spoon excavators and Gingival Margin Trimmers)
Two additional bevels form secondary cutting edges and extend from the primary
edge for the length of the blade. (Hatchets)
z
BEVEL (CONTD.)
Triple – Beveled Instrument:
If 3 additional cutting edges extend from the primary cutting edge, then the
instrument is called triple – beveled instrument.
It results in 3 distinct cutting edges.
This increases cutting edge efficiency of the instrument.
Circumferential Bevel:
Here instrument blade is beveled at all its peripheries , For example : spoon
excavator.
z
APPLICATIONS
z
EXCAVATORS
Ordinary hatchets Hoes
An ordinary hatchet excavator The hoe excavator has the
hasthe cutting edge of the blade
primary cutting edge of the
directed in the same plane as
blade perpendicular to the
that of the long axis of the
axis of the handle.
handle.
Bi-bevelled. Used for planning tooth
preparation walls and for
Used primarily on anterior teeth
forming line angle
for preparing retentive areas and
sharpening internal line angles,
z
Spoons
Angle formers
The shanks may be bin-
Has the primary cutting edge at an
angled or triple-angled.
angle (other than 90 degrees) to the
blade. Used for removing soft
Mon-angled. carious tissue.
Used primarily for sharpening line
angles and creating retentive
features in dentin in preparation for
gold restorations
z
CHISELS
Straight, slightly curved or bin- Enamel hatchet
angled
Similar in design to the
The straight chisel has a straight
ordinary hatchet except that
shank and blade, with the bevel on
the blade is larger, heavier
only one side.
and bevelled on only one side.
Its primary cutting edge is
perpendicular to the axis of the Has its cutting edges in a
handle. plane that is parallel with the
The shank and blade of the chisel axis of the handle.
also may be slightly curved or may Used for cutting enamel.
be bin-angled.
When the second number in the
Gingival margin trimmer
z
instrument formula (found on
Similar in design to the
the handle) is 90–100, the pair
enamel hatchet except the
blade is curved.
is used on the distal gingival
preparation wall.
The primary cutting edge is
at an angle (other than When the number is 75–85, the
perpendicular) to the axis of pair is used to remove
the blade.
unsupported enamel on the
Designed to afford access to mesial gingival wall of the
mesial or distal gingival preparation.
walls.
The gingival margin trimmer is
designed to eliminate
unsupported enamel on gingival
walls of proximal preparations.
z
OTHER CUTTING INSTRUMENTS
KNIVES Files
Known as finishing knives, Blades of the file are
amalgam knives or gold extremely thin.
knives,
Push/pull instrument.
Knives are used for trimming
Used to trim excess
excess restorative material
restorative material and are
on the gingival, facial or
particularly useful at gingival
lingual margins of a proximal
margins.
restoration
NON CUTTING INSTRUMENTS
z
MOUTH MIRROR PROBE
An instrument having a mirror Sharp pointed hand
head top and a detachable instrument.
handle.
Used to explore teeth and
Indirect vision. restoration surface in order to
detect caries and other
Indirect illumination i.e. mouth
defects.
mirror could be held at an
angle to reflect the light onto
working area.
z
PROBE (CONTD.)
TYPES OF PROBE:
Williams Probe
PCP 12 Probe
PSR (Periodontal Screening and Recording probe)
z
PROBE (CONTD.)
USES OF PROBE:
Mainly used for measuring pocket depth.
To determine dimensions of tooth pulp.
z
TWEEZER AMALGAM
Can be used
CONDENSER
to place small Instrument with
objects in serrated tips of
mouth and different
retreiving shapes and
small objects sizes.
from mouth. Shapes are
oval, square
etc.
AMALGAM CONDENSER (CONTD.)
z
Used to derive the restoration to the tooth preparation and properly
condense it.
Hammer like working end should be large enough to pack the restoration
without sinking into it.
Comes in single and double ended designs.
Can be hand or mechanical in nature.
Available in different shaped and sized working ends like sound, triangles
or parallelogram which may be smooth or serrated.
z
EXPLORER
Explorer is commonly used as a
diagnostic aid in evaluating condition
of tests especially pits and fissures.
Parts:
Handle of explorer is straight which
could be plain or serrated.
Shank of explorer is curved with
one/more angle.
Working tip of explorer is pointed.
EXPLORER(CONTD.)
z
TYPES:
STRAIGHT EXPLORER: It is bent perpendicular to the handle. This is used for
examining occlusal surface of teeth.
SHEPHERDS HOOK OR CURVED EXPLORER OR ARCH EXPLORER: It has
semilunar – shaped working tip perpendicular to the handle. This is used for examining
occlusal surface.
INTERPROXIMAL EXPLORER / BACK ACTION PROBE:This explorer has two or
more angles in the shank with working tip – pointed towards the handle.
COW HORN / PIGTAIL EXPLORER:It has smaller arch than curved explorer.
z
EXPLORER(CONTD.)
USES:
o Examination of interproximal caries.
o For assessing marginal fit of the restoration.
z
BURNISHER
Makes the surface shiny by rubbing.
Used to smoothen and polish restoration and to
remove scratches present on the amalgam surface
after its carving.
Has smooth rounded working ends and come in
single and double ended types.
BURNISHER (CONTD.)
z
DIFFERENT TYPES OF BURNISHERS ARE:
PKT 3 [ Designed by Peter K Thomas]
Rounded Cone – shaped burnisher.
Dovetail Condenser.
Ovoid burnisher.
z
BURNISHER (CONTD.)
USES
Finds condensating amalgam.
Initials shaping of occlusal anatomy of amalgam.
Shaping of metal matrix bands,
Shaping of occlusal anatomy in post resin composite before polymerization of resin.
Burnishing margins of cast gold restoration.
z
AMALGAM
CARRIER
Carries the freshly prepared amalgam restorative
materials to the prepared tools.
They have hollow working ends caused barrels into
which the amalgam is packed for transportation.
It can be both single and double ended.
Barrel comes in variety of size: small , large and jumbo.
Lever of amalgam carries is located on the top of the
carries.
When lever is depressed , amalgam is expressed into
the preparation.
After Restoration Completion , remaining amalgam is
expressed out as it can be harden and then the carrier
will be non – serviceable.
z
CEMENT SPATULA
Severe types of cement spatula are available in
the market differing in shape and size.
On the basis of size, Cement Spatula can be
classified into two types:
I. LARGE CEMENT SPATULA: Mixing of luting
cements.
II. SMALL CEMENT SPATULA: Mixing of liner.
Cement Spatula also can be classified on the
basis of thickness , rigid and flexible. Their use
depends on viscosity of cement and personal
preference.
z CARVER
Sharp cutting edges present in carvers are
used to shape and form tooth anatomy from a
restorations.
Comes in different shapes and sizes in double
coded design.
Many carver are designed for carving specific
tooth surface and diamond shaped carvers.
z CARVER (CONTD.)
TYPES:
A. HOLLENBACK / WARDS CARVER:
Double ended , binangle instrument.
Used to carve amalgam and inlay wax preference.
A. DIAMOND CARVER / FRAHMS CARVER: Has bibeveled cutting edge.
B. INTERPROXIMAL CARVER:It has very thin blade and used for carving proximal
surface.
C. DISCOID CLEOID CARVER: Used for carving occlusal surface.
z
THANK YOU : )
