Instruments and Equipment

for Tooth Preparation

By Dr Ali Yahya
 A. Hand Instruments for Cutting
• Terminology and Classification
Categories
1. cutting (excavators, chisels, and others)
2. non-cutting (amalgam condensers,
mirrors, explorers, probes).

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 Design
They are composed of three parts:
1. handle,
2. shank,
3. and blade (
For non-cutting instruments, the part corresponding to the
blade is termed nib.

aDouble-ended
b c b a
component parts of
hand instruments: blade (a), shank (b), and
handle (c). (

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 Names
Black classified all of the instruments by name.

Black’s classification system by instrument name

categorized instruments by
(1) function (e.g., scaler, excavator),
(2) manner of use (e.g., hand condenser),
(3) design of the working end (e.g., spoon excavator,
sickle scaler), or
(4) shape of the shank (e.g., mon-angle, bin-angle, contra-
angle).
These names were combined to form the complete
description of the instrument (e.g., bin-angle spoon
excavator).

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 Formulas
Cutting instruments have formulas describing the dimensions
and angles of the working end.

(e.g., 10–8.5–8–14) . The first number indicates the width of

the blade or primary cutting edge in tenths of a millimeter
(0.1 mm) (e.g., 10 = 1 mm).
The second number indicates the primary cutting edge
angle, measured from a line parallel to the long axis of the
instrument handle in clockwise centigrades
The third number (second number of a three-number code)
indicates the blade length in millimeters (e.g., 8 = 8 mm).
The fourth number indicates the blade angle, relative to the
long axis of the handle in clockwise centigrade
(e.g., 14 = 50 degrees).

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 Applications
The cutting instruments are used to cut the hard or soft
tissues of the mouth.

Excavators are used for removal of caries and refinement of

the internal parts of the preparation.

Chisels are used primarily for cutting enamel.

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 Excavators
The four subdivisions of excavators are (1) ordinary hatchets,
(2) hoes, (3) angle-formers, and (4) spoons.

Chisels
Chisels are intended primarily for cutting enamel and may
be grouped as
(1) straight, slightly curved, or bin-angle;
(2) enamel hatchets; and
(3) gingival margin trimmers.

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 Hand Instrument Techniques
Four grasps are used with hand instruments:

(1) Modified pen,

(2) inverted pen,
(3) palm-and-thumb, and
(4) modified palm-and-thumb.

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 Modified pen grasp. Correct position of middle finger is near the “topside” of
the instrument for good control and cutting pressure. The rest is tip (or tips) of
ring finger (or ring and little fingers) on tooth (or teeth) of same arch.

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 Inverted pen grasp. Palm faces more toward operator. The rest is similar
to that shown for modified pen grasp

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 Palm-and-thumb grasp. This grasp has limited use, such as preparing
incisal retention in a Class III preparation on a maxillary incisor.
The rest is tip of thumb on tooth in same arch.

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 Modified palm-and-thumb grasp. This modification allows greater ease
of instrument movement and more control against slippage during thrust
stroke compared with palm-and-thumb grasp. The rest is tip of thumb on
tooth being prepared or adjacent tooth. Note how the instrument is braced
against pad and end joint of thumb.

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 B. Contemporary Powered
Cutting Equipment
1. Rotary Power Cutting Equipment

known as dental handpieces

1. The air-driven handpiece

2. The electric motor-driven handpiece

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 Advantages of Air Driven Handpieces

1. less costly
2. weigh less than electric handpieces
3. size of the head of the air-driven handpiece is usually
smaller.
Advantages of electric handpieces

1. They are quieter than air-driven handpieces,

2. they cut with high torque with very little stalling
3. they offer high-precision cutting
4. Cutting with electric handpieces is smoother and more
like milling,
5. they offer multiple attachments for the motor
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 Rotary Speed Ranges for Different Cutting
Applications
1. low or slow speeds (<12,000 rpm),
2. medium or intermediate speeds (12,000–200,000 rpm),
3. high or ultrahigh speeds (>200,000 rpm).

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 Disadvantages of low speed instruments

1. It is a traumatic experience for the patient and the dentist.

2. Low-speed cutting is ineffective,
3. It is time-consuming,
4. Requires a relatively heavy force application
5. Burs have a tendency to roll out of the tooth preparation

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 Uses of lows peed instruments

1. for cleaning teeth,

2. caries excavation,
3. and finishing and polishing procedures.

Advantages of low speed instruments

1. tactile sensation is better
2. overheating of cut surfaces is less likely.

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 High speed
Uses of high speed instruments
For tooth preparation and removing old restorations.
advantages :
1) diamond and carbide cutting instruments remove tooth
structure faster and with less pressure, vibration, and heat
generation;
2) the number of rotary cutting instruments needed is reduced
because smaller sizes are more universal in application;
3) the operator has better control and greater ease of operation;
(4) instruments last longer;
(5) patients are generally less apprehensive because annoying
vibrations and operating time are decreased
(6) several teeth in the same arch can be treated at the same
appointment
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2. Laser Equipment
uses of lasers in dentistry

1. The treatment of soft tissues

2. The modification of hard tooth structures

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Rotary Cutting Instruments

Common Design Characteristics

Each instrument consists of three parts:
(1) shank, (2) neck, and (3) head .

Shank Neck Head

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 Shank Design
The shank is the part that fits into the handpiece, accepts the
1. rotary motion from the handpiece,
2. and provides a bearing surface to control the alignment and
concentricity of the instrument.

Neck Design
, the neck is the intermediate portion of an instrument that
connects the head to the shank.
The main function of the neck is to transmit rotational and
translational forces to the head.

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 Head Design

The head is the working part of the instrument, the cutting

edges or points that perform the desired shaping of tooth
structure.

characteristics of the heads of rotary instruments

1. Divided into bladed instruments and abrasive heads.
2. Material of construction,
3. head size,
4. head shape

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 Dental Burs

The term bur is applied to all rotary cutting instruments that

have bladed cutting heads.

This includes instruments intended for

1. finishing metal restorations

2. surgical removal of bone
3. instruments primarily intended for tooth preparation.

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 Shapes
The term bur shape refers to the contour or silhouette
‫( )خيال‬of the head.

The basic head shapes are :

1. Round
2. Inverted cone
3. Pear shape
4. Straight fissure
5. Tapered fissure

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 Round bur
Is spherical.
uses
1. for initial entry into the tooth,
2. extension of the preparation,
3. preparation of retention features,
4. and caries removal.

inverted cone bur

Is a portion of a rapidly tapered cone with the apex of the cone
directed toward the bur shank.
Uses
for providing undercuts in tooth preparations.

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 pear-shaped bur
is a portion of a slightly tapered cone with the small end of the
cone directed toward the bur shank.
The end of the head either is continuously curved or is flat
with rounded corners where the sides and flat end intersect.
Uses
for tooth preparations for amalgam.

straight fissure bur

is an elongated cylinder.

Tapered fissure burs can have a flat end with the tip
corners slightly rounded.
Uses
for tooth preparations for indirect restorations
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