Dr.

Nada Ali
 General classification of
operative instruments:

Instruments used for isolation of

the operative filed:
Instruments used for exploring
the operative filed:
Instruments used for removal of
tooth substance (cutting
instrument ):
Instruments used for finishing
and polishing purposes:
Instruments used for
manipulation and packing of
restoratives:
Instruments used for isolation of the
operative field
 To keep the operative filed dry
(cotton roll holders, rubber dam , saliva ejectors and
evacuation tips )
II- Instruments used for exploring the
operative filed :
 Mouth mirrors
 Explorers (dental probe )
 Magnification
Explorers Periodontal probe
III- Instruments used for removal of tooth
substance ( Cutting instruments)
 Hand cutting instuments
 Rotary tools
 Ultrasonic instruments
 Air abrasion technique
 Optical drills ( Laser )
 Hand instruments

Every instrument has three parts:

Handle or shaft
Shank
working part
 Handle or shaft

It is the part grasped in the operator’s hand.

Perfectly straight, smooth, eight sided or
Serrated for better gripping and control of the
instrument.
 Handle or shaft
Data present on the shaft:
Manufacturer’s name.
Name of the instrument designer.
The number of the set or kit.
Black’s formula (usually in the center).
Identifying marks: R or L, or rings.
 Shank
Part of the instrument that attaches the working
end to the handle.
It usually tapers from its connection with the shaft
to where the working part begins.
It may be straight or have one or more bends
 working part

Portion of the instrument with a specific function.

Cutting instruments: blade + cutting edge.
Non-cutting: nib + face.
 Contrangling:

Definition:
Addition of one or more angles to the shank of the
instrument.

Importance:
Accessibility.
Balance.
Better vision.
Best use of the
instrument.
 Contrangling:

Straight

Mono-angle

Bin-angle
 Contrangling:

Triple angled
 Instrument Formula

First number: Width of blade in tenths of a millimeter.

Second number: Length of the blade in millimeters.

Third number: Angle of the blade from the long axis of

the handle in centigrade.
Instrument Formula

??????
 Instrument Formula

If four numbers???
First number: Width of the blade.
Second number: Angle of the cutting edge from the long
axis of the handle measured in centigrade.
Third number: Length of the blade.
Fourth number: Angle of the blade from the long axis of
the handle.
 Instrument Formula

2 Cutting edge angle

1 Blade width

34 Blade Angle

2
3 Blade length
 Hand Cutting Instruments

Types of hand cutting instruments:

 Chisels

The cutting edge is at right

angle to the plane of the shaft.

Mesial: cutting edge mesial to

or nearer to the shaft.
(contra-beveled or reverse
beveled)

Distal: cutting edge distal to

or far from the shaft.
Uses: Cleaving enamel.
 Chisels

2. Wedel steadt chisel:

slight curvature about 5
starting from the shank up
to the cutting edge without
angulations.

The set is two instruments,

mesial and distal.
 Chisels

Modifications of chisels:
1. Angle former:
Triple beveled blade.
The cutting edge is not
perpendicular to the long axis

of the blade, right or left,

Used: for accentuation of line
and point angles.
Enamel Hatchet
 Hatchets

The cutting edge is in the same

plane or parallel to the shaft.
The paired right and left hatchets
have their blades beveled on
opposite sides to form their cutting
edges.
 Hatchets
Uses:
Planning or cleaving enamel walls during cavity
preparation,
Refining line and point angles and
Removal of loose and short enamel walls.
 Hatchets
Gingival Margin Trimmer:
The cutting edge of G.M.T. is at
an angle other than right angle
to the axis of the blade.
The hatchet has a straight blade,
while the blade of G.M.T. is
curved.
 G.M.T.
Usage
 Hatchets

A:Excavators:
They are designed for:
Excavation and removal of
carious dentin.
Shaping of the internal parts
of the cavities.
Forms:
1. Hatchet excavator.
2. Hoe excavator.
3. Spoon excavator.
4. Discoid excavator.
5. Cleoid excavator.
1 - Hatchet Excavator
 Equally bi-beveled. thus the cutting edge
runs parallel to the central axis of the shaft
 Forward push motion.
 Laterally with scraping motion
 sharping internal line angle
 Chisels

2. Hoe excavator:

The blade more nearly

approaches a right angle.

The chisel is normally used
with a push motion, while the
hoe is frequently used with a

pull motion.
 Excavators
Spoon excavator:
The cutting edge is ground to a semi-circle.
Used to remove decayed dentin.
 Excavators
Cleoid excavator: Discoid excavator:
In the form of a claw. The blade is circular.
Uses: Uses:
Removal of any portion of Removal of carious
dentin. dentin,
Carving instrument for Carving instrument for
amalgam and wax. amalgam and wax.
 Instr. nomenclature

Name of instruments:

According to:

1. Purposes, as excavator, condenser, scaler.

2. Manner of use, as hand condenser, push scaler.

3. Form of the blade as hatchet, chisel,.

4. Number of contrangling, as mono-angle hatchet

excavator, bin-angle chesil.
 Hand instruments

How to cut with hand instrumets?

Direct cutting instrument:
In which the force is applied
in the same plane as that of the
blade and handle. It is called a
“single-planed” instrument (e.g.,
Enamel hatchet, chisels).
 Hand instruments

Lateral cutting instrument:

in which the force is
applied at a right angle to the plane
of the blade and handle.
These usually have a curved blade
and are called “double-planed”
instruments (e.g., spoon excavators
and gingival marginal trimmers).
 Hand instruments

Instruments grasps:

Pen grasp:
The most commonly used grasp.
Accomplished by positioning
the hand as for writing.
The instrument is held between
the thumb and first two fingers.
 Hand instruments

Palm and thumb grasp:

Used more often with the upper teeth.
Occlusal and buccal surface of posterior teeth.
palatal surfaces of anterior teeth
 Hand instruments

Rests:
The fingers that are not
used to grasp.
Functions: support and
stabilize the working hand.
Prevent injury of the
tissues.
Rests should always be on
firm tissue of the teeth.
 Hand instruments

Guards:
Guards are hand instruments or other items.
Used: to protect soft tissue from contact with sharp
cutting or abrasive instruments.
 Hand instruments

Sharpening and care of hand cutting instruments:

Importance:
To achieve cutting (cleaving efficiency with minimum
force).
To allow creation of a smooth surface.
To avoid the necessity of exerting heavy pressures, which
invites loss of manual control.
To avoid injury to the tooth from use of excessive force.
To reduce pain.
 Hand instruments

Devices used to sharpen-cutting instruments:

Arkansas stones, either flat or rotary.
Abrasive disks.
 Hand instruments

Advantages of hand over rotary cutting instruments:

1. It will not cut into sound tooth structure leading to more
conservative cutting procedure.
2. It produces no vibration or heat generation; it is thus
painless and more biological.
3. It has efficient cutting; as it can remove large area of
undermined enamel in one stroke, thus saving time and
effort.
 Hand instruments

4. It cleaves enamel at the

interprismatic substance; the
cavosurface margin is
formed of full length sound
enamel rods.

5. It produces smoother, better finished surfaces.

6. Have longer life span.

 Powered cutting Equipments

Power Sources:
Removal of tooth structure can be done using any
of the following power sources:

1. Rotary Equipments:
The most universally
used instruments for gross
removal of tooth structure.
 Powered cutting Equipments

2. The Ultrasonic equipment:

Diamond-coated working tip that removes tooth material
by ultrasonic energy.
 Powered cutting Equipments

3. The Air abrasion equipment:

Tiny aluminum oxide particles
(abrasive) ejected at great velocity by
means of a high pressure gas stream
directed at a definite angle.
Advantages:
Reducing heat, vibration, & noise.
Disadvantages:
Loss of dentist’s tactile sense,
High cost.
Removal of the dust particles.
 Powered cutting Equipments

4. Laser equipments:
Devices produce beams of very
high light intensity.
They can remove tooth substrate
by means of a thermo-
mechanical ablation (micro-
explosions).
Disadvantages:
Inefficient in removing large amounts of tooth
structure.
High cost.
 Rotary
instruments
 Rotary instruments

Rotary
instruments

Hand piece Cutting point

 Rotary instruments

Operating Speed ranges and uses:

1. Regular, low or conventional

speed: (below 12,000 rpm).

2. Higher or intermediate speed

(12.000 to 200.000 rpm).

3. Ultra or super speed (above

200.000 rpm) is accomplished
with the air turbine.
Low speed high speed
 ineffective, time remove tooth structure
consuming faster with less pressure and
 Need heavy force vibration
 Produce heat and Smaller sizes are used
vibrations Better control
 Used for deep caries More comfortable to the
removal , finishing and patient
polishing procedures Several teeth can be
treated in the same
appointment
 Rotary instruments

Cutting Points:
The smallest unit and the one actually removing
tooth structures, may be one of two:

1. Bur 2. Stone.
 Rotary instruments

Bur parts:
Shank:
The shank is secured to the hand piece for the purpose
of driving the bur.
 Rotary instruments

Shaft:
The Shaft connects the head of the bur with the
shank.
Head:
This part of the bur does the cutting by the means of
the small blades located on the metal.

shaft
 Rotary instruments

Burs are classified according to their shanks

into:

1. The friction-grip bur is

used for the ultra-
speed air turbine.

2. The latch type: are

used for regular and
medium-speed
instruments.
Material of construction
Carbon steel Tungsten carbide
 Used
only with low  Higher hardness
speed  Withstand higher
temperature
 More efficient and
durable
 Generate less heat
 Rotary instruments

Round bur
1. Gainig access.
2. Excavation of caries.
3. De roofing of the pulp
chamber
 Rotary instruments
Inverted cone bur

1. Extension of cavity outline form

2. Flattening of pulpal floor
 Rotary instruments
Fissure Bur
1. May be used instead of
the inverted cone bur in
making extension of
cavity walls to obtain
outline form.
2. Finishing of cavity walls
and margins to form
sweeping curves.
 Rotary instruments
Tapered Fissure
Bur
1. Tapered a few
degrees in order to
place wall inclinations
for the cast gold inlay.

2. The burs are

selected to produce
grooves for retention
of the proximal
amalgam and inlay
restorations.
 Rotary instruments

Finishing bur The blades are shorter and closer

together than in other burs.
They are used for finishing and
polishing of metallic restorations.
 Bur Design

Design of dental bur:

The bur head may be

divided into 6 or 8 blades
(also called teeth, flutes).

Each flute or blade has a

leading side “Face”, and a
trailing side “Back” with
an angle in between, called
Clearance
the “flute Angle” or blade angle

angle.
 Bur Design

Clearance Angle:

It is the angle between the

back of the blade and the
“work”

It acts to decrease the

friction between the back
of bur blade and the work
or tooth tissues during Clearance
cutting, and therefore, angle

decrease heat generation.

 Bur Design
Clearance or Chip Space:.
The space between each two
successive blades
A space where the chips
formed during the cutting
procedures collect and get
eliminated.

Too small, the formed chips

will remain in-between the Clearance
bur blades, causing its angle

clogging generation of more

heat and loss of
effectiveness.
Bur Design
 Bur Design
Rake Angle:
An angle created between the face of the blade with the
radius of the bur .

The rake angle may be positive, Zero (radial), and

negative, depending on whether the radial line is ahead,
over-lying. Or tailing the face of the blade respectively.
 Bur Design

where the radial line is ahead to the

Radius face of the blade.

A positive rake angle enables the blade

to cut more effectively.

making the rake angle more positive

can only be attained by thinning out the
blade.

This will cause the blade to become

weak and to turn and lose its
effectiveness quite more rapidly.
 Bur Design

Zero Rake Angle: where the

radial line is over-lying the face
of the blade.

A positive rake angle enables

the blade to cut more effectively
than a zero one.
 Bur Design

Radius
Negative rake angle: where the
radial line is tailing the face of
the blade.

A positive rake angle enables

the blade to cut more effectively
than a negative one.
 Cutting efficiency

Cutting efficiency:
It is the ability of the instrument to remove a
maximum amount of tooth tissues with a minimum of
effort and time involved.

Factors influencing the cutting efficiency of burs:

1. Bur design.
2. Composition of the bur.
3. Tissues to be cut.
 Cutting efficiency

1. Bur design:
The number of blades.

The more positive the rake angle the more

effective is the bur in cutting.
 Cutting efficiency

The round bur is a most efficient end-cut and is

therefore, used in gaining access through the enamel.
N.B. the inverted cone and the fissure burs are effective
as lateral cutting tools.
 Cutting efficiency

The ability of an inverted cone bur to remove tooth

structure per unit of time has been estimated to be 5
times that of a fissure bur under similar conditions.
Fissure bur is about 3 times that of a corresponding
size inverted cone, so the latter is said to be 15 times
more efficient.
 Cutting efficiency

2. Composition of the bur:

Tungsten carbide Steel

high hardness. Low Hardness.
Greater strength at
Lower melting point.
higher temp.
Cut dentin at low
Cut in enamel &
speed.
dentin at high speed.
 Cutting efficiency
3. Tissues to be cut:
Enamel
Organic
Water 2%
10%

Minerals
88%

Dentin

Water
25%
Minerals
50%
Organic
25%
 0.025 mm
Eccentricity or Run Out:
It is maximum displacement of
the periphery of the working
point of an instrument or tool
from its central axis.
A bur or a stone is said to be
eccentric if this lateral
displacement is more than 0.025
Vibration.
of a millimeter.
Loss of efficiency.
Heat Generation.
The influence of speed
 Thisis the rotational speed at which a
rotary tool will be cutting at its maximum
rate.
 Cutting rate depends on the time of
cutting, the rotational speed (rpm), the
area of tooth to tool contact.
 Carbide burs needs higher rates than
those for diamond points and stones
 Heat generation

Heat generation:
Heat is generated due to:
The friction between the tool and the tooth.
Friction is increased Application of pressure.
Use of higher speeds.
Larger size tools are used.
 Heat generation

The use of Dull tool is used. This is attributed to:

The greater pressure needed to effect cutting.
The greater area of friction the dull blade will
provide in contacting the tooth.
The longer the time the rotary tool remains in
contact with the tooth, the more is the amount of
heat generated.
 Heat generation

The frictional heat generated during

operative procedures will be dissipated
through:
The tool.
The surrounding atmosphere.
The formed chip.
The tooth.
 Heat generation

The dentin is an excellent thermal insulator with a

thermal tolerance of 58” to 130” F.
it can protect the pulp against temperatures
between these extremes.
But if it is subjected to temperature changes beyond
these extremes:
Pain and,
Pathologic changes in the pulp.
 Heat generation

It is essential that a type of coolant be used,

especially if higher speeds are employed, to control the
rise of temperature.
Types of coolants:
Water,
Air or

water-air spray ☺
 Heat generation

The coolant serves to:

Control the temperature at the cut surface of the tooth.
Keep the working field clean.
Improve visibility.
Clean the tool and prevent its clogging with debris.
Lubricate the tooth surface and hence make the
cutting easier and more rapid.
Decrease the need of local anesthesia.
 Heat generation

Frictional heat generated is controlled by:

 Correct use of sharp tools of the proper size.

 Application of minimal force on the rotating tool.

 Selection of the proper rotational speed.

 Use of a coolant, multi-directed
and at body temperature.
 Matrices

Matrices:
A dental matrix is that piece of metal or
non-metal which is used to support and give
form to the restoration during its packing and
hardening.
Types of matrices used according to:
Cavity preparation design and the
Type of restorative material being used.
 Matrices

Importance of Matrices:
It serves as:
Temporary wall during condensation of plastic
restorative material.
To give shape and contour to the restoration and
prevent marginal overhangs.
To maintain this form of the restoration until it
hardens.
 Matrices
Types of matrices
Ready-made : holder and matrix band usually
made of stainless steel including:
1. Ivory matrix holder No.1. this type is used for
compound II cavity preparation, either OM or
OD for amalgam restorations.
 Matrices

2. Ivory matrix holder No.8.; this type is used for

compound and complex cavity preparations
since its matrix band totally encircles the tooth
structure.
 Matrices
3. Tofflemire/Universal matrix system; this matrix is
ideally indicated for compound or complex class II
restorations.
The best in its stability,
Anatomic adaptation,
Suitability for most of the cases and
Ease in introduction and removal.
 Matrices

4. Automatrix; it is a ready-made band loop that

encircles the prepared tooth and becomes tightened
by a specially associated device.
used for compound and complex cavities when
minimal tooth structure is available, i.e. in
extensive preparations.
 Matrices
Matrices for tooth-colored restorations
1. Clear polyester matrix;
Uses:
For class III, resin composite restorations.
Clear matrix; suitable for large Class II and IV
composite restorations.
 Matrices

2. Thin metal matrix; it is used with Class II resin

composite restorations.

3. Sectional Matrix; it is a soft metal matrix band

used with special retainer in the form of a ring to be
used in Class II tooth-colored restorations.
 Matrices

4. Cervical clear matrix; used for Class V light-cured

tooth colored restorations. These forms have a small
handle to aid in picking them up.
 Matrices

5. Anatomic metal matrix used for both light and

chemical cured resins as well as glass ionomer in
Class V
 finishing & polishing

Instruments used for finishing and polishing purposes:

The restorative materials should be finished and
polished to smooth lustrous surface.
This can be done either using:
Hand instruments:
Knifes and scalpels.
Finishing strips.
 finishing & polishing

Rotary instruments:
Finishing burs, fine diamond finishing instruments and
abrasive discs.
Rubber polishing point or cup rotating at low speed.
 Powered cutting Equipments

2. The Ultrasonic equipment:

Diamond-coated working tip that removes tooth material
by ultrasonic energy.
 Powered cutting Equipments

3. The Air abrasion equipment:

Tiny aluminum oxide particles
(abrasive) ejected at great velocity by
means of a high pressure gas stream
directed at a definite angle.
Advantages:
Reducing heat, vibration, & noise.
Disadvantages:
Loss of dentist’s tactile sense,
High cost.
Removal of the dust particles.
 Powered cutting Equipments

4. Laser equipments:
Devices produce beams of very
high light intensity.
They can remove tooth substrate
by means of a thermo-
mechanical ablation (micro-
explosions).
Disadvantages:
Inefficient in removing large amounts of tooth
structure.
High cost.
Thank

you