Dr. Sazan M.

Azeez

Instruments in Assistant Lecturer

(BDS, MSc)

Operative
Dentistry(rotary) 3 rd. YEAR

2021-2022
Dr. Sazan M. Azeez
Assistant Leet u re r
(BDS, MSc)

Department of
Conservative
Dentistry
ROTARY CUTTING INSJRUMENTS

Rotary cutting instruments are those

instruments wt;iich rotate on an axis to do
the work of abrading and cutting on tooth
structure .
Types of Rotary Cutting

shutterstock.com · 406234345
 Hand pieces

Definition and function: it's a device used for:

-Holding rotating instrument (Burs).
-Transmitting power to them.
-Positioning them intraorally.
Speed ranges:
Measured by revolution per minute (rpm)
Low or Slow speed below 12,000 rpm.
Medium or Intermediate speed 12,000 - 200,000 rpm.
High or Ultra-high speed above 200,000 rpm.
 Slow speed
Tooth structure can be removed by slow speed but this must be avoided,
Why?????????
-Traumatic experience.
-Time consuming.
-Require heavy force.
-Excessive vibration and heat generation.
-Burs have tendency to roll out of cavity
-Carbide burs easily broken by slow speed and high pressure.

So it has limited uses for:

-teeth cleaning.
-caries excavation.
-finishing and polishing.

5
 high speed
Advantages over slow speed
-Remove tooth structure much more faster.
-Less pressure required.
-Less vibration and heat generation.
-Better controlled by operator and easier for use.
-Instruments (burs) last longer.
-Patient less apprehensive because annoying vibration and time reduced.

6
 Types of handpiece according to design

*Contra-angle
*Straight
Contra-angle:ln this, head of handpiece is first
angled away from and then back tmwards the
long axis of the handle ,Because of this design,
bur head lies close to long axis of the handle of
hand piece which improve accessibility visibility
and stability of handpiec:e while working.

F igure 7 .35 : Photograph showing airrotor contra-angle handpiece

Figure 7.36: Photograph showing micromotor contra-angle

hand piece
 Airmotor contra-angle handpiece:

-This handpiece has high speed ara d low torque

-Speed range is 100.000-300.S0® rpm
-Used for tooth preparation and removal of old
restoration
 Micromotor contraangle handpiece:

-It has high torque and low speed

-Used for finishing and polishing procedure
 Straight

-In straight handpiece, long axis of bur lies in

same plane as long axis of ha na piece
-It is used in oral surgical an d laboratory
procedure
 Dental Burs

Is rotary cutting instrument

Variable size, type, shape .... . to:

-Accommodate particu la r handpiece.

-Accommodate pa Ftic: ular clinical application

Classification of bur according to their
composition

Stainless steel tungeston carbide bur a combination

of both
Stainless steel burs
-These were the first developed burs designed for
slow speed.
-Usually a bur has eight olades with positive rake
angle for active cutting of dentin. But this makes
steel burs fragile, so they do not have a long life
- Used for cutting soft carious dentin and finishing
procedures.
Tungsten carbide burs
-Designed to withstand heavy stresses and increase
shelf Iife
-Working best beyond 3,00,000
- Have six blades and negative rake angle to provide
better support for cutting edge
-cut metal and der:1ti ra very well.
 Other Classifications of Burs

According to their mode of attacHments to

the handpie[ e

latch type Friction grip type ,

According to their length of their head

Long regular
 According to their use

Cutting polishing
 According to their shape
Round:
Initial cavity preparation.
Extension of preparation.
Preparation of retention grooves.
Removal of caries.

Straight fissure:
For amalgam cavity preparation.

Inverted cone:
Providing undercuts and planing cavity floors.

Pear:
For cavities of amalgam.

Tapered fissure:
For indirect works (inlay/onlay, crown .... ) free of undercuts.
 Head Design

Inverted
Round Straight cone
Fissure

Pear Tapered
20
Fissure
 Blades Design

Plain-cut (non cross-cut)

Advantages:
High quality surface
Durable.
Disadvantages:
Less cutting efficiency.

Cross-cut:
Advantages:
High cutting performance.
Disadvantages:
Low quality surface (rough).
Less durable.
21
Parts of a Bur
Shank: Shank is that part of the bur t hat fits into
the hand piece, accepts the rotary movement from
the hand piece and controls the alignment and
concentricity of the instrument.

The three commonly seen instrument shanks are:

- Straight shank
-Latch type sha r:1 k
- Friction-grip shank
 shank design

Q 2:=
J ----_-_-_-_.
Grasped by metal chuck
-----------------'---.
.
_Q .
...,___ _ _ _ _ _ 1.250 _ _ _ _ _ _..,.I

Grasped by D-shape
socket and retaining latch
... ...• t
{ C ·!···f--····o
•
••
••••
_____ _
.i . __
a~-----~1--0
' I
Grasped by plastic or
0.0628
I
14 0.500 - -'P1~
t
- ~ -k
I I

A = St raight.
B = l.:atch type.
C = Friction grip.

24
Neck: The neck connects the sha rik t o the head.
Transmit rotation and translati onal forces to the
head

Head: the working Rart of the instrument

 Bur Design

Bur head consists of uniformly spaced blades

with concave areas in betweerii t nem. These
depressed areas are called c: hip or concave
flute space, normally, bur has 6,8 or 10
number of blades.
Bur blade: blade is a projection 0rn tn e bur head
which forms a cutting edge.
Blade has two surfaces b(I
- Blade face/Rake face: or:i the leading edge
- Clearance face: on t he trailing edge

--------
Clearance
Cutting ;dge-----
face
Clearance
angle

----- ---
•
Rake angle: This is angle between the rake face
and the radial line(Radial line : line connecting
the center of bur and the blade}
------edge____ __
Cutting
Clearance
face
Clearance
angle

---- ----
•

* positive rake angle: when rake face trails the radial line
*Negative rake angle : when the rake face is ahead of radial line
*Zero rake angle: when rake face and radial line coincide each
other
 Radius

Positive rake Radial or "O" Negative rake

Iii angle g rake angle a angle

Negative
Negative rake angle occurs whe ra t he rake face
(the surface toward the directi0n of cutting) is
ahead of the radius. Negative angle is preferable
for cutting hard, brittle materials as its
increasing the edge angle that make the edge
more fracture resistant. Positive rake angle
decreases the edge angle that make the edge
more efficient but less durable because easily
dull or broken.
Clearance angle:
The angle between the clearance face (the
surface opposite to cutting direction) and a
line tangent to the edge and perpe ndicular to
radius. clearance space prevent olade from
digging into tooth excessively. a greater
clearance space to pro\li de sufficient room for
the cut
chips.

---- --- --- ---- •

Blade angle(edge angle): the angle between the
rake face and the clearance face mmE ,,TOAXISOFBUR

RAKE FACE /
ARANCEFACE --=•- - ----'

Concentricity: measureme nt of symmetry of bur

head(measure wheth er Bl ades are equal in
'
length or not)
Run out(eccentric): it is displacement of rotary
tool from its central axis.
Runout occure if:
-Bur head is off center on the axis of bur
-Bur neck is bent
-Bur is not held straight in handpiece chuck
Effects:
Vibration
Larger cavity than bur diameter
 Bur features affecting cutting efficiency
1- Cross-cut:(notches along the blade)
I
More pressure per unit area.
I
2- Neck diameter:
Larger permits more pressure without fracture
3- Head diameter:
Larger= more surface speed.
4- Spiral angle:
Excessive increase of the angle decrease cutting
efficiency.
5-Number of blades
6-Concentricity
Blade
direction /
Axis

34
 6-10 Excavator 12-40 Finishing

35
 Diamond burs
Diamond is the hardest of all known materials. When bonded to
stainless steel through a special metallurgical process, it can be
used to create a cutting edge with superior cutting ability.

Diamond burs are generally used for reducing tooth structures to

place crowns or porcelain veneer. Diamonds may also be used to
smooth, refine, and polish composite or porcelain
material.

However, compared with carbide burs, diamond burs usually

have a more pronounced decrease in cutting effectiveness over
time leading to a shorter lifespan.
Types of Diamond Bur Shapes
Unlike carbide burs, which are available in a
variety of shank types, diarnor;ia burs are most
commonly friction grip t¥Re because they are
used primarily in high speed handpieces.
However, similar to carbide burs, they come in a
variety of head sha~es and sizes.
 Inverted cone Taper d round 9
Round Cylinder round

Tapered e lipse-sha ped

Round with collar Pear 1
Cylinder pain d

Bud
Inverted cone Cylinder,
Pained
end-cu ing only

Egg
Inverted cone
with collar Tapered

Special

Diabolo
Cylinder Tapered
wi h rounded edaes wi h rounded ed es
38
Diamond Bur Grits
Diamond burs also come in a variety of grit
sizes. Coarse and super-coarse diamond grits for
tooth reduction , witli f ine and super-fine for
polishing and smoothing .
 Dentist position
• Chair position is a very important aspect in the
success of a dental treatment.
• The correct positioning helps the operator to
have a good visibility and accessibility of the
oral cavity
• If operator maintains proper position, the
operator is less likely to get strain, fatigue, and
less chances ef getting musculoskeletal
disorders.
 Chair position

► For restorative dental procedures, the most

preferred operating positions are:
1. Upright position, The initia l position.
2. Almost supine, patient Head, knees and feet are
approx. At same leve l.
3. Reclined 45 degree, Patient's head should not
be lower than feet except in case of syncopal
attack.
► The most common patient positions for
operative dentistry are almost supine or reclined 45
degrees.
Chair position

4
 Operating positions
For better understanding, sitting positions of operator
are related to a clock.

• The operator's positions:

• (right handed operator)
• 7 o'clock, 9 o'clock, 11 o'clock, and 12
o'clock
• Left handed operator's positions,
• 5 o'clock, 3 o'clock and 1 o'clock.
 Operating positions
► Right front position (7 o'clock)
1. It helps in examination of the patient
2. Working areas include:
a) Mandibular anterior
b) Mandibular posterior teeth (right
side)
c) Maxillary anterior teeth
 Operating positions
► Right position (9 o'clock)
1. In th is position, dentist sits exactly
right to the patient
2. Working areas include:
a) Facial surfaces of maxillary right
posterior teeth
b) Facial surfaces of mandibular right
posterior teeth
c) Occlusal surfaces of mandibular
right posterior teeth.

7
 Operating positions
► Right rea r position (11 o'clock)

1. In this position, dentist sits behind and slightly

to the right of the patient and the left arm is
positioned around patient's head
2. This is preferred position for most of denta l
procedures
3. Most areas of mouth are accessible fro m this
position either using direct or indirect vision
4. Working areas include:
a) Palatal and incisal (occlusal) surfaces of
maxillary teeth
b) Mandibular t eeth (direct vision).
All maxillary teeth (indirectly by mirror (
Directly without mirror for labial surface of
maxillary anterior and lingual surface of
mandibular anterior specially right side
 Operating positions
Direct rear position (12 o'clock) ►
1. Dentist sits directly behind the patien...___...r-:---------,
and looks down over the patient's
head during procedure.
2. Working areas are lingual surfaces of
mandibular teeth.
3. This position has limited application.

9
I -Right front: working field include Mandibular anterior
Maxillary anterior
Mandibular posterior (right and left)
2-Right: working field include
Buccal surface of maxillary and mandibular posterior Occlusal of
right mandibular posterior
3 ight rear: working field include
)All maxillary teeth (indirectly by mirror (
Directly without mirror for labial surface of maxillary anterior and
lingual surface of mandibular anterior specially right side
4Direct rear : working field include lingual surface of mandibular
anterior teeth
 22

Operator Positions
 Considerations regarding patient position:
1. While doing work in maxillary arch, maxi llary occlusal
surfaces should be perpendicular t o the floor.
2. In mandibular arch, mandibul ar occlusal surface
should be oriented 45° to t he floor.
3. Maintain proper working distance during dental
procedure.
4. Operator should not rest forearms on the patient's
shoulders and harids on the face of the patient.
Cons1derat1ons regarding patient position:

s. Dentist should not use patient's chest as a

instrument tray.

6. The operator should leave left hand free during

most of dental procedures for retraction using mouth
mirrors or fingers of left hand.

7. Operator should keep changing position if

procedure is of long duration to decrease the muscle
strain and fatigue.
 23

REFERENCE

Art and science of operative dentistry-6 th Edition chapter (6 & 7).

1790