Q: in formula of periodontal instrument is 15,38,84,13, The angle of cutting edge is

A. 15= width of the blade

B. 38 = angle of the cutting edge*************( 2nd number)
C. 84 = length of the blade
D. 13 = angle of the blade
Q:GV black cutting instrument angle :
A. First
B. Second
C. Third
D. Fourth
A method of defining dental hand instruments devised by G. V. Black (1836-1915). It
consists of three figures (sometimes four). The first figure denotes the width of the blade in
tenths of millimetres; the second denotes the length of the blade in millimetres; and the third
describes the angle of the blade in relation to the shaft and is measured in hundredths of a
circle (centigrades). A fourth number is added if it is necessary to additionally describe the
angle of the cutting edge to the instrument shaft, such as for margin trimmers; the fourth
number is entered in brackets as the second number of the formula.
 Instrument stabilization (grasp, rest, guard)
INSTRUMENT GRASP
Standard pen grasp (not used)
Modified pen grasp
Inverted pen grasp
Palm and thumb grasp, modified palm and thumb
FINGER REST
Conventional
Cross arch
Opposite arch
Finger on finger , extra oral rest
Both useful for stabilizing instruments during sharpening & for manipulating air & water syringe

Not recommended for periodontal instrumentation

1- Intraoral inter-arch finger rest

 Extra-oral PALM UP( for right side) :- the palm fulcrum is established by resting the backs of
the middle finger &fourth finger on the skin overlying the lateral aspect RT side

Guards
A. Hand instruments or other items such as interproximal wedges used to
protect soft tissue from contact with sharp cutting or abrasive
instruments
B. May be mouth mirror, check retractor, lip retractor or even the operator’s
own finger of the other hand.
C. This should be placed in the direction of movement of instrument
D. Advantages
• Avoid accident slippage of instrument.
• Prevent injuries
Scaling and root planning --- pull stroke not push
Cutting hand instrument ---- push motion (as chisel, hatchet)
 1. Bur least heat generation carbide, while with highest diamond.
2. To plane line angle(straight), smoothening enamel margin (mono angled)
Plane line angles of proximal cavity by bi-angled chisel, but triple angled chisels to flatten
pulpal floor
3. Enamel hatchet --- heavier blade chisel to cut enamel margins (provide proper cavosurface
margin) Enamel hatched is used for planning l, f line angles during cavity preparation
4. To form internal line angles and retentive groove for dentine scratch and beveling angle: angle
former. , to leveling line angles --- enamel hoe
5. Remove loose enamel rod at the gingival floor from class II – gingival trimmer
6. The most retentive pin ,post is Self-threaded
7. Carbide 12 fluted bur used to finish composite, 30 flutes carbide bur for smoothening the
surface before polishing
- aluminum oxide disc or paste used to finish GI after 24hrs .( knife or scaler immediate,
finishing stones later)
8. Sharpening of hand instrument mounted air driven better than unmounted due to fine grift
9. Unmounted better due to less particles of instrument are removed.
Bur used to make grooves for veneer or on composite veneer: tapered round ended carbide
Dark color in dentin remove with Large excavator
But, the hard caries in dentine remove with round carbide bur low speed
‫ھاد الكالم موجود باالصدار‬.. oxford
Q: Excavation of deep carious dentin which is contraindicated to use:
·Low speed round bur
·Low speed fissure bur
·High speed round bur with stall out speed
- Most recommended instrument to use during deep caries excavation are {low speed
round bur }
- Contraindicated to use during dentin excavation is: a high speed
- Stall out speed it means change high speed to low speed by foot control outside the
cavity.
- Fissure bur never use in deep cavity either high speed or low speed
10. Removal of caries --- large round bur from periphery to center
11. Use no. 33½ inverted cone bur. OR no 35 inverted cone bur for slot preparation
12. In standard instrument for proper work the cutting edge should be: perpendicular to the handle.
*** (cutting edge of the blade is at a right angle to the handle of the instrument).
13.Which part of periodontal instrument is parallel to long axis of the tooth
A. hand
B. blade
C. shank ***
D. cutting edge
celluloid matrix composed of: Bis-gamma
Types of matrix metal (criumferantial for amalgam restoration or MOD
composite restoration of sectional better for proximal composite
 Celluloid matrix
Mylar strip class iii
Cervical strip class V
Celluoide crown or crown former class iv

Blade no 12 for what→ Incision-suture cutting, they are also used within
Dental surgery for raising skin flaps and for removing excess polymerized
composite resin on the facial and interproximal region of the tooth.

Operator positions and zones

* For right handed dentist,
1. Operator Zone : 8 _ 11 o’clock.
2. Static Zone : 11 _ 2 o’clock.
3. Assistant Zone : 2 _ 4 o’clock.
4. Transfer Zone : 4 _ 8 o’clock.

To plan the line-angles in the proximal cavity in a class II you use:

A. Straight chisel.
B. Bin-angled
chisel.*******************************************************
C. Enamel hatchet.
d. Beveled chisel.
To plane the facial and the lingual wall of enamel, which enamel will use
A. Straight chisels.
B. Bin-angled chisel.
C. Enamel hatchet. **************
For post dam ( posterior palatal seal )
1- T-bunisher to locate it intraoral
2- kingsley scraper --- to scrap on the model
 Oral Surgery
1. Curved hemostat: use in suturing of lower 8

2. Walsham's forceps: for nasal fracture treatment, and if nasal bone is deviated it will be
straightened by Ash's forceps afterward.
 3. Allis forceps: to hold tissues prior to excision (epulis fissuratum}

4. Adson forceps: to hold tissues for suturing

5. Still’s forceps :for wisdom teeth suturing because it is longer than adson's forceps.

6. Artery forceps: to ligate ruptured arteries or arteries planned to be removed.

7. Metzenbaum scissors are surgical scissors designed for cutting delicate tissue and blunt
dissection.
How do you retract flap of up. Lip with bland-end scissor?
Metzenbaum scissor.
8. Minnesota retractor: retract flap and cheek together.

9. Farabeuf retractor the retractor which retract the flap and the cheek together when
doing surgery

During extraction of mandibular premolar tooth dislodged in oral cavity, which

instrument is used to retrieve it? Russian Tissue Forceps *********
Russian Forceps are medium-heavy forceps used for grasping heavy or thick
tissue. They are also used during wound closure.
This product is straight with Atraumatic, radially serrated, cupped tips.
The length is 6 inches

All elevators are basically levers; they are used to apply a large amount of force on the tooth or root to
be removed. It needs a fulcrum
Parts of elevators
1. Handle (May continuous with the shank or at right angle to it)
2. Shank
3. Blade (part which engage the tooth)
Blade Use

10 Extra oral incisions

11 Stab incision in perio, apical ,abscess

incision in surgery

12 Tuberosity incision Undercut posteriorly

over crest removal
Incision-suture cutting, they are also used
within Dental surgery for raising skin flaps
and for removing excess polymerized
composite resin on the facial and
interproximal region of the tooth.

15 ( universal –most common ) For all flaps

Suturing material
1.non- absorbable 2.Absorbable
Need to be removed by surgeon Not need removal
1.slik (black or white)—natural 3/0 1.cat gut (natural from intestine of the sheeps)
2.nylon synthetic substitute for silk it is absorbed by proteolytic enzymes
3.prolene (poly propylene ,pigmented blue ) Plain cut gut ---absorbed 7-10 days
4.mersilene polyester fibers Chromic cat gut ---18-21 days
5. wire (steel nickel chromium extra orally) 2.synthetic (poly glycolic acid)—vicryl , dexon
6.cotton : not used now Absorbed by hydrolysis by action of phagocytic
cells
Absorption ---2-3 weeks

1.monofilaments 2.multi-or -polyfilaments

Made of single strand Made of several fibers that braided or twisted
Nylon ,prolene ,catgut Silk, mersilene , vicryl
Dental Forceps It is the instrument used for tooth extraction.
All Forceps Consists of: no shank in the extraction forceps
Two handles +One joint ( hinge)+ Two blades (peaks)
forcep uses
Universal # 150 Maxillary universal
Universal # 150S PEDO Maxillary universal
Universal #151 Mandibular universal
Universal # 151 S Pedo mandibular universal

Cow horn forcep Posterior mandibular molars

Ash forcep Mandibular premolars

The instrument used to remove half of a root after fracture: Crane pick Crane indicated for
removing half of the root

Diameter of suture used commonly in oral cavity is: •

0.2
Size of suture used commonly in oral cavity is: • 3/0.
Metric scale of suture used commonly in oral cavity is: • 2

10. Needle gauge of aspiration :18- 19 gauge with 5mml syringes

Gauge Diameter IN MM uses

25 0.508mm Anesthesia
27--- most common used o.417mm Anesthesia , RCT irrigation
30 0.315 Mainly RCT irrigation
18, 19 18--- 1.219mm Aspiration biopsy
19----1.016mm

: Bone file or rasp

It is a double-ended instrument with a small and large
end.
Used only for final smoothing of the bony ridge in one
direction after gross removal with the Rongeur.

Closure of the wound (suturing)

Surgical Needles
Two basic configurations for curved needles
1.Cutting: triangular edge can cut through tough tissue, such as skin and mucoperiosteum
2.Tapered: non cutting round edge. For softer tissue inside the body “mucosa”
Principles of suturing
1.suture needle should be suitable size and shape(circular 3\8 most widely used) to be more accessible
2.insertion of needle 2-3 mm away from the free edges
3.suture should not be too tight
4.the knots should be tied 2-3mm away from the incision line
5.suture end is cut 4-5mm away from the knot
6.suture removed 5-7 days after surgery but ny suture with pus or signs of infections should be removed
immediately
Types of Closures
● Simple interrupted closure – most commonly used, good for shallow wounds without
edge tension
● Continuous closure (running sutures) – good for hemostasis (scalp wounds) and long
wounds with minimal tension
● Locking continuous - useful in wounds under moderate tension or in those requiring
● additional hemostasis because of oozing from the skin edges
 Files lengths (21,25,31)
File taper (2%, 4% , 6% ,8%)
Length of the working part is 16 mm
The degree of tapers means that file increase in diameter from D0 (diameter at the tip
distance zero to the D16 (diameter at distance 16mm end of working part)
D0 is constant according to file size not changed by change the taper
D16 – change according to degree of taper
‫ مثال للشرح‬file 30 ( taper .02 , 0.6)
File 30 0.02 taper 2%
D0= size of file \100= 0.3
D16 = (degree of taper *16) + D0 =( .02*16)+0.3=0.62
For file 30 .06 taper
D0= 30\100= 0.3
D16= (.06*16) +0.3 =1.26
Note: iso standard gutta percha is the same sizes as standard files
Conventional gutta percha not standardized (fine ,medium ,large)
 Rotary files: convex triangle cross section
The S-FILE is the endodontic instrument with the perfect blend of flexibility, durability and cutting ability.
This unique instrument can be used with any hand motion to provide increased clinical safety and
enhance tactile control of all canal preparation procedures. A combination between a K-File and H-File

s- files used to remove guttapercha from the canals

The different between Hedstorm file & K file:

OR Hedstorm better than K file due to:
OR H file more efficient in cutting than K file:
a. More positive rank angle***
b. More negative rank angle
c. Sharp tip
d. More in width
The H file has more cutting surface than the k file
The Hedstorm file has more than K-file:
hedstrom file has more flutes than reamer
hedstrom file is a type of k-files which has more cutting efficiency than other files
Definition of a rake angle is the angle between the leading edge of a cutting tool and a perpendicular to
the surface being cut.
Gates-Glidden burs These are bud-shaped with a blunt end( 6 instruments diameter start from
0.5 to 1.50) and are used, at slow speed, for preparing the coronal 2/3 of the canal.

Looks like gates gliden but working part larger , longer , used to remove gutta-percha during
retreatment , or during post space preparation

Sizes from 1-6 , diameter from 0.7 to 1,70

Size 1 – lower incisors
Size 2,3 – posterior molars , premolars
Size 4--- upper lateral
Sized 5 ---canines
Size 6 --- upper central

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