Oper Lec 2

The removal and shaping of tooth structure are essential
aspects of restorative dentistry

Initially this was a difficult process accomplished entirely by the.
use of
- Hand instruments.
- Rotary, powered cutting instruments
Hand instruments
Definition: It is hand-powered dental instruments.
G.V. Black is credited with the first acceptable nomenclature
and classification of hand instruments. His classification system
enabled both dentists and manufacturers to communicate
more clearly and effectively in regard to instrument design
and function.
For many years, carbon steel was the primary material used
in hand instruments because they were harder and maintained
sharpness better than stainless steel.
Stainless steel is now the preferred material because stainless
steel instrument remains bright with steam or dry heat
sterilization, and because the properties of stainless steel have
improved by incorporating a significant amount of chromium
imparts corrosion resistance and carbon imparts hardness.
Hand instruments used in operative dentistry may be

categorized as:
1. Cutting instruments and,
2. Non cutting instruments.
Cutting instruments
These instruments are used to cut hard or soft tissue of the
mouth. Hand cutting instruments are composed of three parts:
handle, shank and blade. For non cutting instruments; the part
corresponding to the blade is termed the nib or working end.
The blade or nib; is the working end of the instrument and is

connected to the shank. Some instrument have a blade on both
ends of the handle and are known as double ended instrument.
The blades have many designs and sizes, depending on the
function they are to perform.
The Shank; serves to connect the handle to the blade of the
instrument. The shank may be straight, mono-angle (with one
angle), bin-angle (with two angles) , triple-angle (three angles) ,
or quadr-angle (four angles). The term contra-angle refers to
shank in which two or more angles are present.
The angles in the shank are important to keep the blade edge
within 1-2 mm to the long axis of the instrument. This is a basic
factor to concentrate the force onto the blade for balancing the
instrument during use and prevent its rotation
The Handle; is the part that is grasped by the operator hand
while he is using the instrument
Instrument Formula Given by G.V.Black:
3 Number instrument formula: Cutting edge of the Instrument
is at a right angle to the blade.
a. First number- Width of the blade in tenths of a millimeter.
b. Second number - Length of the blade in millimeter.
c. Third number - Angle the blade forms with the axis of the
handle in centigrade.
4 Number instrument formula: Cutting edge of the instrument

is at an angle other than a right angle to the blade.
a. First number - Width of the blade in tenths of a millimeter.
b. Second number - Angle the cutting edge forms with the axis
of the handle in centigrade.
c. Third number - Length of the blade in millimeter.
d. Fourth number - Angle the blade forms with the axis of the
handle in centigrade.
Examples of the cutting instruments are:
1. Chisel: - either has a straight shank or with slight blade
curvature or bin-angle chisel, and the blade has bevel only on
one side of the edge. Its cutting edge is perpendicular to
the axis of the handle. The chisels are used for cutting enamel
and dentin with pushing motion.
2. Hoe: - It is like chisel with cutting edge is perpendicular to

the axis of the handle, however its blade has a greater angle
from the long axis of the handle than does that of the chisel. It
has the same uses of the chisel.
3. Hatchet: - also called enamel hatchet. The cutting edge of
the hatchet is parallel to the long axis of the handle and
beveled only from one side. It is used for cutting enamel and
dentin and comes as right or left types for using on opposite
Dentin + enamel
sides of the preparation.
4. Gingival margin trimmer: - This instrument is used for

beveling of the gingival enamel margin of proximo-occlusal
preparations. Also it is used for beveling of axiopulpal line angle
of two surface preparation as in class II cavities.
It is similar in design to the hatchet, except the blade is curved,
and cutting edge is at an angle (other than parallel) to the long
axis of the blade. It is made as right and left types. Also it is
made either a mesial pair or a distal pair.
5. Spoon excavator:- The blade is curved and the cutting edge

at the end of the blade is in the form of a semicircle. This gives
the instrument an outer convexity and inner concaving that
makes it looks like a spoon.
Like the hatchet the cutting edge at the end of the blade is
parallel to the handle, therefore there are left cutting and right
Hatchet
cutting spoons. The shank of some spoons holds a small
circular (disk blade) or claw – like blade at its end. The disk
blade is known as a discoid, where the claw - like blade is
Discoid
termed a cleoid.
Non-cutting instruments
In these instruments the blade is replaced by a nib or point.
These are divided according to function into: -
1- Diagnostic instruments
2- Plastic instruments
3- Amalgam instruments
Diagnostic instruments
These are basic instruments that will be needed during each
appointment for diagnosis and treatment.
1. Mirror: used for:
- indirect visualization of any tooth surface that cannot be seen
by the eye.
- reflection of light into the area being examined or treated.
- retractor of soft tissue (tongue, cheek and lip) to aid access
and visualization.
2. Probe or explorer: pointed instruments used:

- to feel tooth surface for irregularities
- to determine the hardness of exposed dentin and caries
detection.
- Probes have different shapes either sickle, straight or angled
3. Tweezer or cotton forceps: used for aiding the operator to
carry small items to the mouth of the patient.
Plastic instruments: Or plastic filling instrument are used to:
- carry and shape tooth colored restorative material such as
composite resin and glass ionomer.
- packing temporary filling material inside unfilled cavities
preparation.
- or for placing of basing and lining material into the cavities. In
past these instruments are made of plastic.
Ash 49: - is double ended instrument with cylindrical nibs and

rounded ends.
Ash 6: - is one of plastic instrument similar to carver but the
margin of its working end is not sharp.
Dycal applicator: - is small hand instrument with small round
nib used for mixing and placing dycal lining material in the
cavity.
Cement spatula: - it is used for mixing variety of material which
required mixing (such as cement or temporary filling material)
on glass or on a paper pad.
Amalgam instruments
Those instruments used to place dental amalgam, and to a
certain extent, resin composite restorative material.
Condensers: - condensers are used to compress the amalgam
into all areas of the prepared cavity. The working end or nib of
the condenser is usually round with flat end (face). The nibs
have different shapes triangular, rectangular or diamond shape
ends
Burnisher: It have different nib shapes: round, oval or rounded
cone shapes, also with different sizes, used for several Amalgam
functions such as; carrier:- used to
carry the
• burnishing of the amalgam on the margins of the cavity. amalgam and
• smoothing of the carved amalgam surface. place into
• shaping metal matrix band to have more desirable contours the prepared
cavities.
for restoration.
bend cast gold restoration (inlay or onlay) near the margin of

the prepared cavity to narrow the gap between gold and theTeeth
Carver: - carvers are used to shape amalgam or resin
composites (tooth colored) material after they have been
in the tooth preparations.
Carvers have many shapes but usually the nibs are flat with
sharp margins for carving
Hand instrument grasping
1. Pen grasp: - It is similar to that used in holding a pen. Pads of
the thumb, index and middle fingers hold the instrument, while
the tip of the ring finger , or tips of ring and little fingers, is
placed on a nearby tooth surface of the same arch as a rest.
The palm of the hand generally is facing away from the
operator
2. Inverted pen grasp: - The finger position is the same as of

pen grasp, but the hand is rotated so that the palm more
toward the operator. This grasping is used mostly for preparing
of upper teeth with indirect viewing technique.
Palm and thumb grasp: - The handle of the instrument is placed
in the palm of the hand and grasped by all fingers, while the
thumb is free of the instrument and used for resting on a
nearby tooth of the same arch
Rotary instruments:-
Handpieces:-
Two basic types of handpieces:
- Straight handpiece: used for laboratory work
- contra angle handpiece: used in the mouth.
The contra – angle handpiece are classified according to their
speed of rotation into:-
Low speed handpiece: have a free running speed range from
500 to 15,000 rpm (revolution per minute).
- used for removal of carious dentin with round bur rotating
slowly.
- used with different bur shapes to finish the prepared cavity
(e.g. rounding of sharp edges, or flatting of the floor).
- used in finishing and polishing of restorations.
High speed handpiece: - have a free running speed above

160,000 rpm and some have speed up to 500,000 rpm.
- Preferred for cutting enamel and dentin.
- Penetration through enamel and extension of the cavities
outline are more efficient at high speed.
Small diameter burs should be used in the high
speed
handpiece.
High speed generates considerable heat during
cutting, even
with small diameter burs and should be used
with water
coolant and high efficiency evacuation.

Oper Lec 2

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Oper Lec 2

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The removal and shaping of tooth structure are essential

aspects of restorative dentistry

Hand instruments used in operative dentistry may be

The blade or nib; is the working end of the instrument and is

4 Number instrument formula: Cutting edge of the instrument

2. Hoe: - It is like chisel with cutting edge is perpendicular to

4. Gingival margin trimmer: - This instrument is used for

5. Spoon excavator:- The blade is curved and the cutting edge

2. Probe or explorer: pointed instruments used:

Ash 49: - is double ended instrument with cylindrical nibs and

bend cast gold restoration (inlay or onlay) near the margin of

2. Inverted pen grasp: - The finger position is the same as of

High speed handpiece: - have a free running speed above

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