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Dental Instruments
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Learning Outcomes
• Classify the main types of dental instruments and their uses.
• Identify the materials used in manufacturing hand instruments and
explain their properties.
• Describe the key parts of hand instruments and their functions.
• Name dental instruments based on their function and design.
• Demonstrate correct instrument grasp techniques.
• Explain the procedures for cleaning, sterilizing, and disposing of dental
instruments.
• Compare different sterilization methods and discuss their advantages
and disadvantages.
• Recognize the limitations of alternative disinfection methods.
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Introduction
Hand instruments are those instruments that are
used manually without a power source.
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Classification of dental
instruments
Hand Rotary Auxillary
Condensing/packing Scalers High Low
Speed Speed Fibreoptic Ultra sonic
Carving/finishing
lights scalers
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Marzouk
Hand instruments
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Cutting Instruments
,
Hand cutting instruments are manufactured
from two main materials
Other alloys of nickel , cobalt , or chromium are used in the manufacture of
hand instruments
Stainless Steel Carbon Steel
Corrosion-resistant High risk of Corrosion
High cost Low cost
Lower thermal conductivity Higher thermal conductivity
Superior surface with Dull matte finish
lustrous finish
Less hard More hard
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Cutting Instruments
Tungsten carbide inserts or blades to provide
more durable cutting edges (brittle). They may
be soldered to steel handles .
Some instruments are made with carbide to
provide more durable cutting edges .
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Design
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Blade
working part of the instrument.
connected to the handle by the shank.
has a cutting edge-working part of the
instrument.
Has a bevel (acute angle) that cuts into the
tooth structure.
On non cutting instruments e.g. condensers the
part corresponding to the blade is called the tip.
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Shank
Connect the handle to the working end of the
instrument.
Normally smooth, round and tapered.
Have one or more angles to avoid twisting of
the instrument.
Balance allows for the concentration of force
onto the blade without causing rotation of the
instrument.
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Handle
It is the part grasped in the operator’s hand.
Perfectly straight, smooth or eight sided.
Serrated for better gripping and control of the
instrument.
Handles are in conjunction with the shank or it
may be separable.
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All instruments are classified by name
according to:
a) Function e . g . scaler, excavator .
b) Manner of use e.g. hand condenser.
c) Design of the working end e.g. spoon excavator,
sickle scaler nomenclature.
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Instrument Grasp
• Modified Pen Grasp
• Permits the greatest control of the instrument, while simultaneously
maintaining ergonomic positioning of the wrist and elbow
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Instrument Grasp
• Inverted Pen Grasp
• Similar to modified pen grasp,
but with palm facing the
operator
• Used mostly for tooth
preparations employing the
lingual approach on anterior
teeth.
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Cleaning and Sterilization
All instruments need to be cleaned and
thoroughly dried before they sterilized .
Cleaning
Hand Automated Ultrasonic
scrubbing washer cleaning
1- Manual cleaning of
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instruments
Advantages
Effective if performed properly.
Disadvantages
Increases chances for operator injury.
Increases spread of contamination through
splatter.
Labor-intensive.
Need proper care of scrub brush
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O Heavy-duty gloves (utility gloves)
provide extra protection while
handling instruments during the
cleaning, rinsing, drying, packaging
and sorting procedures that take place
during instrument reprocessing .
Utility gloves
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2- Ultrasonic Cleaning of
instruments
Advantages
Safer than manual cleaning .
Effectively cleans all instruments . Reduces
chances for spread of contaminants through
splatter.
Allows for more efficient use of staff time
Disadvantages
Microorganisms may accumulate in cleaning
solution.
Ultrasonic cleaning will not remove
hardened Permanent cement , (Solution:
remove cement while it is still soft.).
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3-Automated Washer
Advantages
Safer than manual cleaning .
Effectively cleans all instruments .
Reduces chances for spread of contaminants of
contaminants through splatter and aerosols.
Allows for more efficient use of staff time.
Disadvantages
Not all instruments are compatible with automated
washers.
Please see manufacturer's instructions for detailed
requirements.
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Disposal of instruments
o Single-use items that are sharp or
otherwise pose a risk of injury must be
discarded into a sharps container .
o Items without risk, such as a saliva ejector,
can be thrown into the trash.
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Sterilization
Is a process that destroys or eliminates all
forms of microbial life including bacteria,
viruses, fungi and spores.
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Sterilization
Steam pressure sterilization
( autoclave )
Chemical vapor pressure
sterilization (chemiclave)
Dry heat sterilization ( dryclave )
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1-Steam pressure sterilization
(autoclaving)
Sterilization with steam under pressure is
performed in a steam autoclave .
For a light load of instruments, the time
required at 121° C is a minimum of 30
minutes at 15 psi.
Time can be reduced to 4 minutes if the
temperature is raised to approximately 134° C
at 28 psi.
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An example of a steam pressure sterilizer
(autoclave )
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Advantages of Autoclaves:
• Autoclaving is the most rapid and effective
method of sterilization.
• Automated models are available.
• They must be evaluated with a biologic
spore test monitoring system.
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Disadvantages of autoclaves :
• Items sensitive to the elevated temperature
can not be autoclaved.
• Autoclaving tends to rust carbon steel
instruments.
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2-CHEMICAL VAPOR PRESSURE
STERILIZATION
(CHEMICLAVING )
Sterilization by chemical vapor under pressure
is performed in a Chemiclave.
Chemical vapor pressure sterilizers operate at
131° C and 20 psi.
They are similar to steam sterilizers and have a
cycle time of approximately half an hour.
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Chemical vapor pressure sterilizer (Chemiclave )
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3-Dry heat sterilization (dryclave)
Is an excellent means of sterilization of sharp
instruments but rubber and plastic material
cannot be sterilized by this method .
Holding period : 160°C, 1 hour .
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Dry heat sterilizer
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BOILING WATER
Boiling water does not kill spores and cannot
sterilize instruments. However, heat can reach
and kill blood borne pathogens in places that
liquid sterilants and disinfectants used at
room temperature cannot reach.
Boiling is a method of high-level disinfection
that has been used when actual sterilization
cannot be achieved (e.g., in case of a sterilizer
breakdown)
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Ultraviolet light is not highly effective against
RNA viruses such as HIV and is not very
effective against bacterial spores.
Ultraviolet light
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Ultraviolet light
Incomplete exposures of all surfaces and poor
penetration of oil and debris are other
limitations.
Ultraviolet irradiation may be useful for
sanitizing room air to help control tuberculosis
bacteria .