INSTRUMENTS AND

INSTRUMENTATION IN
OPERATIVE DENTISTRY
CONTENTS
 HISTORY  ROTARY CUTTING
 GENERAL CLASSIFICATION INSTRUMENTS
 HAND CUTTING INSTRUMENTS  history
 classification  characteristics
 materials  design
 parts  dental burs
 nomenclature & formulae  dental abrasives
 other design features
 cutting mechanisms
 instrument applications
 NEWER
 instrument grasps
DEVELOPMENTS
 sharpening, sterilization
 CONCLUSION
 REFERENCES
INTRODUCTION
 In order to perform the intricate and detailed
procedures associated with operative dentistry,
the dentist must have a complete knowledge of
the purpose, availability and application of the
many instruments required.
CLASSIFICATION OF
INSTRUMENTS
G.V. BLACK CLASSIFICATION
 CUTTING INSTRUMENTS
 CONDENSING INSTRUMENTS
 PLASTIC INSTRUMENTS
 FINISHING & POLISHING INSTRUMENTS
 ISOLATION INSTRUMENTS
 MISCELLANEOUS
 1. Cutting instruments 3. Plastic instruments
• Hand - Spatulas
-Hatchets - Carvers
-Chisels - Burnishers
-Excavators - Packing instruments
-Others
• Rotary 4. Finishing and polishing instruments
- Burs - Hand
- Stones - Orange wood sticks
- Disks - Polishing points
- Others - Finishing strips
- Rotary
2. Condensing instruments - Finishing burs
Pluggers - Mounted brushes
- Hand - Mounted stones
- Mechanical - Rubber cups
- Impregnated disks and wheels
5. Isolation instruments
- Rubber dam frame
- Clamps, forceps, punch
- Saliva ejector
- Cotton roll holder
- Evacuating tips and
equipment
6. Miscellaneous instruments
- Mouth mirrors
- Explorers
- Probes
- Scissors
- Pliers
- Others
CLASSIFICATION
CLASSIFICATION BY MARZOUK

EXPLORING REMOVAL OF RESTORING

INSTRUMENTS TOOTH STRUCTURE INSTRUMENTS
Mixing
To dry Plastic
To illuminate Hand cutting Condensing
Burnishing
Retraction Rotary cutting
Carvers
Probe the Files
potential lesion Knives
Finishing
& polishing
I)Those used for exploration

A) Dry the area on the tooth:

 This necessitates the use of an
 Air syringe.

 Pair of tweezers (pliers)

 Cotton pellets to dry the tooth.

 Cotton rolls – to isolate the area around the tooth.

B) Illuminate the area:
A source of light could be either an overhead fixture supplying
non-reflecting light or an intra-canal light.
They can be
 Battery operated lights.
 Built in lights attached to dental unit.
 Light attached to mirror or hand piece.
 Light can be introduced directly or indirectly by reflecting it on the
filed via a mirror.

C) To retract the soft tissues:

 The hand mirror is used to move the tongue and cheek away.
 Blunt plastic instruments may help in retraction.
 Tongue depressor or retractors are sometimes helpful for this
procedure.
D) To probe the potential lesion:
Explorers are used for this purpose.
 These are 4 types of explorers.

1. Straight explorer.
2. Right angled explorer
3. Arch explorer
4. Interproximal explorer.

II) Those used for tooth structure removal:

 Hand cutting instruments.
 Rotary cutting and abrasive instruments.
 Ultrasonic instruments
III) Those used for restoring:
 Mixing instruments
 Spatulas
 Plastic instruments
 Condensing instruments
 Burnishing instruments
 Carvers
 Files
 Knives
 Finishing and polishing instruments.
MOUTH MIRROR
PROBES / EXPLORERS

RIGHT ANGLED
STRAIGHT
STRAIGHT RIGHT ANGLED

ARCH INTERPROXIML
INSTRUMENTATS FOR
RESTORATION
HAND CUTTING
INSTRUMENTS
CLASSIFICATION OF HAND
INSTRUMENTS

CUTTING NON-CUTTING
INSTRUMENTS INSTRUMENTS

Excavators Amalgam condensors

Chisels Mirrors
Special forms of chisels Explorers
Others Probes
MATERIALS
Soft
 Carbon steel
Hard
 Stainless steel

 Monel
 Nichrome
 Stellite
 Tarno
HEAT TREATMENT
 Hardening heat treatment
 - The hardening heat treatment hardness the
alloy, but also makes it brittle, especially when the
carbon content is high.
- 1500°F (815°C)

 Tempering
- The tempering heat treatment relieves
stains and increases toughness.
- 350°F (176°C)
PARTS OF HAND CUTTING
INSTRUMENTS
 HANDLE
Small, medium, large
¼ inch diameter,
octagonal
CONE-SOCKET
INSTRUMENT
 SHANK
Monoangled
Binagled
Tripleangled

BLADE/NIB
Cutting edge
Blade angle
Cutting edge angle
 CONTRANGLED INSTRUMENTS

Instruments with longer shanks require 2 or 3 angles

in the shank to bring the cutting edge near to the long
axis of the handle such shanks are termed contra-angled.
ADVANTAGES OF CONTRA-
ANGLING
NOMENCLATURE
 Order

 Suborder
Eg: binangle hatchet
 Class push excavator

 Subclass
 Order: The order denotes the purpose or function of the
instrument. E.g. Excavator, scaler.

 The sub-order denotes the position or manner of use of the

instrument. E.g Push, pull.

 The class describes the form of the blade. Eg. Hatchets, chisel.

 Subclass. Shape of the shank –Eg. Mon-angle, Binangle.

INSTRUMENT FORMULA

 1st unit: width of the blade

 2nd unit: length of the blade
3rd unit: blade angle
Cutting edge angle: 2nd position
MEASUREMENT OF
INSTRUMENTS

Dental instrument gauge

Boley gauge
Instrument motions
 Chopping-- Using the instrument parallel
to the long axis of the blade

 Pulling-- Moving the instrument towards the

operator's hand

 Pushing-- Moving the instrument away from the

operator's hand
 Scraping-- Moving the instrument from side to side
or back and forth on the tooth surface. For
this motion, the blade should be held at 45
to 90° to the surface being scraped.

 Thrusting--Forcibly pushing the instrument against a

surface.
OTHER DESIGN FEATURES
 DIRECT CUTTING & LATERAL CUTTING
INSTRUMENTS
 Single plane instruments
 Double plane instruments
BEVELS
 Primary Bevel
 Secondary Bevels
Right and Left bevels
 To determine whether the instruments has a right or
left bevel, the primary cutting edge is held down and
pointing away, and if the bevel appears on the right
side of the blade, it is the right instrument of the pair
and vice versa.
Mesial and Distal bevel

MESIAL BEVEL DISTAL BEVEL

Bibevel Triple bevel Circumferential
bevel
SINGLE AND DOUBLE ENDED
INSTRUMENTS
 Most instruments are available with blades and
shank on both ends of the handle. Such
instruments are termed double-ended.
CUTTING INSTRUMENT
APPLICATIONS

CLASSIFICATION OF HAND INSTRUMENTS

 EXCAVATORS
 CHISELS
 SPECIAL FORM OF CHISELS
 EXCAVATORS
 Ordinary hatchet
 Hoes
 Angle formers
 Spoon excavaters
ORDINARY HATCHET

FUNCTION:

Used primarily on anterior

teeth for preparing retentive
areas.

Sharpening internal line

angles particularly in
preparations for DFG
restorations.
 Has cutting edge of blade directed in same plane as that of
long axis of handle.

 Single planed bibevelled instrument.

 Motions- push, pull, vertical or even lateral scraping.

HOES

• Has primary cutting

edge of the blade
perpendicular to the
axis of handle.

• Single planed
instrument

FUNCTIONS:
 Planing cavity walls
 Refine line angles
 Cl-III & Cl-IV
preparations for DFG
ANGLE FORMERS

FUNCTIONS:
Sharpening line angles
Retentive features
Beveling enamel margins
MOVEMENTS: 4 types
 The instruments are made by grinding the bevel at an
angle of 80o with the shaft, thus forming an acute
angle with the long axis of the blade. This creates a
pointed and a linear cutting edge.

 4 unit instrument formula.

 Paired instrument- right and left.

 Single planed insts with right & left bevelling.

SPOON EXCAVATERS
 Spoon excavator
 Discoid & cleoid
 FUNCTIONS
 MOVEMENTS:right & left
only
 Modified hatchet.

 Double planed instrument.

 Circumferentially bevelled.

 Shank is binangle or triple-angled

 to facilitate accessibility.

 Paired (right and left).

 Double ended instrument.

CARVING AMALGAM WITH DISCOID BLADE
CHISELS

 Straight

 Mono angled chisel

 Binangled chisels

 Triple angled chisels

[Link]:

Chisels are instruments intended primarily for

planing or cleaving enamel. It is characterised by a
blade that terminates in a cutting edge formed by a
one sided bevel.

Cutting edge of the blade is at a right angle to the

long axis of the instrument.
 STRAIGHT: planing & cleaving enamel
 MONOANGLED: smoothening margins
 BINANGLED: cleave or split undermined enamel.
 TRIPLE ANGLED: flattening pulpal floor
 MOVEMENTS: vertical, right, left, push or pull
SPECIAL TYPE OF CHISELS
 Enamel hatchet
 Offset hatchet
 Offset hatchet with cutting edge angle
 Gingival marginal trimmer
 Wedelstaedt chisel
 Triangular chisel
 Hoe chisel
ENAMEL HATCHET

 FUNCTIONS:
split/cleave undrmined
enamel in prox cavity
(buccal, lingual walls)

 MOVEMENTS: 4
types
 The hatchet shank has one or more angles. The
blade is in the same plane as this angle or angles
parallel with the shaft.
 Paired instruments: right, left.
 Single planed instruments.
 Single bevelled instruments.
 Bevel on the right side: right side instrument.
 Bevel on the left side: left sided instrument.
 Used with push stroke (planing or direct cutting
motion as well as lateral cutting motion).
OFFSET HATCHET
 Blade :1/4th turn rotated
 Set of 4

 FUNCTION: provide specific

angulations in cavity walls
(difficult access)
 Enamel hatchet/Offset hatchet
with cutting blade angle:
 Mesial & distal
 right & left
GINGIVAL MARGINAL
TRIMMER

 Mesial instrument: 85-75

 Distal instrument:90-100
 FUNCTIONS:
 Beveling gingival margin
 Rounding axio-pulpal
 Refine line/point angles
 Cutting edge of the instrument is parallel to the axis of the
instrument.

 Cutting edge of the instrument is at an angle other than a right

angle to the blade and blade is curved.

 Is a Modified hatchet

 Binangle and single bevelled.

 Double plane instrument (better lateral scraping efficiency/

scooping effect).

 2 pairs: mesial(right & left)

distal (right & left)

 4 unit instrument formula

- Mesial pair – 10- 80- 6- 12 ( < 80 )
- Distal pair – 10- 95- 6- 12 ( > 95)
OTHERS

 WEDELSTAEDT CHISEL
• Straight chisel but with a slight
vertical curvature in its shank.

• Bevelled on one side of blade only.

 USE: cleaving enamel & shaping

walls TRIANGULAR
 MOVEMENTS: 4 types CHISEL
OTHER CUTTING
INSTRUMENTS
 Knives: trimming excess

restorative material from

proximal preparations and

contouring the surface of

class-V restorations

 Files: trim excess restorative

materials from gingival

margins.
INSTRUMENT GRASPS

MODIFIED
PEN GRASP
CORRECT INCORRECT
 It is similar to that used in holding a pen but not identical.
 Pads of the thumb, index and middle fingers contact the
instrument, while the tip of the ring finger or tips of the
ring and little finger is placed on a nearly tooth surface of
the same arch. The palm of the hand generally is facing
away from the operator. The pad of the middle finger is
placed near the top side of the instrument.
INVERTED PEN GRASP
 The finger position of the inverted pen grasp are the
same as for the modified pen grasp, but the hand is
rotated so that the palm faces more towards the
operator.
 This grasp is used mostly for cavity preparations utilizing
the lingual approach on anterior teeth.
 The modified pen and inverted pen grasps are practically
universal.
PALM AND THUMB GRASP
 The handle is placed in the palm of the hand and grasped
by all the fingers, while the thumb is free of the instrument
and the restoration is provided by supporting the tip of the
thumb on a nearby tooth of the same arch or on a firm,
stable structure. It may be useful on maxillary teeth
especially the right side when working from the right rear
position.
 This form of grasp is usually necessary where the rest
support for the thumb is at some distance from the point of
operation, so that the thumb itself must be extended and
hence cannot be used for gripping.
MODIFIED PALM AND
THUMB GRASP
 In this, the handle of the instrument is in contact
with the tips of the 4 fingers on one side,
opposed to which are contacts with the mesial
end of the 1st phalanx of the thumb. The hand is
only half closed instead of being fully closed.
The end of the thumb is used as a rest.
Rests:
A proper instrument grasp must include a firm rest to
steady the hand during operating procedures.
The closer the rest areas are to the operating area, the
more reliable they are.
In cases where it is impossible to establish a rest on tooth
structure then soft tissue may be used.

Guards- are hand instruments or other items such as

interproximal wedges, used to protect soft tissue from
contact with sharp cutting or abrasive instruments.
SHARPENING OF HAND
INSTRUMENTS
 ADVANTAGES
 Improved removal of caries/tooth
structure
 Decreased clinician fatigue
 Improved tactile sensitivity & control
 Less patient discomfort
 Better quality/precision of cavity
preparation
 Less time
EQUIPMENT USED:
STATIONARY SHARPENING STONES
 Coarse, medium, fine
 Variety of shapes
 Materials:
 Arkansas stone
 Silicon carbide
 Aluminium oxide
 diamond
MECHANICAL
SHARPENERS
STONES USED IN HAND PIECE:
ADVANTAGES OF HAND
CUTTING INSTRUMENTS
 Self-limiting in cutting
 Removes large pieces quickly
 No vibration, heat-painless
 Precise cutting (near adjacent tooth)
 Smoothest surface
 Longest lifespan
ROTARY CUTTING
INSTRUMENTS
ROTARY INSTRUMENT
DESIGN/PARTS
Shank design:
 The shank is the part
 That fits into the hand piece
 Accepts rotary motion from the hand piece.

 Three of these
 Straight hand piece shank.
 Latch type angle hand piece shank.
 Friction grip angle hand piece shank. Are commonly
encountered.
 
Neck design:
 The neck is the intermediate portion of
an instrument that connects the head
to the shank.
 The main function of the neck is to
transmit rotational and translation
forces to the head.

Head design:
 The head is the working part of the
instrument, the cutting edges or points
of which perform the derived shaping
of tooth structure
CHARACTERISTICS OF
ROTARY INSTRUMENTS
SPEED
By Sturdevant:
 Low or slow speed-below 12,000 rpm
 Medium /intermediate speed-12,000 to 2,00,000 rpm
 High or ultra-high speed-above 2,00,000 rpm

By Marzouk:
 Ultra low speed-300 to 3000 rpm
 Low speed- 3000 to 6000 rpm
 Medium high speed-20,000 to 45,000 rpm
 High speed-45,000 to 1,00,000 rpm
 Ultra-high speed-above 1,00,000 rpm
By Charbeneau:
 Conventional/low speed-below 10,000 rpm
 Increased or high speed- 10,000 to 1,50,000
rpm
 Ultra-speed-above 1,50,000 rpm
LOW SPEED
Disadvantages:
 Time consuming
 Heavy force application
 Heat & vibration
 Bur rolls out
 Carbide burs not useful
Uses
1. Removal of soft caries
2. Finishing of the cavity
HIGH SPEED:
Advantages:
 Faster
 Less pressure, vibration, heat
 Smaller sizes-universal
 Better control, ease
 Instruments last longer
 Patient is less apprehensive
 Several teeth treatment
Uses
1. Cavity preparation
DENTAL BURS
HISTORY
 Early burs-hand made
 Machine made [Link]

STEEL BURS
 Dull at high speed
 Finishing & polishing
 VHN: 800

CARBIDE BURS
 Used at high speed
 Cavity preparation
 VHN:1650-1700
BUR CLASSIFICATION

1. Material used
2. Size of head
3. Shape of head
4. Mode of attachment
5. According to motion
6. According to use
SHAPE OF BUR
 Shape: contour/silhouette of head
 Basic shapes
Round bur – is spherical. The shape has been used for
 Initial entry into the tooth.
 Preparation of retention potholes.
 Caries removal.

Inverted cone bur:

 It is a portion of a rather rapidly tapered cone with the
apex of the cone directed towards the bur shank.
 It is particularly suitable for providing undercuts in cavity
preparation.
 Finishing of pulpal floor and gingival seat in amalgam
cavity preparation
Pear-shaped bur:
 It is a portion of a slightly tapered cone with the
small of the cone directed towards the bur
shank. (Normal length)
 It is advocated for use in Class I cavity
preparation for gold foil. Long length pear bur is
advocated for cavity preparations for amalgam.

Straight fissure:
 A straight fissure bur is an elongated cylinder.
This shape is advocating some for amalgam
cavity preparation
Tapered fissure bur:
 Is a portion of a slightly tapered cone with the
small end of the cone directed away from the
bur shank. This shape is useful for
 Inlay and crown preparations where freedom
from undercuts is essential for successful
withdrawal of patterns and final seating of cast
restoration.
BUR BLADE DESIGN
Three important angles:
 Rake angle (angle made between the rake face and
the line connecting the edge to the axis of the bur)

 Edge angle (is the internal angle at the edges

followed by the forces of the bur blade)
.
 Clearance angle (is the angle between the clearance
face immune behind the edge and a tangent to the
path of rotation).
RAKE ANGLE
FACTORS AFFECTING CUTTING
EFFICIENCY
RAKE ANGLE
 Radial angle > negative
rake angle
 Positive angle - more
clogging

CLEARANCE ANGLE
 Prevent friction

EDGE ANGLE
NO. OF BLADES
 Less blades remove
more material
 Less clogging

12 BLADE BUR 40 BLADE BUR

 RUN-OUT
 Max displacement of
bur head while it rotates
 Value:0.023 mm
ABRASIVE INSTRUMENTS:
 The second major category of rotary dental cutting instruments
involves abrasive rather than blade cutting.

 Abrasive instruments are based on small angular particles of a hard

substances held in a matrix of softer material.

 Cutting occurs at a large number of points where individual hard

particle protrude from the matrix rather than along a continuous
blade edge.

 Abrasive instruments are generally grouped as diamond or other

instruments.
 Diamond instruments have a great clinical impact because of their
long life and great effectiveness in cutting enamel and dentin.
DIAMOND ABRASSIVES
 1st introduced in USA-
1942

ADVANTAGES:
 Longer life
 Better cutting
effectiveness
Diamond instruments consist of 3 parts.
 A metal blank,
 powered diamond abrasive,
 Metallic bonding material that hold the diamond powder
onto the blank.

The blank has the same parts

 Head
 Neck
 Shank

 The diamonds employed are industrial diamonds either

natural or synthetic that have been crushed to powder
and then carefully graded for size and quality
Method of manufacture:
 The diamonds are attached to the blank by
electroplating a layer of metal on the blank
while holding the diamonds in place against it.
CLASSIFICATION
 SHAPES

& SIZES
Size:
 coarse (125-150µm)
 medium (88-125µm)
 fine(60-74µm)
 very fine(38-44µm)
 finishing(10-38µm)
FACTORS INFLUENCING THE
CUTTING EFFICIENCY
 Size of the abrasive particles
 Shape of abrasive particles
 Density of abrasive particles
 Hardness of abrasive particles
 Speed and pressure
OTHER ABRASSIVES
MOULDED INSTRUMENTS
 Made by pressing uniform
mixture of abrasive and matrix
around end of shank
TYPES:
 Hard & soft

MATERIALS
 Silicon carbide (carborundum)
 Aluminium oxide
MOUNTED STONES

FINISHERS

POLISHERS
COATED INSTRUMENTS
 They are mostly discs that have a
thin layer of abrasives cemented to
a flexible backing.

 They are used in finishing /

smoothening procedure of certain
enamel walls of cavity preparations
for indirect restoration as well as in
finishing procedures for restoration.
MATERIALS
 Garnet
 Quartz
 Flint (sand)
 Crocus
 Emery
 Cuttlefish-polishing
FINISHING KIT
FOR
AMALGAM

FINISHING KIT
FOR COMPOSITES
ADVANTAGES OF ROTARY CUTTING
 Most efficient for gross tooth removal
 Diamond abrasives : enamel
 Carbide burs : dentin
 Less cumbersome

DISADVANTAGE:
 In deep carious lesions-hand instruments preferable
HAZARDS
 PULPAL HAZARD

 SOFT TISSUE HAZARD

 EYE HAZARD

 EAR HAZARD

 INHALATION HAZARD