Hand Instruments Used in
restorative Dentistry
Dr Ramesh Bharti
Professor
Conservative Dentistry & Endodontics
Faculty of Dental Sciences,
King George’s Medical University UP Lucknow
Design Characteristics of Hand Cutting
Instrument
Handle or Shaft
Shank
Blade/nib
Cutting edge
Blade angle
Cutting edge
angle
Handle/Shaft:
Handle:
Straight
Mostly straight and serrated
Variable in sizes and shapes
If shank and blade are separate
from the handle and is screwed
into handle ,this instrument is
known as Conescket Instrument.
Shan
k:
Connects with blade
Usually tapers from its connection
with handle towards the blade
Blade/
Nib:
Working end of the cutting instrument is called blade
Working end of non cutting instrument such as
condenser is called as nib.
Cutting
edge:
Working part of the instrument
Usually in the form of bevel with
different shapes
Blade
angle:
Cutting edge
angle:
The main principle of cutting with hand instruments
is to concentrate forces on a very thin cross section
of the instrument at the cutting edge.
Thinner the cross section, more pressure
concentrated and more efficient instrument.
Instrument Nomenclature: Given by Sir G V
Black
1. Order: Purpose of instrument , eg. Excavator or Scaler
2. Sub order: Manner of use, pull, push.
3. Class: Form of working end, eg. Hatchet chisel.
4. Sub class: shape of the shank, eg. Monagle, Binangle
Instrument
formula
Given by Sir G V Black which describe the dimension and
angulation of the hand instruments.
The 1st figure represents the width of the blade in tenths of a
millimetre.
The 2nd figure represents the length of the blade in millimetre.
The 3rd figure represents the angle which the blade forms with
axis of the [Link] angle is expressed in the 100th of a
circle or centigrades.
However, for instruments with their cutting edges at an
angle other than right angle to the long axis of the blade, a
fourth unit cutting edge angle is added to the basic three
unit formula.
So this additional unit represent the angle formed between
the cutting edge and long axis of the handle.
Single Bevelled
Bi Bevelled
Tri BevelledCircumferentially
bevelled instrument
Direct and Lateral
Cutting
Direct Cutting: Instruments
Force is applied in the same plane as that of blade and handle.
They can be used in direct and lateral cutting, provided the they are
angled.
These instruments are made either left or right by placing a bevel on one
side of the blade.
Lateral cutting instruments
Force is applied at a right angle to the of plane of the blade and
handle.
Usually have curved blade and called double plane instruments.
They have an angle or curve in a plane perpendicular to that of
the handle .
Used for lateral cutting.
Contra-angling
In many instruments, shank has bends at one or more points to angle the blade
relative to the long axis of handle.
Working point is moved out of line with long axis of handle due to which
instrument will be out of balance in lateral cutting motion.
Force will be required to keep the instrument balance.
To eliminate this problem, instruments are designed to have one or more angles
in the shank, this is called contra-angling.
Instruments Grasps
1-Pen grasp:
It is similar to that 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 arrest.
The position of 2nd finger is important for good control to the instrument.
2-With the modified pen grasp, hold the instrument
in basically the same way as in the pen grasp,
except that the fleshy part of your middle finger
rests lightly on the shank of the instrument.
This finger is used to feel the shank vibrate when
the instrument's working end rubs over a rough
surface. The middle finger also helps to guide the
instrument.
2-Palm and thumb Grasp:
It is similar to the method of holding a knife, when cutting a
piece of wood. A supporting rest provided by thumb is necessary
because digital control is somewhat insufficient.
It may be useful on maxillary teeth particularly the right side ,
when working from the right rear chair position.
Modified palm and thumb grasp:
When it is feasible to rest the thumb
on the same tooth being operated
or on the tooth immediately
adjacent , then this grasp may used.
It provides greater freedom of
movement and delicacy of control
may be obtained.
Sharpening of Hand Instruments
Sharpening instruments include oilstones eg. Arkansas stones,
mechanical sharper, diamond hone stones that are used in hand
piece.
Principles for sharpening the instruments:
1. Do not sharpen the dirty instruments.
2. Establish the proper bevel angle and desired angle of the cutting
edge to the blade before placing the instrument against the stone
and maintain these angles while sharpening.
3. Use light stroke or pressure to minimize the friction heat.
4. Use rest to guide whenever possible.
5. Keep the sharpening stones clean and free of metal outings.