HAND INSTRUMENTS IN OPERATIVE DENTISTRY

Dr. V. Pradeeba , MDS

Dept. of Conservative Dentistry & Endodontics
Faculty of Dental Sciences
 INTRODUCTION
 Instruments: tool, device or implement used for specific
purpose or type of work and is preferred in professional or
scientific fields as precision items, are generally required
to perform specific procedures.
 In order to perform, the intricate or detailed procedures
associated with operative dentistry, the dentist must have
a complete knowledge of
 The instruments available.
 The purpose of the instrument.
 The position or manner of use.
 The application of the instrument

Dr. V. Pradeeba , MDS

Dept. of Conservative Dentistry & Endodontics
Faculty of Dental Sciences
 HISTORY
 Large & heavy

 Poor quality metals & alloys

 No standardization

 Can be grasped with palm only

 [Link] - first acceptable nomenclature &

classification of hand instruments

Dr. V. Pradeeba , MDS

Dept. of Conservative Dentistry & Endodontics
Faculty of Dental Sciences
OPERATIVE INSTRUMENTS.

HAND ROTARY

Dr. V. Pradeeba , MDS

Dept. of Conservative Dentistry & Endodontics
Faculty of Dental Sciences
ISTRUMENT DESIGN

Dr. V. Pradeeba , MDS

Dept. of Conservative Dentistry & Endodontics
Faculty of Dental Sciences
 HANDLE
 Straight and is usually without variations in size.
 Length-5.5 inches
 Diameter-5.5 mm
 Available in various sizes and shapes- small, medium, large
diameter Hexagonal or octagonal
 Smooth, serrated or knurled
 Knurled to facilitate control and to increase the friction for
hand gripping
 Instrument formula and Manufacturing kit number
incorporated on it
 Handle is either continuous with shank or separable.

Dr. V. Pradeeba , MDS

Dept. of Conservative Dentistry & Endodontics
Faculty of Dental Sciences
 SHANK
 Connects the shaft - blade or working point or nib.

 Extends : shaft to where the blade begins.

 Smooth, round, tapered and contra-angled

 It is here where any angulation of the instrument can be

placed.

Dr. V. Pradeeba , MDS

Dept. of Conservative Dentistry & Endodontics
Faculty of Dental Sciences
 [Link] classified instruments depending
on the number of angles in the shank as-
1. Mon angle
2. Bin angle
3. Triple angle
4. Quaternary angle

Dr. V. Pradeeba , MDS

Dept. of Conservative Dentistry & Endodontics
Faculty of Dental Sciences
 BALANCE
 Allows for concentration of forces onto the blade with out
causing rotation of the instrument in the operator’s grasp.

 Achieved by designing the angle of the shank so that the

cutting edge of the blade lies within the projected
diameter of the handle and coincides with the long axis of
the handle
 All dental instruments need to satisfy this principle of
balance.

Dr. V. Pradeeba , MDS

Dept. of Conservative Dentistry & Endodontics
Faculty of Dental Sciences
 CONTRA-ANGLE
 The term “Contra – Angle” refers to a shank in which two
or more angles are necessary to bring the working end
into near alignment with (within 2mm) the axis of the
handle.
 Advantages:
 Prevent rotation
 Modified access
 Greater stability and balance
 Ease of control
 concentration of force onto the blade – high stress

Dr. V. Pradeeba , MDS

Dept. of Conservative Dentistry & Endodontics
Faculty of Dental Sciences
 BLADE
 Working end of the instrument

Dr. V. Pradeeba , MDS

Dept. of Conservative Dentistry & Endodontics
Faculty of Dental Sciences
 BLADE
 It is the working part of the instrument.
 It is usually in the form of a bevel in different shapes.
 Beveled-
 single beveled
 Bibeveled
 Triple beveled
 Circumferentially beveled
 Regular bevel - distal to shaft
 Reverse bevel- mesial to shaft (binangle chisel)

Dr. V. Pradeeba , MDS

Dept. of Conservative Dentistry & Endodontics
Faculty of Dental Sciences
 Cutting edge
It is the working part of the instrument.
It is usually in the form of a bevel in different shapes.
Bevelled-
single bevelled
Bi-bevelled
Triple bevelled
Circumferentially bevelled
Regular bevel - distal to shaft
Reverse bevel- mesial to shaft
eg:- binangle chisel

Dr. V. Pradeeba , MDS

Dept. of Conservative Dentistry & Endodontics
Faculty of Dental Sciences
 DIRECT CUTTING LATERAL CUTTING
Force is applied in the same Force is applied at a right
plane as that of the blade angle to the plane of the
and handle blade and the handle
Straight blade (single Curved blade (double
plane). plane).
All the curves and the Angles or curves in a plane
angles in the shank are in at a right angle to the
the same plane as the handle.
handle.
Can only be used in lateral
Used in direct & lateral cutting (scraping action).
cutting.

Dr. V. Pradeeba , MDS

Dept. of Conservative Dentistry & Endodontics
Faculty of Dental Sciences
CLASSIFICATION OF HAND INSTRUMENTS (G. V. Black)

Classification of hand instruments

Cutting hand instruments Other cutting Non-cutting hand instruments

A. Excavators insruments: Amalgam condensors
ordinary hatchet Knives, Mirrors
hoes carvers Explorers
angle formers files, Probes
spoons Scalers
B. Chisels
straight
curved
bin angle
enamel hatchet
GMT

Dr. V. Pradeeba , MDS

Dept. of Conservative Dentistry & Endodontics
Faculty of Dental Sciences
 NOMENCLATURE
1. function- purpose of the instrument. Eg:- excavator, scaler
2. Manner of use - position or manner of use of the
instrument Eg:- push, pull
3. Design of working end- Eg:- hatchet, chisel
4. Shape of the shank - number of angles in the shank/ shape
of the shank Eg:- 1- mon angle, 2- bin angle

NAMING GOES FROM 4-1

Bin-angle hatchet push excavator

Dr. V. Pradeeba , MDS

Dept. of Conservative Dentistry & Endodontics
Faculty of Dental Sciences
 INSTRUMENT FORMULA
 To describe the parts of an instrument accurately.

3 unit instrument formula:

First number : Width of the blade or primary cutting edge, in

tenth of a mm. (Eg 10 = 1mm)

Second unit : length of the blade in mm (eg. 8mm)

Third unit : Angle the blade forms with the axis of handle in
clockwise centigrade. ()
Dr. V. Pradeeba , MDS
Dept. of Conservative Dentistry & Endodontics
Faculty of Dental Sciences
 INSTRUMENT FORMULA
4 unit instrument formula:
(Gingival marginal trimmer & angle former)
Cutting edge of the instrument is at an angle other than a right angle to
the blade.
First unit – Width of the blade in tenths of a millimeter. (Eg :1313/10 –
1.3mm)
Second unit - Angle the cutting edge forms with the axis of the handle in
clockwise centigrade. It is expressed as percentage of 360 degree. (Eg:
85 85% *360 = 306 degree)
Third unit – Length of the blade in millimeter. (Eg: 8 8mm)
Fourth unit – Angle the blade forms with the axis of the handle in
centigrade. (Eg: 14 14* 360% =50.4)

Dr. V. Pradeeba , MDS

Dept. of Conservative Dentistry & Endodontics
Faculty of Dental Sciences
INSTRUMENT FORMULA

Dr. V. Pradeeba , MDS

Dept. of Conservative Dentistry & Endodontics
Faculty of Dental Sciences
 Cutting instruments
Chisels:-
Cutting edge - right angle to the axis of the
instrument.
Used for planing or cleaving enamel.
1) Straight chisel: ( 12 – 7 – 0 )
- No bend in shank
- Single beveled/ Triple beveled.
- Minimal accessibility.
- Used with push stroke or lateral scraping action.

Dr. V. Pradeeba , MDS

Dept. of Conservative Dentistry & Endodontics
Faculty of Dental Sciences
2) Mono angle chisel:-
Blade is shorter as compared to straight chisel.
Single angle in the shank to enhance the convenience form.
Used with push stroke or lateral scraping action.
 Hoe:- ( 4 ½ - 1 ½ - 22 )
Difference between mono angle chisel and hoe:- If the angle of the blade
MONO ANGLE CHISEL HOE
< 12.5 centigrade >12.5 centigrade

Used with pull stroke.

Use:- To define line and point angles.
Class III and V preparations for direct filling gold restorations.

Dr. V. Pradeeba , MDS

Dept. of Conservative Dentistry & Endodontics
Faculty of Dental Sciences
3) Hatchet:- ( 3 – 2 – 28 )
Cutting edge of the instrument is parallel to the axis of the instrument.
Cutting edge of the instrument is at right angle to the axis of blade. -
Mono angled
Length of blade is very small
Bibevelled
Single ended
Used with push stroke
Use:-
Preparing retentive areas on anterior teeth.
Sharpening internal line angles in DFG restorations.

Dr. V. Pradeeba , MDS

Dept. of Conservative Dentistry & Endodontics
Faculty of Dental Sciences
4)Enamel hatchet: ( 10 – 7 – 14 )
Cutting edge of the instrument is parallel to the axis of the
instrument.
Binangle hatchet
Monobeveled
Single plane instrument
Paired instrument
Bevel on right side - Right side instrument
Bevel on left side – Left side instrument

Dr. V. Pradeeba , MDS

Dept. of Conservative Dentistry & Endodontics
Faculty of Dental Sciences
Used with push stroke (planing or direct cutting motion as well as
lateral cutting motion) for
smoothening buccal and lingual walls of proximal box.
breaking enamel of proximal box.
smoothening gingival seat (lateral scraping motion

Dr. V. Pradeeba , MDS

Dept. of Conservative Dentistry & Endodontics
Faculty of Dental Sciences
5) Gingival marginal trimmer ( 12 ½ -
100 – 12 – 14 )
Cutting edge
parallel to the axis of the
instrument.
at an angle other than a right angle
to the blade.
Modified hatchet
Binangle instrument
Monobeveled
Double plane instrument (better lateral
scraping efficiency/ scooping effect

Dr. V. Pradeeba , MDS

Dept. of Conservative Dentistry & Endodontics
Faculty of Dental Sciences
5) Gingival marginal trimmer ( 12 ½ - 100 – 12 – 14 )
Cutting edge is parallel to the axis of the instrument, at an angle other
than a right angle to the blade.
Modified hatchet
Binangle instrument & Monobeveled
Double plane instrument (better lateral scraping efficiency/ scooping
effect
Used to give gingival cavo surface bevel.
Used for rounding or bevelling axio- pulpal line angle
4 unit instrument formula
Mesial pair – 10- 80- 6- 8 ( < 80 ) &Distal pair – 10- 95- 6- 8 ( > 95)

Dr. V. Pradeeba , MDS

Dept. of Conservative Dentistry & Endodontics
Faculty of Dental Sciences
2 pairs:
1. MESIAL PAIR (RIGHT AND LEFT)
2. DISTAL PAIR (RIGHT AND LEFT)

Dr. V. Pradeeba , MDS

Dept. of Conservative Dentistry & Endodontics
Faculty of Dental Sciences
ANGLE FORMER:- ( 12 – 85 – 5 – 8 )
Instruments are made by grinding the bevel at an angle of 80 degree
with the shaft, thus forming an acute angle with the long axis of the
blade.
creates a pointed and a linear cutting edge.
4 unit instrument formula
Paired instrument with right and left
Ring on the shank – right side
3 cutting edges (blade is bevelled on the sides as well as the end).
Use:-
To exaggerate line and point angles in DFG restorations to establish the
retention form

Dr. V. Pradeeba , MDS

Dept. of Conservative Dentistry & Endodontics
Faculty of Dental Sciences
 Dr. V. Pradeeba , MDS
Dept. of Conservative Dentistry & Endodontics
Faculty of Dental Sciences
Spoon excavator: ( 15 – 7 – 15 )
Modified hatchet.
Double ended instrument.
Bin angle / Triple-angle ( 13 – 7 – 14 )
Paired (right and left).
Double plane instrument.
Circumferentially beveled.
Cutting edge either
circular (discoid)
claw like (cleoid).
Uses:
Spooning or scooping of softened carious material.
Carving amalgam or direct wax patterns.

Dr. V. Pradeeba , MDS

Dept. of Conservative Dentistry & Endodontics
Faculty of Dental Sciences
 Diagnostic instruments:
1 ) MOUTH MIRROR:- (odontoscope)
Types:-
A) Front surface:
the reflecting surface is on the top of the
glass piece.
Gives better visibility.
Absence of intervening glass.
No double image.
Mercury coating on top is lost due to scratching.
B) Rear surface (regular):
Reflecting surface is on the back surface of the mirror lens.
Surface is less easily scratched.
Produces a double or ghost image.

Dr. V. Pradeeba , MDS

Dept. of Conservative Dentistry & Endodontics
Faculty of Dental Sciences
 Diagnostic instruments:
C) Magnifying mirror (concave):-
Reflecting surface - front surface of the mirror lens.
IMAGE : magnified but slightly distorted.
Concave surface - magnifies the image
For seeing enlarged internal details of the cavity.
For endodontic surgeries.
Instrument movements - smaller than the clinician
visual perception - clinician to learn to
accommodate movement.
D) Double sided mirror:
For retraction
D) Disposable mirror:-
Made of plastic.
Dr. V. Pradeeba , MDS
Dept. of Conservative Dentistry & Endodontics
Faculty of Dental Sciences
 Diagnostic instruments:
Uses:-
Indirect vision.
Indirect illumination: - held at an angle - reflect the light onto the
working area.
Retraction : patient’s lip or cheek or tongue so that the clinician is
able to view tooth surfaces.
Guard - Protects from injury.
Different sizes of mouth mirror:-
No. 2 (5/8 inch)
No. 4 (7/8 inch)
No. 5 (15/16 inch)

Dr. V. Pradeeba , MDS

Dept. of Conservative Dentistry & Endodontics
Faculty of Dental Sciences
 Diagnostic instruments:
2 ) Probe:
Sharp pointed single-ended or double-ended hand instrument
Uses:-
For detecting and assessing carious lesion in the tooth
Detecting demineralized dentin.
Releasing debris from the tooth.
Removing slight excess fill up around cavo-surface margins
Identifying hypersensitive areas in the tooth
Assessing marginal fit of the restoration

Dr. V. Pradeeba , MDS

Dept. of Conservative Dentistry & Endodontics
Faculty of Dental Sciences
 Diagnostic instruments:
Types:-
1)Straight.
2)Interproximal probe
No.2 cow horn (arch explorer)
No. 23 shepherd’s hook
Orban –type explorer
No.17 back action

Dr. V. Pradeeba , MDS

Dept. of Conservative Dentistry & Endodontics
Faculty of Dental Sciences
 Diagnostic instruments:
3) Periodontal probe:-
Detect and measure the depth of
periodontal pockets.
In operative dentistry:-
Used to determine the dimensions
of instruments and of various
features of preparations or
restorations

Dr. V. Pradeeba , MDS

Dept. of Conservative Dentistry & Endodontics
Faculty of Dental Sciences
 Plastic carrying/ filling instruments:
It is an instrument used for carrying
the mixed base cements which are in
soft (plastic) stage or the restorative
cement from a cement spatula to the
cavity.

one end - flat - carrying the cement

other end – cylindrical - manipulating
and positioning the cement.
Made of: Stainless steel / Plastic
Also can be plated with teflon to
minimize material adhesion.

Dr. V. Pradeeba , MDS

Dept. of Conservative Dentistry & Endodontics
Faculty of Dental Sciences
 Condensing instruments:
To pack material into prepared cavity.
Types:
A) Amalgam condenser
Hand
Mechanical
Vibratory and Impact
B) Gold condenser
Hand
Mechanical.
Hand condenser:-
Are double-ended instruments with the nibs (condensing tips)
coming in different size and shapes.
Force varies inversely with the area of the face.

Dr. V. Pradeeba , MDS

Dept. of Conservative Dentistry & Endodontics
Faculty of Dental Sciences
 Condensing instruments:
Nibs may be:-
Of different shapes:-
- Round - Elliptical
- Diamond - Triangular
- Parallelogram - Rectangular
Sizes vary considerably;
Large round condenser
Small round condenser
III) Depending on working end;
(condenser face).
Serrated – For spherical amalgam
Non-serrated (smooth) – For
admixed amalgam

Dr. V. Pradeeba , MDS

Dept. of Conservative Dentistry & Endodontics
Faculty of Dental Sciences
 Carving instruments
Hand instrument with a blade or nib used to contour the surface of
filling material in their plastic state, waxes, models and patterns.
e.g.-
Hollenback carver (Knife- edged- elongated bibeveled)
Diamond (Frahm’s) carver
Bibeveled cutting edge
Wards ‘C’ carver
Discoid
cleoid
Interproximal carver
Hollenback, Diamond and Wards :
One blade is parallel to the long axis of the instrument and the
other is perpendicular to the long axis of the instrument.

Dr. V. Pradeeba , MDS

Dept. of Conservative Dentistry & Endodontics
Faculty of Dental Sciences
 Burnishing instruments:
Hand instrument with rounded edges used to polish or burnish the
surface of metallic restorations by rubbing.
Burnishing is the process of rubbing, usually performed to make a
surface shiny or lustrous.
Double-ended.
Nibs are :
Spherical. Ball shaped.
Egg shaped. Apple shaped.
Beaver tail shaped. Conical.
Hour glass. Fish tail.
Bullet shaped etc.
Nibs are smooth-faced.
Different angulations and curvature in their shank.

Dr. V. Pradeeba , MDS

Dept. of Conservative Dentistry & Endodontics
Faculty of Dental Sciences
Instrument grasps
Modifie
d pen

Modifie
d palm Inverte
and d pen
thumb

Palm
and
thumb

Dr. V. Pradeeba , MDS

Dept. of Conservative Dentistry & Endodontics
Faculty of Dental Sciences
  Modified pen grasp
 The grasp that permits the greatest
delicacy of touch.
 Pads of thumb, index and middle
fingers contact the instrument, while
the tip of the ring finger is placed on
a nearby tooth surface of the same
arch as a rest.
 The palm is generally facing away
from the operator.
 The instrument should not be
allowed to rest on or near the first
joint of the middle finger.

Dr. V. Pradeeba , MDS

Dept. of Conservative Dentistry & Endodontics
Faculty of Dental Sciences
Inverted pen grasp
The palm is rotated upwards with
the pad of the thumb and index
fingers close to each other but the
middle finger is farther down the
shank.
Used mostly for the tooth
preparation utilizing the lingual
approach on maxillary anterior
teeth.

Dr. V. Pradeeba , MDS

Dept. of Conservative Dentistry & Endodontics
Faculty of Dental Sciences
Palm and thumb grasp
 The handle of the instrument is held between the palm and four fingers
firmly with the tip of the thumb acting like a rest.
 Power grasp.
 Advantages: More control and precision & Limited movement.
 EnhanceD bracing (a forward thrust with the arm of wrist can be controlled
by the opposing action from the thumb, which is braced against the teeth).
 Gives the possibility of applying pressure precisely.
 Example: holding a hand piece for cutting incisal retention for Class III
preparation on maxillary incisor.

Dr. V. Pradeeba , MDS

Dept. of Conservative Dentistry & Endodontics
Faculty of Dental Sciences
 Dr. V. Pradeeba , MDS
Dept. of Conservative Dentistry & Endodontics
Faculty of Dental Sciences
Modified palm and thumb grasp
The handle of the instrument is held by all four fingers whose pads
press the handles against the distal area of the palm, as well as the
pad and first joint of the thumb.
The rest is tip of thumb on tooth being prepared or adjacent teeth.
Advantages:
Most valuable aid in operating inside and outside the mouth.
Allows greater ease of instrument movement.
More control against slippage during thrust stroke compared to palm
and thumb grasp.
Grasping the handle under the first joint of the ring and little finger
acts as a stabilizer.
More delicate manipulation.
Dr. V. Pradeeba , MDS
Dept. of Conservative Dentistry & Endodontics
Faculty of Dental Sciences
 Dr. V. Pradeeba , MDS
Dept. of Conservative Dentistry & Endodontics
Faculty of Dental Sciences
 REST
Finger rests classified as
 Intra oral finger rest
 Extra oral fulcrum Intra oral finger
rest

Sturdevant’s classification of rest:

 Intra –arch hard tissue rest.

 Soft tissue rest.
 Indirect rest.

Dr. V. Pradeeba , MDS

Dept. of Conservative Dentistry & Endodontics
Faculty of Dental Sciences
 Intra oral finger rest
1. Conventional : Finger rest is
established on the tooth surfaces
immediately adjacent to the working
area.

Closer rest areas are more reliable.

Dr. M. Indumathi, MDS

Dept of Cons & Endo
Faculty of Dental Sciences
2. CROSS ARCH
Finger rest is established on the tooth surfaces on the other side of the
same arch.

Dr. V. Pradeeba , MDS

Dept. of Conservative Dentistry & Endodontics
Faculty of Dental Sciences
3. Opposite-arch :
Finger rest is established on tooth surfaces on the opposite arch (e. g:-
mandibular arch finger rest for instrumentation on the maxillary arch).

Dr. V. Pradeeba , MDS

Dept. of Conservative Dentistry & Endodontics
Faculty of Dental Sciences
4. Finger – on – finger :
Finger rest is established on the index finger or thumb of the non
operating hand.

Dr. V. Pradeeba , MDS

Dept. of Conservative Dentistry & Endodontics
Faculty of Dental Sciences
 Extra oral fulcrums :

Two most commonly used-

(1) Palm-up fulcrum is established by resting the backs of the middle
and ring fingers on the skin overlying the lateral aspect of the
mandible on the right side of the face.

Dr. V. Pradeeba , MDS

Dept. of Conservative Dentistry & Endodontics
Faculty of Dental Sciences
(2) Palm-down:
Palm- down fulcrum is established by resting the front surfaces of the
middle and ring fingers on the skin overlying lateral aspect of the
mandible on the left side of the face.

Dr. V. Pradeeba , MDS

Dept. of Conservative Dentistry & Endodontics
Faculty of Dental Sciences
THANK YOU

Dr. V. Pradeeba , MDS

Dept. of Conservative Dentistry & Endodontics
Faculty of Dental Sciences