hand insturments

Instrument in operative dentistry

Lec. 2 Karam ahmed Msc .operative dentistry

Instruments in Operative Dentistry

nib (face) - blade
Hand Instruments
Instrument Design
Single ended - Double ended
Shank
Shank
Handle
blade
blade
Cutting and non cutting



Instrument Nomenclature
Function: e.g. condensers, carvers, cutting inst. ……. etc. Manner of use: hand condenser, mechanical condenser … Design of working end: spoon excavator, sickle scaler.
Angulations of the shank: mon-angle, bin-angle, triple…

Examples of hand instruments called chisels (with corresponding instrument formulas). A, Enamel hatchet (B, Gingival margin trimmer (C, Gingival margin trimmer (


Examples of hand instruments called chisels (with corresponding instrument formulas). A, Straight B, Wedelstaedt (). C, Bin-angle


Other cutting instruments Cleoid-discoid: used for caving unset amalgam and burnishing inlay/onlay margins

Knives: finishing knives, amalgam knives, gold knives. All used for trimming the excess filling materials at cavity margins. Files: different size and shape also used for trimming the excess of filling material particularly at gingival margins.

discoid

Cleoid
file

Non cutting instruments

Diagnostic: mirror, probe (dental explorer), tweezers.
Filling : Dycal applicator, Cement spatula, Ash 49, Glass slap, Retainer, Dappen dish, Amalgam carrier, Condenser, Hollenback carver, Burnisher, Plastic instrument…….


Pen Grasp
Modified Pen Grasp

Inverted Pen Grasp

Palm and Thumb Grasp

9:00 Right

Operating Positions
Operator stool
Dental chair
6:00
7:00 Right front
11:00 Right rear
12:00 Direct rear
Patient's head


Right front: Mandibular anterior. Maxillary anterior. Mandibular posterior (right and left). Right: Buccal surface of maxillary and mandibular posterior. Occlusal of right mandibular posterior. Right rear: All maxillary teeth (indirectly by mirror) Directly without mirror for labial surface of maxillary anterior and lingual surface of mandibular anterior specially right side. Direct rear: Directly for lingual surface of mandibular anterior (both sides).



General position considerations Miner rotation for patient head to accommodate the demands of accessibility and vision is acceptable. When working on maxillary arch, the occlusal surfaces or maxillary teeth oriented to be approximately perpendicular to the floor. When working on mandibular arch, the occlusal surfaces of mandibular teeth oriented to be approximately 45 degree with the floor. Avoid close face proximity to the patient (the ideal distance is as reading a book). Minimize body contact and avoid resting forearm on patient’s shoulders, head or face as possible. Left hand usually free and used for holding mirror for viewing or retracting soft tissues and tongue and reflecting light onto operating field to view the cavity indirectly. For long operations, operator must change the position even for a short period to reduce muscle strain and fatigue. Proper distribution of balance on both feet in standing position. In sitting position, the stool must be adjustable up and down and well padded with smooth cushion, backrest adjustable all directions as well. Operator stool without foot ring to permit resting the feet on floor. Thighs parallel to the floor. Spinal column straight or slightly forward bended with minimal tension. Assistant’s stool 4-6 inches higher than operator for better vision, so assistant stool is provided by foot ring for feet rest.

Operator

Assistant
Foot ring
Back-rest