1. College of Dentistry, Almajma University, Zilfi

3.  Name and identify parts of hand instruments  Differentiate between double and single ended instruments  Distinguish and use mono, bin and triple angled instruments  Define and identify primary cutting edge of blades

4.  Use and identify single and bi beveled inst  Name examination instruments  List uses of a mouth mirror, probe & tweezers  Identify and demonstrate use of various restorative instruments  Enumerate hand -cutting instruments

5.  Identify and mention use of hand-cutting instruments  Explain significance of instrument formula and describe 3 -digit formula  Name, identify and mention uses of restorative instruments  Name, identify and mention uses of accessory instruments used in operative dentistry

6. A tool or device used for specific purpose or task

7. Hand instruments Rotary instruments

9.  Stainless steel  Carbon steel  Alloys of Nickle, Chromium and cobalt

10. Handle (shaft) Shank Working End / Blade Slide 10

11. SINGLE ENDEDDOUBLE ENDED

12.  Mon angle  Bin angle  Triple angle

16.  Primary cutting edge  Secondary cutting edge

17.  Single beveled instruments  Bibeveled instruments

18. an edge that is not perpendicular to the faces of a structure مسطار الزوايا

19. Examination Hand-cutting Restorative Accessory

20. Mirror Explorer /probe Tweezers/ cotton pliers Periodontal probe Articulating paper holder

21. Slide 21

22. Indirect vision Light reflection Retraction Tissue protection

23. Slide 23

24. A: front view gives normal image B: Rear view mirror gives enlarged image

25. Distinguish areas of calculus Distinguish decay Distinguish areas of discrepancies on teeth

26. Measure the sulcus or pocket depth of the periodontium

27. used to check a patient’s “bite ”

28. Carry, retrieve and place small objects

29. NON-LOCKINGLOCKING

30.  Excavator  Hatchet  Gingival margin trimmer  Hoe  Chisel

31. used for the removal of soft dentin, debris, and decay from the tooth

32. excavators Bin-angle Tri-angle Mono-angle

33. Used for cutting enamel, and to smooth the walls and floors of cavity during preparation

34. Used to cut enamel and place bevels along the gingival enamel margins of the preparation

35. Used to plane the walls and floors of a cavity during preparation

36. Used to cut the enamel margin of the tooth preparation, form sharp lines, point angles, and place retention grooves  Straight chisel  Bin-angle chisel

37. chisels

38. Cutting instruments have formulas describing the dimensions and angle of blade

39. 15-8-14

40. First two digits (15) designate the width of the blade in tenths of a millimeter It means 15/10 = 1.5 mm blade width

41. 3 rd digit (8)designate its length in millimeters It means Length of blade = 8 mm

42. 4 th & 5 th digit (14 ) represents the angle which the blade forms with axis of the handle expressed in hundredths of a circle (100 gradations or centigrades) It means 14% of a circle Circle = 360 degree Converting % into circle degrees 14/100 X 360 = 50 degree

44. It transfers amalgam from amalgam well to the cavity

45. condenses amalgam into the cavity

46. Amalgam carver carves amalgam after placement

47. Burnishes amalgam after insertion

48. Designed specifically for the placement of composite restorative materials  Anodized aluminum  Teflon

49. used for carrying dental materials to the prepared tooth structure

50. Cement Spatulas Used for mixing cements

51. Used for cutting dental dam material, retraction cord, and stainless steel crowns

52. Hold certain liquid, dental materials during a procedure

53. newly mixed amalgam is kept

55.  Define rotary instrument  Mention various rotary instruments  Identify and distinguish b/w high and low speed hand pieces  Mention speed ranges of high and low speed hand pieces  Mention uses of high and low speed hand pieces  Define a dental drill and mention its types

56.  Differentiate b/w a bur and a point  Name parts of a drill  Identify and name shank designs of drills  Name the material for making blade of commonly used burs  Name the material used for making commonly used abrasive points  Mention types of tungsten carbide burs  Identify & name basic shapes of burs 

57.  Mention various lengths of shanks of drill  Name and hold instruments using various grasp  Mention precautions to use rotary instruments

58. Hand Pieces Burs Polishing instruments

59.  Low speed  High speed

60. Low speed Speed ranges from 10,000 to 30,000 rpm Operates in clock and anti clock direction

61. Slide 61  Removal of soft decay  Finishing of a cavity preparation  Finishing and polishing restorations  Coronal polishing and removal of stains  Porcelain adjustments  Root canal treatment

62. Slide 62  Straight Attachments  Contra-Angle Attachment

64. High-Speed Handpiece Operates with air pressure Operates at speeds 200000- 450,000 rpm Slide 64 Also known as Air-Turbine or Air rotor

65. Slide 65  Remove decay  Remove old or faulty restoration  Reduce crown portion of the tooth for preparation of a crown or bridge  Prepare outline and retention grooves for a new restoration  Finish restoration

66. 1. Diamond and carbide cutting instruments remove tooth structure faster with less pressure and vibration 2. Number of rotary cutting instruments needed is reduced because smaller sizes are more universal in application 3. Operator has better control and greater ease of operation

67. 4. Instruments last longer 5. patients are generally less apprehensive because annoying vibrations are decreased 6. Several teeth in the same arch can be treated at the same appointment 7. Operating time is reduced

69. The powered rotary instruments used for cutting and shaping a tooth or a prosthesis

70.  Bladed  Abrasive

71. They have bladed cutting heads and known as Dental Bur Made of tungsten carbide, steel, vulcanite

72.  Plain cut  Cross cut

73. For most Operative Dentistry procedures at high speed

74. For more efficient cutting at slow speed

75.  Diamond abrasives  Other abrasives

76. They are made of diamond which has abrasive action 

77. Diamond particles with some matrix are glued on a shaftand called Diamond points

78.  Many types of abrasive instruments are used in dentistry in addition to diamond instruments  They were at one time extensively used for tooth preparation, but their use is now primarily restricted to shaping, finishing & polishing

79. Slide 79

81. 1. Shank 2. Neck 3. Head 1 2 3

82. Unlike shank in the hand-instruments, rotary instrument shank fits into a hand piece and accepts the rotary motion

83. Latch lock Friction lock

84.  It is used for LOW Speed Hand Pieces

85.  It is used for HIGH Speed Hand Pieces

86. 16 mm 19 mm (most common) 21 mm 25 mm

89. Grasp handle with your thumb and first finger while your middle finger supports the instrument from underneath This is a favorite grasp for mouth mirror

92. Almost everything done in a dental office involves some risk to the  patient  Dentist  Auxiliaries

93. 1. To pulp from the tooth preparation and restoration procedures 2. To soft tissues 3. To eye 4. To ear 5. Inhalation danger

94.  The use of cutting instruments can harm the pulp by exposure to mechanical vibration, heat generation, desiccation and loss of dentinal tubule fluid  As the thickness of remaining dentin decreases, the pulpal insult (and response) from heat or desiccation increases  Slight to moderate injury produces a localized, protective pulpal response in the region of the cut tubules  In severe injury, destruction extends beyond the cut tubules, often resulting in pulpal abscess and death of the pulp

95. These pulpal sequelae (recovery or necrosis) take from 2 weeks to 6 months or longer, depending on the extent and degree of the trauma Although a young pulp is more prone to injury, it also recovers more effectively when compared with an older pulp, in which healing and recovery are slower and less effective

96.  Enamel and dentin are good thermal insulators and will protect the pulp if the quantity of heat is not too great and the remaining thickness of tissue is adequate  The longer the time of cutting and the higher the local temperature produced, the greater is the threat of thermal trauma  Burs and diamond instruments that are dull or plugged with debris do not cut efficiently, resulting in heat production  When used without coolants, diamond instruments generate more damaging heat than carbide burs

97.  The lips, tongue, and cheeks of the patient are the most frequent areas of soft tissue injury  The handpiece should never be operated unless there is good access and vision to the cutting site  A rubber dam is very helpful in isolating the operating site  When the dam is not used, the dental assistant can retract the soft tissue on one side with a mouth mirror, cotton roll, and/or evacuator tip

98.  The dentist usually manages the other side with a mirror and/or cotton roll  If the dentist must work alone, the patient can help by holding a retraction-type saliva ejector evacuator tip, after it is positioned in the mouth

99.  With air-turbine handpieces, the rotating instrument does not stop immediately when the foot control is released  The operator must either wait for the instrument to stop or be extremely careful when removing the handpiece from the mouth so as not to lacerate soft tissues  The large disc is one of the most dangerous instruments used in the mouth  They should be used with light, intermittent application and with extreme caution

100.  When using high speeds, particles of old restorations, tooth structure, bacteria, and other debris are discharged at high speeds from the patient's mouth  The operator, assistant, and patient should wear glasses with side shields to prevent eye damage from airborne particles during operative procedures utilizing rotary instrumentation

101.  Precautions must be taken for prevention of eye injury from unusual light sources, such as visible light-curing units and laser equipment  Dental personnel and patients should be protected from high intensity visible light using colored plastic shields (attached to the fiber-optic tip)  Laser light can be inadvertently reflected from many surfaces in the dental operatory; therefore the operatory should be closed, and everyone should wear protective goggles

102.  Turbine handpieces at 30 pounds air pressure, may have noise levels as high as 70 to 94 decibels (db) at high frequencies  Noise levels in excess of 75 db in frequency ranges of 1000 to 8000 cycle per seconds (cps) may cause hearing damage

103.  The effect of excessive noise levels depends on exposure times  Normal use of a dental handpiece is one of intermittent application that generally is less than 30 minutes per day  Earplugs can be used to reduce the level of exposure but have several drawbacks  Room sound proofing helps and can be accomplished with absorbing materials used on walls and floors  Anti-noise devices can be used to cancel unwanted sounds

104.  A rubber dam protects the patient against oral inhalation of aerosols or vapors, but nasal inhalation of vapor and finer aerosol may still occur  Disposable masks worn by dental office personnel filter out bacteria and all but the finest particulate matter 

105.  Chapter 7  Sturdevant’s Art and Science of Operative Dentistry