CONSULTATION KIT

1) DENTAL MIRROR
It presents three parts :
1.Working end of instrument
2. neck of the instrument
3. Handle ot the instrument

1) Working end of instrument

- is usually round
- may have several diameters :
vsize 1 (16mm),size 2 (18mm), size 3 (20mm), size 4 (22mm), size 5 (24mm ) and
size 6 (26mm)
There are two general types of mouth mirrors:
Ø plane glass mirrors in which the reflected image is the same size as the object being
viewed,
Ø magnifying mirrors in which the reflective image provides an enlarged view.

2. Neck of the instrument

- The part between the working end and the handle

- Can be straight / angled / forked
Can be can be fixed or Mirrors are screwed to their handles

3. Handle ot the instrument

Is the part of the instrument that the operator grasps
may be of stainless steel / plastic
 may have length / thickness different
surface can be smooth or may have different impressions (for grasp)

Depending on the material dental mirror can be :

- Disposable mouth mirror
- Metallic mouth mirror

The mouth mirror has a wide range of uses.

Four of its most important functions are:
1.allowing indirect vision by the dentist,
2.reflecting light onto desired surfaces,
3.retraction and protection of oral soft tissues
4.magnification

2) DENTAL TWEEZER, COTTON FORCEPS

The working end of a pair of cotton pliers consists of two tapered opposing portions
that form a 60-degree angle with their handle. Varieties
- Locking dental tweezers
- Dental tweezers non-locking
Working end can be straight, curved, serrated or smoothFUNCTIONS
¨Placing small objects in the mouth and retrieving small objects from the mouth
¨Handling small instruments
¨To carry liquid medication between the closed beaks for deposit in areas of the
mouth or teeth

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 3)DENTAL PROBE
Are sharp, thin, pointed metallic instruments
Presents 3 parts:
a.Working end
b. Neck
c. Handle
- Can be single ended or double ended
- Working end may vary: straight or curved
- Three different explorers are commonly used in the Dental Service: 6, 17, 23
Function:
Detection of:
¨Caries
¨Defective pits and fissures
¨Calculus
¨Deficient margins of restauration, crowns and bridges
¨Examination (pointed tip allow good tactile sensitivity)

Instruments used in dental prevention

a) Remove plaque by mechanical means

The main instruments to remove plaque: The toothbrush

The two basic types of toothbrushes are: Manual and Electric

Electric toothbrushs
INDICATIONS
 Electric toothbrushes are an effective choice for anyone, but especially for
children
 Electric toothbrushes also work well for people who have limited use of their
hands due to arthritis since less manual motion of the toothbrush is required.
 Older people also may have more success using an electric toothbrush.

To prevent gum disease,halitosis and dental caries is necessary to use adjuvant

means brushing : Dental floss, Interdental brush, Rubber stimulator, Interdental
picks, End or Single tuft toothbrush

a. Interdental brush
There are two types of these brushes : Tapered and cylindrical
Interdental brushes are available in various sizes (they come in eight color-coded
sizes) .
Interdental brushes are available in various forms: can be straight or angled
b.End or single tuft toothbrushes
 These are toothbrushes with only one tuft of bristles.
 They are used where the normal, multi-tufted toothbrushes cannot reach.
 These brushes are designed for brushing around crowns, bridges, displaced
and rotated teeth.

b)Remove plaque by chemical means

Mouth rinses
Toothpastes

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 Dental plaque can be removed at home (by mechanical brushing, using brushes)
but can be removed in the office by dentist (professional teeth cleaning, using
appropriate tools)

We need :
1) Dental Handpieces
2) Brushes, prophy cup
3) Prophy paste

1. ) Dental Handpieces – Slow speed handpieces (Contra angle, Straight

handpiece)

-The speed of the motor ranges from 4,000, or 40,000 rpm depending on the
model.

2) Prophy cup brushes

Presents three parts: handle, shank, and working end
-Working end can have three forms: - Tappered , - Flat , - Cup-shape
- Available with:
•Nylon filaments , •Chunking, .•Goat hair, remarkably soft hair for use on
periodontal or gingivitis patients; also very good for polishing teeth of expectant
mothers

3) Prophy paste
 The prophy paste is the material aplied to the tooth with the rubber cup or
prophy brush that remove stains and soft deposits , leaving a clean tooth
surfaces.
 Are available in measured amounts , in individual packets as well as in bulk.

INSTRUMENTS USED IN PARODONTOLOGY

1) PERIODONTAL PROBE
Functions of periodontal probe
 Measures the depth of a gingival crevice (sulcus)
 Measures the depth of gingival and periodontal pockets
 Measure the loss of attachment of the tooth.
 determine the configuration of the periodontal pocketsassessment of furcation
lesionsA healthy sulcus depth is usually three millimeters or less. More than 3
mm talk about periodontal pockets Presents 3 part: a.Working end b. neck c.
Handle

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 a.Working end - The working end of the periodontal probe is basically a
small, calibrated stick for measuring periodontal pockets or other lesions
There are many choices for probe design.
The end may be long or short,
- Round in diameter (ball end), or flattened
- and is marked in millimeters on the side
Depending the gradations we can talk about : Nabers probe (is curved, 3-6—9mm,
Marquis probe (3-6-9-12mm), Michigan probe - 3.6.8 mm., Williams probe
(1,2,3,5,7,8,9, 10 mm),
Periodontal probe can be - single ended /double ended

According to the material: metallic probes , plastic probes (indicated for implants)
Ex. The Periowise
The Periowise patented, multi-coloured Periodontal Probe is easy to read, gentle on
tissue and safe to use around implant fixtures.
- Clear, well-defined markings in green and red give high visibility against tooth
substance and soft tissue and ensure accurate pocket depth readings.
Ex. Colorvue Probes (Hu-Friedy)
Vivid yellow tip and black markings provide increased intraoral visibility for
faster and more accurate assessments.
Flexible, rounded tip ensures greater patient comfort and acceptability.
Safe for use with implants.

2) Instruments used for scaling and root planning are classified as

A) Hand instruments and B)Ultrasonic and sonic

A) Hand instruments

Parts of Periodontal Instrument

instrument.
Handle—the part of a periodontal instrument used for holding the instrument.
Neck/shank —a rod-shaped length of metal located between the handle and the
working-end of a dental

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-The shanks of an instrument are classified as simple (straight) or complex (angled).
- In general, simple shanks are designed for use in areas of easy access like the
anterior teeth.
-The more complex or angled shanks are designed for areas that are more difficult to
access, such as the posterior teeth.
Working-End (blade)—the part of a dental instrument that does the work of the
-There is tremendous variation in the working end of dental hygiene instruments
based on their usage, including differences in toe and tip length, angulation, cutting
edges, and working strength.

TRAPEZOIDAL INSTRUMENTS
- pair instruments

- The activ part is trapezoidal

CLAW
- Pair instruments
- The active part has the form of an eagle's claws;
- Has a peak (which is inserted into the interdental space) and two sharp
sides
- Can has varios sizes

For subgingival scalling and rootplaning we use CURETTES

Two Types of Curette Designs: Universal Curette and Specific curette (Ex. Gracey
curettes)
UNIVERSAL CURETTE. The universal curette is a paired instrument designed to
adapt to most areas of the dentition by

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altering and adapting the finger rest, fulcrum, and hand position.
• the blade of the universal curette is situated perpendicular to the edge of the
terminal shank (90 degree blade angulation)
• Two parallel cutting edges are formed, one on either side of the face.Both
cutting edges are used
SPECIFIC CURETTE
Differ from the universal curettes in several ways:
- First, they are a set of several instruments designed and angled to adapt to a
specific anatomic area of the dentition.
Second, these curettes are designed with only one cutting edge
Gracey Curette
- has a blade that is laterally offset by 70 degrees relative to the shank.
- complete set includes 9 pairs of curette, active at both ends -are numbered according
to the area of use .
- on the curettes handle there are a number , but to be easier to detect, handle is
colored (each number has a color )
The Gracey 1-2 and 3-4 are used for the removal of subgingival plaque, calculus and
rootplaning in the upper and lower anterior areas.
Gracey curettes 5-6 are used for the removal of subgingival plaque, calculus and
rootplaning: incisors, canines, premolars
Gracey curettes 7-8 , Vestibular, lingual surfaces in the premolar and molar areas
Gracey curettes 9-10, Vestibular, lingual surfaces in the premolar and molar areas
Gracey curettes 11-12,mesial surfaces in the premolar and molar areas.
Gracey curettes 13-14, distal surfaces in the (pre)molar areas.

- The Gracey curettes can be: sterilizable (mettalic, silicone) or disposable (Are
indicated for implants (avoid their damage )Ex Implacare curette (Hu-Friedy)
Besides of standard curetts there are other types of curettes :
1.Curettes spécial Gracey After-Five (Hu-Friedy)- The shank is longer by 3 mm, in
order to penetrate the deeper pockets of 5mm
2.Curettes spécial Gracey Mini-Five (Hu-Friedy) - The active part is half , of the
standard currettes lengh . It allows a easy insertion in deep and narrow pockets

SHARPENING OF PERIODONTAL INSTRUMENTS

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-For efficient and effective root planing and scaling, it is essential that curettes and
hand scalers are sharpend correctly and frequently.
The objective of sharpening is to produce a sharp cutting edge without changing the
original design of the instrument
Sharpening stones are available in various grits (textures) and designs to meet a
particular need. (Ex. Arkansas stones, India stones, Ceramic stones)

B) Ultrasonic and sonic instruments

- Ultrasonic scaler is mainly used to remove dental calculi, tobacco stains,
bacterial specks and tea stains.
Compared with manual scaling, it has such advantages as:
- less bleeding,
- high efficiency
- no damage to teeth
- more comfortable access to the root surfaces, thanks to the small tip.
It consists of a wand with a small scaling tip that produces a soft ultrasonic
vibration
There are two types of ultrasonic scalers: Magnetostrictive and Piezoelectric
-IN MAGNETOSTRICTIVE, PATTERN OF VIBRATION IS ELLIPTICAL- ALL
SIDES OF THE TIP ARE ACTIVE
-IN PIEZOELECTRIC, VIBRATION IS LINEAR- TWO SIDES OF TIP ARE
ACTIVE
There are inserts for cleaning implants : plastic or carbon fiber (disposable)

Crane – Kaplan pliers

- is a Periodontal Pocket Marker
Pocket markers are similar in appearance to cotton pliers; however, one tip is smooth
and straight and the other is sharp and bent at a right angle
The smooth tip of the pocket marker is inserted at the base of the pocket, and when
the instrument is pressed together the sharp tip makes small perforations in the
gingivae.
These perforations, which are referred to as bleeding points, are used to outline the
area for an incision on the gingivae

INSTRUMENTS TO REMOVE SOFT TISSUE (lips, tongue, cheeks

Retractor Farabeuf
a. Metalic instrument
b. presents a horizontal part and 2 vertical parts - Vertical parts have
different sizes

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Choosing the right size is according to the:
-patient (children- small parts ; adult - large parts)
-region (anterior-small parts, posterior – large parts)
-tissue removed

INSTRUMENTS FOR INCISION (INSTRUMENTE PENTRU INCIZIE)

- The instrument for making an incision is the scalpel (periodontal knife).
- There are scalpel with blade fixed or disposable
Scalpel with disposable bledes
Scalpel components:
a) Blade,
b) Handle
Scalpel blades may have different forms. The most blades used in oral surgery : 11,
12, 15. The blades are disposable and are mounted in the handle
Scalpel Handle may be : Disposable (plastic) ; Sterilisable (metalic)
- handle may have a different design -- At the handle there are a number. Iin oral
surgery are used handles 7 and 8

Periodontal knives: (ex Kirkland, orban, Bulk)

The most commonly used periodontal knives are the Kirkland and the Orban
The Kirkland knife is one of the most commonly used knives in periodontal surgery
This knife is a single-ended or double-ended knife used for initial gingivectomy
incision, tuberosity and retromolar pad reduction, and free gingival grafts preparation
Kirkland knives have three cutting edges to sharpen, the inner, outer, and back
edge.
The Orban knife is used to remove tissue from the interdental areas.
These knives are shaped like spears and have cutting edges on both sides of their
blades

INSTRUMENTS FOR RETRACT THE TISSU FLAPS(PERIOSTEAL

ELEVATORS)
Periosteal elevators are used to separate and raise periosteum from the surface of the
bone and retract the tissue flap
Periosteal elevator is composed of:
1) handle,

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 2) neck,
3) working end (blade)
3) All edges are rounded slightly to avoid needless injury to the tissues.
- Presents 2 sides : concave (in contact with periosteum) and convexe (in contact with
the bone)
Periosteal elevator can be - single ended /double ended

INSTRUMENTS FOR RESECTION OF BONE

For bone resection can use:

-1) Rongeurs (Bone cutting)
-2) Bone files
-3) Surgical drills

1) Rongeur bone(bone cutting)

Rongeur is composed of : handle, articulation (joint),working end
- Between the the arms of rongeurs there are an arch that allows repeated sectioning
of the bone The blade (working end):
- presents an external face (convex) and and an internal face (concave)
•This instrument has sharp blades that are squeezed together by the handles , cutting
or pinching through the bone.
•The blades can be straight or curved • Rongeur forceps have a leaf spring between
the handle so that when hand pressure is released, the instrument will open.This
allows the surgeon to make repeated cuts of bone without manually reopening the
instrument FUNCTION
-The forceps can be inserted into sockets for removal of interradicular bone, but they
can also be used to remove sharp edges of bone.
-Rongeurs can be used to remove large amounts of bone efficiently and quickly.
Because rongeurs are relatively delicate instruments,the surgeon should not use the
forceps to remove large amounts of bone in single bites. Rather , smaller amounts of
bone should be removed in each of multiple bites.
-Likewise,the rongeurs should not be used to remove teeth, because this practice will
quickly dull and destroy the instrument.
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-Rongeurs are usually quite expensive, so care should be taken to keep them in
working order.
2) Bone files
When access is small can be used the bone files and the surgical drills
Files are a series of fine short blades or hoes at an angle to the shank and are quite
difficult to sharpen
Are used for smoothing edges and irregular bone surfaces.

3)Surgical drills -surgical drills are used at lower speeds ( straight or contra-angle
handpieces).
-The most used drills : Lindemann drill, drills round no 8, cylindrical drills

INSTRUMENTS FOR HEMOSTASIS

Kocher Hemostatic forcepsFUNCTION:

- to achieve haemostasis
Can exist in different dimensions •(14 cm, •16 cm, •20 cm, •24 cm, •25 cm
•28 cm)

Hemostatic forceps consist of:

- handle (locking dandle)
- joint (articulation)
- working end
Active part is formed of two jaws. Each jaw presents an external face (smooth) and
an internal face (provided with many grooves ) . At the top of the jaws are 2 beaks

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Locking HandleThe locking mechanism allows the surgeon to clamp the

hemostat onto a vessel and then let go of the instrument, which will
remain clamped onto the tissue.
They can be of different types: straight, curved

SURGICAL FORCEPS PEAN

FUNCTION:
- to grasp tissue or bone fragments
- to hold and grasp material in and out of the oral cavity

INSTRUMENTS FOR SUTURING MUCOSA

Needle holderThe needle holder is composed of:
1) WORKING PART,
2) HANDLE,
3) JOINT
1) Working end (blade short and thick ) with:
- an external face (convexe) smooth and
- an internal face (concave) which has many grooves
- different lengths, curved or straight
2)At the handle exist a locking system (allow keeping the needle in needle holder)

FUNCTION;
- to grasp and manipulate suture needle during use
• The face of the beak of the needle holder is crosshatched to permit a positive grasp
of the suture nee dle and suture.
• The hemostat has parallel grooves on the face of the beaks, thereby decreasing the
control over needle and suture. Therefore the hemostat should not be used for suturing
The beak of the needle holder is shorter and stronger than the beak of the hemostat

INSTRUMENTS FOR EXTRACTION

1. Dental elevator
• These instruments are used :- to luxate teeth from the surrounding bone. (by luxating
the teeth before the application of the forceps, the clinician can minimize the
incidence of broken roots and teeth.)

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-Finally,elevators are used to remove broken or surgically sectioned roots from their
sockets. Elevators are designed with specific shapes to facilitate the removal of roots
from sockets
The major components of the elevator are: blade , shank, handle

a.The handle of the elevator is usually of generous size, so it can be held comfortably
in the hand to apply substantial but controlled force.
.b. The neck of the elevator simply connects the handle to the working end, or blade,
of the elevator. •The neck is generally of substantial size and is strong enough to
transmit the force from the handle to the blade. . Can be straight, curved or double
curved (in bayonette- for posterior maxilar zone)
c. The blade of the elevator is the working tip of the elevator and is used to transmit
the force to the tooth, bone, or both

Dental elevators for maxillary

Features:
- are unique, the shank can be straight or in bayonet (for posterior upper teeth)

1) Straight elevator
-internal face is concave (applies to the root) and the external face is convex-
(comes in contact with the edge of the socket)
2) Double curved elevator
3) Straight elevator with the blade in form of flame -
-active part is sharp as a flagship

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Dental elevators for mandible
Features:
- are paire (for the right / left side of the tooth )
1) Curved elevators
2. Triangular-shaped elevator The blades are short, very strong, triangular

DENTAL FORCEPS
The basic components of dental extraction forceps are : handle, joint, blade
•The handles are usually of adequate size to be handled comfortably and deliver
sufficient pressure and leverage to remove the required tooth.• The handles have a
serrated surface to allow a positive grip and prevent slippage. The joint of the
forceps, like the shank of the elevator, is mereiy a mechanism for connecting the
handle to the beak.
- The joint transfers and concentrates the force applied to the handles to the beak
The beaks of the extraction forceps are the source of the greatest variation among
forceps.
- The beak is designed to adapt to the tooth root at the junction of the crown and root
1) Dental forceps for upper incisors and canine- is a straight forceps, the beaks are in
extension of handle
-between the two beaks is a space of 0.5 cm
-beak tip is rounded
-presents a convex external face (smooth) and a concave internal face (many grooves)

2) Dental forceps for first/second upper premolars

-Active part (beaks) make an obtuse angle with the handle to allow operation in the
axis tooth
-The tip is rounded -The space between the beaks = 1 cm

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3) Dental forceps for upper first and second molars-Powerful beaks that make an
obtuse angle with handle
-Great distance between the beaks (about 1,5 cm)
-One beak is rounded and the other is sharp or both beaks are sharp

We need 2 forceps (one for cadran 1, the other for cadran 2)

4) Dental forceps for upper winsdom-Forceps have a double curvature to make

possible application in the axis tooth
-The beaks are short, broad
- 2 variants: One end is rounded and another is sharp and bouth tips are rounded
-The space between the beaks is less than the upper molars forceps

5) Dental forceps for upper roots-Is an "Bayonet“ forcep, presents a double curvature
-The beaks are close, thin and angulated in the "bayonet" to allow action in the the
axis of implantation of the roots
-The tip is sharp

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1.Dental forceps for lower incisors

- beaks are thin, make a right angle to handle , a small space between the
tips

2.Dental forceps for lower canine and premolars

--Beaks make an obtuse angle with handle. The tips are rounded
-Distance between the beaks is 0.5 -1 cm (greater than the incisors)

3.Dental forceps for lower molars

Because the bifurcation is on both the buccal and the lingual sides, only single molar
forceps are necessary for the left and right, in contradistinction to the maxilla, with
which a right- and left-paired molar forceps set is required
--The beaks are thick, robust and distance between them. Both jaws are sharp
For extraction of lower molars can be used 2 types of forceps

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4) Dental forceps for upper winsdom
-The beaks are robust, broad. Also 2 variants: rounded at the top or both pointed tips
-Bending of jaw is made away from the joint, allowing for the insinuation in the
posterior dental arch

3) Dental forceps for upper roots

-The handle make at right angles to the jaws
-The beaks are straight, sharp, close to allow insinuation between the gums and
mucous

APPICAL CURETTE
- The periapical curette is an angled , double-ended instrument used to remove soft
tissue frombony defects .
- The principal use is to remove granulomas or small cysts from periapical lesions, but
it is also used to remove small amunts of granulation tissue debris from the tooth
socket .
- 3 PARTS : handle, neck, active parte (2 faces : convex and concave)

INSTRUMENTS USED IN DENTAL RESTAURATION

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I.Instruments needed isolation of operator field
Advantages:
 to obtain a clean and dry operative field
 to have access and optimum visibility
 to protect the operator and patient
 operative efficiency
It is achieved by mechanical metods and chemical metods
Mechanical metods : rubber dam, saliva ejector tip, oral evacuator tip, cotton rolls,
dry tips

1) THE RUBBER DAM

Advantages:
- Aid moisture control
- Aid operator visibility and acces
- Reduce aerosols caused by the air turbine handpiece
- Provide patient comfort by reducing the amount of water ant materials
in the mouth
-Better tactile sensitivity during the cleaning and shaping procedure
-Retraction (very important for working in the posterior areas) and protection of the
soft tissues (gums, tongue, lips, and cheeks), which are sheltered from the cutting
action of the bur.
DISADVANTAGES:
- Non-acceptance by the patient
- Time consuming to implement
- Not apply to the insufficient teeth erupted, M3
Components:
1. Rubber dam
2. Rubber dam punches
3. Rubber dam clamps
4. Rubber dam clamp forceps
5. Rubber dam frame

SALIVA EJECTOR TIPFUNCTION: To evacuete smaller volumes of

fluid from the oral cavity
FEATURES: Disposable plastic/metallic. Variety of styles
Can be bent for placement under tongue and in other areas of mouth or can be used
straight
- attaches to low-velocity tubing on dental unitORAL EVACUATOR TIP
Also known as Aspirator, High Volume Evacuator, Suction, or Vacuum tip
FUNCTION:To maintain a dry working field by removing saliva, blood, and debris
with highvolume evacuation
FEATURES: Disposable (plastic), sterilizable (metal )May have different forms,
colors
Evacuator tip attaches to hight-velocity tubing on dental unit
DRY TIPS

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  are more effective and economical than cotton rolls.
 can absorb up to 30x their weight but will not lose moisture when handled and
will not leave loose fibers or other residue in the mouth.
 provide complete coverage of the parotid orifice and buccal mucosa and are
ideal for work far back in the oral cavity.
 are extremely flexible.
 they remain in place during treatment yet remove easily with a simple water
application.

II. Instruments used for tooth structure removal

HAND INSTRUMENTS: Excavators
Presents 3 part: working end, neck, handle.
a. neck
.Connect the handle to the working end of the instrument -
.Normally smooth, round and tapered
.Normally smooth, round and tapered
Have one or more angles to avoid twisting of the instrument (Mon-angle, bin-angle,
triple angle.)

b. Handle
It is the part grasped in the operator’s hand
Serrated for better gripping and control of the instrument
c. Working end can have different forms (discoid, cleoid excavator)
Designed with a round working end and a curved cutting edge.
2 faces: convex and concave
Function -
Spoon excavators are extensively used in the removal of the tooth debris and decayed
dentin from the tooth cavities.
DYNAMIC AND ROTARY INSTRUMENTS

DYNAMIC INSTRUMENTS
1 - According to their shape into
1. Straight hand piecece
2. Contra angle hand piece

2. After to the speed range (RPM)- revolution per minute

c. conventional or low speed (4000-40000 rpm)
d. ultra high speed handpiece (turbine 40000- 400.000 rpm)
Ultra high/hight speed handpiece
Used for efficient tooth preparation.
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lRemoval of old restoration.
Advantages:
-Less traumatic to the pulp (less pressure is applied and less vibration and heat
generation)
-Time saving for both operator & patient.
-Instruments lasts longer. Can be:
- sterilisable or disposable
-with or without fiber optics – (to illuminate tooth during preparation for restauration
and to provide light intraorally during use of handpiece)
-depending on the attachements: push-button , friction

Conventional handpiece: contraangle and straight handpiece

and pieces are classified:
Conventional or low speed (Straight hand pieces, Contra angle hand pieces)Uses
1. Finishing and Polishing .
2. Caries excavation.
3. Cleaning teeth.
4.Initial preparation of grooves and pin holes.
Disadvantages:
Ineffective
Time consuming
Requires heavy force application
Produces vibration of low frequency and high amplitude.

ROTARY INSTRUMENTSThe rotary cutting instruments are held and operated

by a hand pieceDental burs presents 3 parts
Handle : Part of bur that fits into the handpiece.Neck: Part of bur that connects the
shank to head.
Head: Part of bur that cuts, polishes or finishes-Long shank for straight hand piece
-Latch shank for latch contra angle
-Friction grip shank for high and ultra high speed hand –piece

BUR HEAD

1) ROUND BUR
FUNCTION:
-To remove caries from tooth structure
-To open tooth for endodontic treatment

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-To remove the temporary filling, - usually has 8 cutting blades that may or may not
cross-cut grooves - more than 8 blades- used to finishing ; smooth round surface- for
polishing

2) CONE INVERTED BUR

active part is a truncated cone with the large base upper Function:
- To remove caries
- To estabilish retention in tooth for cavity preparation
3) STRAIGHT FISSURE BUR (CILINDRICAL) – PLAIN CUT

FUNCTION;
-To cut cavity preparation
-To form inner walls of cavity preparation
-To place retension grooves in walls of cavity preparation
May have different sizes
Cutting part of bur- has paralel sides
4) ROUND END FISSURE

5) STRAIGHT FISSURE BUR- CROSSCUT

Cutting part of bur- has paralel sides with horizontal cutting edges

6) ROUND END FISSURE CROSSCUT

7) TAPPERED FISSURE (CILINDRICO_CONICAL)

FUNCTION
-To cut cavity preparation
-To form angles in walls of cavity preparation
-To place retension grooves in walls of cavity preparation
Cutting part of bur- has tapered sides
-may have short ot long shank for adaptation to a variety of cavity preparation
8) TAPPERED FISSURE CROSSCUT

Cutting part of bur- has tapered sides with horizontal cutting edges

III. Instruments used for restoring

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Matrix systems
FUNCTION
- to replace missing proximal wall or walls of cavity preparation for condensation of
restaurative material for class II preparations
Matrix band = thin metal piece, attached to the tooth by different techniquesa) Ivory
Matrix bands are made of flexible stainless steel and are available in premolar,
molar, and universal sizes and thicknesses.
•The larger circumference of the band is the occlusal edge and is always placed
toward the occlusal surface.
•The smaller circumference of the band is the gingival edge and it is always placed
toward the gingiva. b) Ivory retainerl device in the form of pliers with arms
provided with claws l by manipulation the screw (located on opposite arms ) the arms
are approaching or leaving This device holds the matrix band in position.

Wooden wedges
Function and features:
- used in conjuction with a matrix band, sectional matrix or celluloid strip
- help to support and adapt the matrix to the tooth
- assist in maintaining adequate contact points between two adjacent teeth
- Essential for the elimination of overhangs
- Single use
Varios sizes (6 types), shapes and materials (wooden , plastic)

CONDENSERS. -are instruments used to condense or pack the filling

materials into the cavity preparation.
-Condensers come in single- and double-ended designsThey have various shaped and
sized working ends, which may be serrated (for amalgam) or smooth (for
glassionomer, composite)
The shanks may be bin-angled or triple-angled to facilitate accessibility.

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Daycalon (LINE APPLICATOR)-Has 3 parts: handle, shank and workig
end (as a small metal ball)
-Are available as a single-ended instrument or as a double-ended instrument
-ROLE : to mix, carry, and place calcium hydroxide or glass ionomer in cavity
preparation

SPATULLAS OR CEMENT SPATULLA

3 parts: handle, shank, working end
e. can be: single ended or double ended; mettalic or plastic
Are available in different sizes, degrees of flexibility and shapes
FUNCTION: Used to mix dental materials

Composite placement instrument or bucal spatulla

Functions :
- to carry composite material for cavity preparation
- to place and condense composite material in cavity preparation
- to carve composite material in cavity preparation
Presents three parts: handle, shank, working end
- working end is in the form of blade (can have different sizes )

Can be: metalic or plastic

Can be: single ended or double ended

- Plastic instruments can be heat sterilized and used on composites and cements.v
-Some advantages to using plastic instruments are that they won't discolor or
contaminate the composite restoration, and composite resin material will not cling to
the instrument.

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Polymerization of comoisite resin is the process in which the resin material is
changed from a plastic state into a hardened restauration . Can be: auto cured or light
cured
Photoactivation can be achieved: 1.HALOGEN CURING LAMP, 2 LED CURING
LAMP, 3. PLASMA CURING LIGHT

ENDODONTIC INSTRUMENTS
Instruments used for diagnosis
For testing tooth vitality we can use:thermal tests or electrical tests
In thermal test , the response of pulp to head and cold is noted.
The basic principle for pulp to respond to thermal stimuli is that patient reports
sensation but it disappears immediately
a.Cold tests - It can be done in a number of ways .
1. The most commonly used method for performing pulp testing is spray with cold air
2. The other frequently used method is use of ethyl cloride in form of:
- cotton palet saturated with ethyl cloride
- Spray of ethyl cloride
3. The frozen carbon dioxide ( dry ice). The frozen CO2 is availeble in the
- form of solid sticks which is applied to the facial surface of the tooth
4. One of the easy methods for cold test is to wrap an ice piece in the wet gauge
b. Heat test
Piece of gutta-percha or instrument handle heated and applied to the facial surface of
the tooth
- Warm air
- Hot water
- Hot bruniser
Some dentists use a device called electric pulp tester to identify the condition of
the pulp. The results of these tests will indicate whether or not an endodontic
procedure is necessary. First, is necessary to isolate the tooth . Then, the electrode
is applied on healthy enamel surface (the third medium )

Instruments for determination of working length

- precise determination of working length is of critical importance for a
successful endodontic outcome.
- without knowledge of the exact working length , no root canal should be
instrumented and/or filled
Methods for determining working length:

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 - · Radiographic
- · Electronic (Apex locators)
- · Tactile determination

instruments used in endodontic therapy – Root canal files

The components of the root canal files has 3 parts : handle,
handle, neck,
neck, working end1)
end1)
HANDLE-
HANDLE- has a hole for security thread (avoid loss the file in the patient's mouth
or swallowing
-is colored (the color indicates thickness of the working end)
-has numbers . Instruments are numbered to 0.6 from 140
- there is increase in 5 units up to size 60 and in 10 units
till they are size 140
has symbols (star, circle, triangle, square ) -indicate the type of files2)
2) The neck
-has different lengths: 19,21,25,28,31 . (working end has 16 mm)
3)The working end
- has different shape
I

2) TIRE NERFS
- thorns is placed obliquely on the active part.
- Different size: 10-40
FUNCTION:To remove pulp tissue from canal

2)Kerr FILE
FUNCTION:
f. To clean inside walls of canal
g. To contour inner walls of canal
h. is manufactured by twisting or grinding a square or triangular tapered
shaft so that the cutting edges are almost perpendicular to the long
access of the instrument. It is the instrument most commonly used for
cleaning and shaping

-Working end more twists per milimeter than reamer (18-20)

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-neck- availeble in different lenghts (21, 25,31mm)
-Handle – colored, has a symbol . Symbol is a square
Different size: 0.6-140

3)Kerr REAMER
Working end – twisted triangular cutting edge (similar to K-file, but cutting edge is
farther apart and has fewer twists per milimeter) (8-10)
Neck
- In different lenghts (21, 25,28)
Handle
- colored (color coded according to size) . different size: 0.6-140. -
has a symbol a triangle

2) Hedstrom FILE

FUNCTION
i. To clean inside walls of canal
j. To enlarge and smooth inner walls of canalWorking
Working end – triangular
cutting edge
Shank : - In different lenghts (21, 25,28)
Handle: -colored (color coded according to size). Different size: 0,6-140. has a
symbol a circle

ENDODONTIC STOPPERS

FUNCTION: to place onto an intracanalar instrument such as a file or reamer to help

determine length of canal
-stopper are made from rubber, silicone or plastic

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-endodontic stopper are color coded to corespond to a particular file or reamer, or a
single color of stopper is used for all files or reamerThe working end can be made of
different materials : carbon steel, stainless steel, Nikel titanium.
Advantages of Ni Ti files
- Shape memory
- Super elasticity (are 5 times more flexible than steel - are indicated in curved
channels)
- Softer
- Corrosion resistant
- Biocompatibility

3) Ni-Ti flex files

-Ni-Ti flex file are manufactured from Ni-Ti wire that is ground to give the typical
profile of a K-file
- The tip of the instruments is not cutting which makes the Ni-Ti flex file well suited
for the preparation of curved canals without the risk of ledge formation
 Ni-Ti flex file come in sizes 15-60
 Ni-ti flex file can be best distinguished from normal K-file by de code that in
Ni-Ti flex files is a square with 2 colors

Traditionally, files have been hand instruments. This simply refers to the fact that the
dentist creates their filing action by manipulating them with their fingers.
- The dentist may, however, have a special dental drill (handpiece) that produces the
needed file motion for them.
Handpieces can be :
Mechanical motion
- Handpieces with complete rotation
- Handpeices with reciprocal action ¼
- Hanpieces with vertical and reciprocal action

Vibratory motion
- Sonic handpieces
- Ultrasonic handpieces

Special endodontic handpieces presents two functions: torque and reverse

 The "Torque" function determined to stop the movement of the instrument if it
encounters a higher resistance that could lead to instrument fracture
 The "reverse" function -consists of reverse rotation of the file if it encounters a
higher resistance than the recommended

Instruments used for obturation

1) Paper points
Range of sizes availeble : 15-40
Size of point correspond to width of canal
2) Gutta-perca points
Comes in preformed cones whose dimensions match the size (diameter, taper)
of the files that have been used to shape the tooth's canals.
3) LENTULLO files

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 FUNCTION- To place endodontic sealer or cement in canal for final seal before
placement of gutta-percha

Consists of 3 parts : handle, neck, an active part (spiral form

a)Handle – for straight handpiece or contra-angle handpiece
b)Active part - has the form of spiral , is flexible
There are 4 diameters (red, blue, green, black) and three lengths 17,21,25 mm

4) Spreader
Function: is used for lateral condensation of the gutta percha. Working end is
longer (than a dental probe) and sharp. Has
Has rings in mm increments
5) Plugger
Function: To help condense gutta-percha vertically in canal
Working end :Flat tip , Has rings in mm increments

INSTRUMENTS USED IN PROSTHETIC

DIAMOND ROTARY INSTRUMENT
They are used for rapid reduction of tooth structure during cavity and crown
preparation, polishing and finishing composite restauration and oclusal
adjustmentThree basic parts to a rotary instrument:
•handle: Portion that fits into the handpiece.
•Neck: Portion of the rotary instrument that connects the shank and the head.
•Head: diamons burs are manufactured in a wide variety of shapes , sizes , forms and
grits
After neck:
•Long shank for straight hand piece
•Latch shank for latch contra angle
•Friction grip shank for high speed hand –piece
After diameter
diameter of active part is variable 0.5mm-30mmAfter grit sizesAfter forme-can have
very varied forms
-choosing the burs according to the face teeth that prepare
Round diamond

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Inverted cone
Wheel
Pear
Barrel (The
( Barrel is used for occlusal reduction and the contouring of occlusal
aspects.)
The Football diamond bur
Shaped diamond bur
Taper, Flat End
Taper, Round End
Cylinder, Flat End
Cylinder, round End

When we have root debris

In this case we will prepare the root debris using special burs (Pesso, Gates,
Beutrelock) and contra-angle/straight handpiece .
3 parts: handle, neck and head
neck – is long
head – eliptical or flame shaped cutting edge
Available in lengths 28mm and 32mm, and sizes 1-6. Size is indicated by the number
of rings at the handle level. Can be for contraangle or straight handpiece

Instruments for choosing the tooth color

1. The color key
Now there’s an even faster and easier way to measure accurate shades regardless of
differences in color perception
2.The VITA Easyshade incorporates multiple color spectrophotometers
at varying angles for the measurement of exceptionally accurate shades.
3. Demetron Shade Light-Kerr. Is a lighting device which develops a light neutral
perfect (similar to daylight at the North Pole) which allows correct evaluation of tooth
shade

Instruments for dental impressionImpression trays-Used to carry the impression

material into the oral cavity
Can be:
k. for maxilarary or mandible
l. metalic or plastic
m. perforated (Holes in the tray create a mechanical lock to hold the
material in place) or smooth.

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 n. For dentate patients or edentatoulus patients

o. May have different size and colors

p. Full arch tray, quadrant tray (covers one halfof the arch), anteryor tray
(covers the anterior portion of arch), posterior tray

RUBBER BOWL

 it is a bowl made up of rubber

 it may be soft and hard
 soft bowl is communly used to perform mixing of alginate
 Hard bowl is used to mix dental plaster or dental stone
MIXING SPATULA
 It is a metallic instrument with wooden or plastic handle
 spatula can be straight or curved
 Straight spatula is communly used to mix dental plastic or dental stone
 Curved spatula is communly used to mix alginate

Instruments for removing crownsThere are two methods of removing crowns :

a. desdtructive methods
b. non-destructive methods
a. destructive methods.
The crown is cut with dental burs or dental disc
An elevator or crown-removing instrument is placed into the notch and twisted
sideways to expand the crown.

2. non destructive methodsCrown and bridge remover- produce mechanical shocks

Presents 2 parts: Handle and the tips
INSTRUMENT FOR ANESTHESIA
Local anesthetic instruments:
• Anesthetic carpules
• Syringe
• Needle

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Depending on the material syringes can be: a) Disposable (plastic) b) Sterilisable
(metallic)
b) Sterilisable (metallic) can be:
Aspirating or Non - Aspirating

Syrine parts:
q. threated tip
r. harpoon
s. piston rod
t. barrel of syringe
u. finger grip
v. finger bar
w. thumb ring
FUNCTION: to administer a local anesthesic

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