e190 Online Chapter 23—Additional Information on Instruments and Equipment for Tooth Preparation

PROPERTIES OF ROTARY INSTRUMENTS

“
➤ Air-water spray:
- Water must be sprayed 50ml/min
Online Fig. 23-16 Electric handpieces and unit. (Courtesy of DENTSPLY

- 3 or 4 point water spray

Online Fig. 23-14 Contemporary contra-angle air-turbine handpiece
connected to the air-water supply line. (Courtesy of KaVo Dental Corp.,
International, York, PA.)

Charlotte, NC.)

(see Online Chapter 19). Sterilization produces some damage

to parts of the handpiece, however, necessitating more fre-

Dental handpieces and rotary ➤ Lighting

quent service and repair. Other improvements of the angle
handpiece include smaller head sizes, more torque, lower
noise levels, and better chucking mechanisms. Since 1955,
angle handpieces have had an air-water spray feature to

attachments help to make dental provide cooling, cleansing, and improved visibility.6 Most
modern-angled handpieces also include fiberoptic lighting of
the cutting site (Online Fig. 23-15). Electric handpieces that
compete effectively with air-turbine designs have also been

treatment more comfortable for the developed (Online Fig. 23-16).

References
patient and reduce the amount of time 4-port
spray 1. Guerini V: A history of dentistry, Philadelphia, 1909, Lea & Febiger.
2. Sockwell CL: Dental handpieces and rotary cutting instruments. Dent Clin
North Am 15:219–244, 1971.
3. SS White Dental Manufacturing Company: A century of service to dentistry,

needed to complete procedures. Fiberoptic

lighting
Philadelphia, 1944, SS White Dental Manufacturing.
4. Nelson RJ, Pelander CE, Kumpala JW: Hydraulic turbine contra-angle
handpiece. J Am Dent Assoc 47:324–329, 1953.
5. Taylor DF, Perkins RR, Kumpala JW: Characteristics of some air turbine
Online Fig. 23-15 View of the handpiece showing four spray ports handpieces. J Am Dent Assoc 64:794–805, 1962.
for cooling and fiberoptic illumination. (Courtesy of KaVo Dental Corp., 6. Peyton FA: Effectiveness of water coolants with rotary cutting instruments.
Charlotte, NC.) J Am Dent Assoc 56:664–675, 1958.
ROTARY INSTRUMENTS RPM (REVOLUTIONS PER MINUTE)
➤ The rotational speed of an instrument is measured in
revolutions per minute (rpm).
➤ Straight handpiece ,

➤ Three speed ranges are generally recognized:

➤ Contra-angle handpiece • low speed (<12,000 rpm),
- Low speed contra-angle • medium or intermediate speed
- High speed contra-angle (12,000–200,000 rpm),
• high or ultra-high speed (>200,000 rpm)

STRAIGHT HANDPIECE (PİYASEMEN) ELECTRIC MOTOR (MİKROMOTOR)

➤ Can reach speeds of 100 000 rpm depending on the type
• The long axis of the bur is the same as the long axis of attachment
of the handpiece. ➤ It is attached to the dental unit
• Used more frequently for laboratory work.
• It can be used extra-orally at chairside.
 HAND INSTRUMENT TECHNIQUES PEN GRASP
Four grasps are used with hand instruments:
(1) modified pen, ➤ This grip is unsuitable for use by
dentists.
(2) inverted pen,
➤ Because the used pinch grip
(3) palm-and-thumb, requires much force of muscles of
(4) modified palm-and-thumb. hand and upper arm while stability
and flexibility are low as a
consequence of using the middle
finger for both holding the
instrument and supporting the
hand.

MODIFIED PEN GRASP INVERTED PEN GRASP

➤ The finger positions are the same as for the modified pen grasp. The hand is
rotated, however, so that the palm faces more toward the operator.
➤ The first three fingers, thumb, forefinger and middle finger, are positioned with
the tips of the fingers against the instrument while the phalanxes are bent. ➤ This grasp is used mostly for tooth preparations employing the lingual approach on
➤ The thumb and forefinger are positioned across from each other and the middle maxillary anterior teeth.
finger is located closer to the working end of the instrument. ➤ The modified pen and inverted pen grasps are the primary grasps used in the
➤ For supporting the hand the ring finger and little finger are used and positioned preparation and direct restoration of teeth.
on a firm surface.
PALM AND THUMB GRASP MODIFIED PALM AND THUMB GRASP

The instrument is
The handle of the instrument
positioned in the palm of
is held by all four fingers,
the hand. The four fingers
whose pads press the handle
are bent around the
instrument from one side, against the distal area of the
while the thumb is free of palm and the pad and first
the instrument, and the joint of the thumb.
rest is provided by
supporting the tip of the
thumb on a nearby tooth
of the same arch or on a
firm, stable structure.

RESTS GUARDS
A proper instrument grasp must include a firm rest to steady the Guards are hand instruments or other items (e.g., cotton rolls,
hand during operating procedures. When the pen grasps are interproximal wedges) used to protect soft tissue from contact
used, rests are established by placing the ring finger (or both ring with sharp cutting or abrasive instruments.
and little fingers) on a tooth of the same arch and as close to the
operating site as possible.
 Cross arch finger rest

Palm down finger rest Palm up finger rest

 CONTRA-ANGLE HANDPIECE
➤ High Speed Contra-Angle (Aeratör):
•Preferred for cutting enamel and dentin.
•High speed generates considerable heat and should
ROTARY be used with air and water coolant sprays.
•Speed: Up to 500.000 rpm

INSTRUMENTS

➤ Used in: CONTRA-ANGLE HANDPIECE

• Removal of tooth tissue during restorations and preparation
of teeth for fixed prosthetic appliances ➤ Low speed contra-angle handpiece (Angldruva):
•Used for removal of carious dentin.
• Finishing of restorations
•Useful for various finishing and polishing procedures.
45 DEGREE CONTRA-ANGLE HANDPIECE DIFFERENT COLOR CODES
➤ An electric motor will allow you to set the correct speed ,
however air-driven motor often require a reduction handpiece
to attain slower speed

➤ Recognizing the contra angle band is very helpful in

determining which contra angle you should use
RED

BLUE GREEN
- 45 Degree contra-angle handpiece

- Ideal for surgical operations in posterior region

RED CONTRA-ANGLE HANDPIECE (KIRMIZI KUŞAKLI ANGLDRUVA) BLUE CONTRA-ANGLE HANDPIECE (MAVİ KUŞAKLI ANGLDRUVA)
Is a speed increaser handpiece which means the handpiece will Neutral handpiece with no increase or reduction.
operate at a higher rpm than the motor
➤ For example:
• Ratio 1:5 =
This is the most common contra angle handpiece.
• Handpiece Speed 200,000 rpm
• Motor Speed : 40,000 rpm
GREEN CONTRA-ANGLE HANDPIECE (YEŞİL KUŞAKLI ANGLDRUVA)
Reduction handpiece which means the handpiece will operate at a
lower rpm than the motor.
172
➤ For example:
Chapter 6—Instruments and Equipment for Tooth Preparation

ROTARY
• Ratio 4:1
• Handpiece Speed : 5,000 RPM Connection
• Motor Speed: 20,000 rpm to device
• AIR PRESSURE (20-55 psi)
• WATER FLOW RATE
• POWDER FLOW RATE
CUTTING
• PARTICLE SIZE (25-250 !m)
• PARTICLE TYPE and HARDNESS
• TIP DIAMETER
INSTRUMENTS
• TIP GEOMETRY (e.g., round) BURS and ABRASIVES
• DISTANCE " 3-5 mm • ANGLE OF ATTACK (60-90 to surface)

• SUBSTRATE " Enamel, • MOTION (e.g., 12 mm/s

dentin, cementum, amalgam, scanning pattern)
composite, casting alloy, • DURATION (e.g., 2-20 seconds)
or ceramic
BURSFig.
AND6-15
ABRASIVES
Schematic representation of range of variables associated with
any bur
typeisofapplied
air abrasion equipment. Each bur consists of three parts:
The term to all rotary cuttingThe cleaning that
instruments or cutting
have action is a
function of kinetic energy imparted to the actual surface, and this is (1) shank
bladed cutting heads. his includes instruments intended for finishing
affected by variables concerning the particle size, air pressure, angulation Fig.
(2)6-16
neckExample of air abrasion equipment used for tooth cleaning
metal restorations, surgical removal of bone, and tooth preparation.
with surface, type of substrate, and method of clearance. (Courtesy of B. showing the Prophy tip and handle attached by a flexible cord to the
(3) head
The second major
Kunselman category
[Master’s of rotary
thesis, 1999],dental
Schoolcutting instruments
of Dentistry, University of North Caro- control unit with the reservoir of powder and source of water (left).
involves
lina,abrasive cutting
Chapel Hill, NC.) rather than blade cutting. Abrasive (Courtesy of DENTSPLY International, York, PA.)
instruments are based on small, angular particles of a hard substance
(diamond) held in a matrix of softer material .

a limited amount of enamel or dentin is involved. Although

Shank Neck Head
promoted for caries excavation, air abrasion cannot produce
well-defined Diamond
preparation wall and margin abrasive
details that are pos- Fig. 6-17 Normal designation of three parts of rotary cutting
Steel bur
sible with conventional rotary cutting techniques.
instrument Generally, instruments.
the finest stream of abrading particles still generates an effec-
tive cutting width that is far greater than the width of luted
cement margins or the errors tolerable in most caries excava- specialized designs for particular clinical applications or to fit
tions. Roughening of surfaces to be bonded, luted, or repaired particular handpieces, but much of the variation also results
SHANK
•The shank is the part that fits into the handpiece, accepts For different types of handpieces, there are different
the rotary motion from the handpiece, and provides a designs and dimensions.
bearing surface to control the alignment of the instrument.
•The shank design and dimensions vary with the handpiece 1) the straight handpiece shank
for which it is intended. Chapter 6—Instruments and Equipment

to as shank. Except in th
instruments, the neck nor
0.0925 1.250 eter to a smaller size imm
main function of the neck
lational forces to the head
0.0925 0.520 the operator to have the
cutting head and the grea
0.0628
reason, the neck dimensio
0.500
the need for a large cross
Fig. 6-18 Characteristics and typical dimensions (in inches) of three small cross-section to imp
common instrument shank designs for straight handpiece (A), latch-
angle handpiece (B), and friction-grip angle handpiece type (C).
Head Design
The head is the working
held in the handpiece by a metal chuck that accepts a range edges or points that perf
Chapter 6—Instruments and Equipment for Tooth Preparation 173 of shank diameters. Precise control of the shank diameter is structure. The shape of t
not as crucial as for other shank designs. Straight handpiece construct it are closely rel
to as shank. Except in the case of the larger, more massive instruments are now rarely used for preparing teeth except for technique of use. The h
instruments, the neck normally tapers from the 2) shankthediam-latch- type
caries excavation. angle
They are handpiece
commonly used, shank
however, for fin- variation in design and co
1.250 eter to a smaller size immediately adjacent to the head. The
0.0925
main function of the neck is to transmit rotational and trans-
ishing and polishing completed restorations. main portions. For this
lational forces to the head. At the same time, it is•The desirableposterior
for portion
The more of the shape
complicated shank is latch-type
of the flattenedshank on reflects
one sidehead so form the basis on w
0.0925 0.520 the operator to have the greatest possible visibility that of
the the end the different
of the mechanisms byfits
instrument whichintothese
a instruments are
D-shaped held atclassified.
socket the
0.0628 0.500
+
Fig. 6-18 Characteristics and typical dimensions (in inches) of three
common instrument shank designs for straight handpiece (A), latch-
cutting head and the greatest manipulative freedom. For this in the handpiece. Their shorter overall length permits substan-
reason, the neck dimensions represent a compromise bottom
the need for a large cross-section to provide strength and a
small cross-section to improve access and visibility.
betweenof tially
•The latchpared
instrument.
the improved
slides
bur tube.
withinto
access to posterior
the handpiece
straight groove found
regions of
at the
instruments.
use latch-type burs normally have a metal bur tube within
the mouth
shank end
Handpieces
com-
Many characteristics o
could
that of isthe
be used for classific
the division into blade
ments. Material of constru
angle handpiece (B), and friction-grip angle handpiece type (C). which the instruments fit as closely as possible, while still additional characteristics
Head Design •This typepermitting of instrument is used predominantly
easy interchange. The posterior portion at lowof theand sion. Bladed and abrasive
The head is the working part of the instrument, the cutting
held in the handpiece by a metal chuck that accepts a range edges or points that perform the desired shaping mediumof tooth speed shank isranges.
flattened on one side so that the end of the instru- different clinical perform
of shank diameters. Precise control of the shank diameter is structure. The shape of the head and the material used to ment fits into a D-shaped socket at the bottom of the bur tube,
Chapter 6—Instruments and condition
nearly identical Equipme

=
not as crucial as for other shank designs. Straight handpiece
instruments are now rarely used for preparing teeth except for
caries excavation. They are commonly used, however, for fin-
ishing and polishing completed restorations.
The more complicated shape of the latch-type shank reflects
the different mechanisms by which these instruments are Chapter held
construct it are closely related to its intended application and causing the instrument to be rotated. Latch-type instruments
technique of use. The heads of instruments show greater are not retained in the handpiece by a chuck but, rather, by a
variation in design and construction than either of the other
main portions. For this reason, the characteristics of the
head form the basis on which rotary instruments are usually end of0.0925
6—Instruments and Equipment for Tooth Preparationdominantly
classified.
retaining

173
latch that slides
the instrument. This type
into the groove found

at low and medium speed ranges for finishing

at the
1.250of instrument is used pre-
shank
ences in the mechanism o
to as shank. Except in
designs.
instruments, the neck n
eter to a smaller size im
Dental Burs of the ne
main function
in the handpiece. Their shorter overall length permits substan- Many characteristics of the heads of rotary instruments procedures. At these speeds, the small amount of potential Thelational
term burforces to the he
is applied to
tially improved access to posterior regions of the mouth com- could be used tofor
as classification.
shank. ExceptMost important
in the case of among these
the larger, morewobble 0.0925
massive 0.520 thebladed
operator to heads.
have
pared with straight handpiece instruments. Handpieces that is the division into bladedtheinstruments and tapers
abrasive instru- inherent in the clearance between the instrument and have cutting
instruments, neck normally from the shank diam-
use latch-type burs normally have a metal 1.250
bur tube within ments. Material
eteroftoconstruction,
a smaller sizehead size, and head
immediately shapetoare
adjacent the handpiece
the head. The bur tube is controlled by the lateral pressure forcutting head
finishing andrestora
metal the g
0.0925 reason, the neck dimen
which the instruments fit as closely as possible, while still additional characteristics
main functionthat are neck
of the useful fortransmit
is to further subdivi-
rotational and exerted
trans- during cutting
0.0628 0.500procedures. At higher speeds, the latch- and instruments primarily
permitting easy interchange. The posterior portion of the sion. Bladedlational
and abrasive instruments
forces to the head. Atexhibit
the samesubstantially type shank
time, it is desirable for design is inadequate to provide a true-running the need for a large cr
shank is flattened on one side0.520
0.0925 so that the end of the instru- different clinical performances,
the operator to haveeventhe when operated
greatest possibleunder
visibility of the small cross-section to i
ment fits into a D-shaped socket at the bottom of the bur tube, nearly identical conditions. This appears to result from differ- instrument
Fig. 6-18 head, and as aand
Characteristics result, an improved
typical dimensions shank design
(in inches) is
of three
causing the instrument to be rotated. Latch-type instruments
cutting head and the greatest manipulative freedom. For
ences in the reason,
mechanism of cutting that are inherent in their
this
common
required forinstrument
these shank designs for straight handpiece (A), latch- Historical Developm
speeds.
the neck dimensions represent a compromise between
are not retained0.0628
in the handpiece0.500by a chuck but, rather, by a designs. the need for a large cross-section to provide strengthThe angle handpiece (B),shank
and afriction-grip and friction-grip
design was angle handpiecefor
developed type (C).with
use The earliest burs were han
retaining latch that slides into the groove found at the shank small cross-section to improve access and visibility. high-speed handpieces. This design is smaller in overall length
Head Design
sive but also variable in
Fig. 6-18 Characteristics and typical dimensions (in inches) of three
end of the instrument. This type of instrument is used pre- The head is the workin
common instrument shank designs for straight handpiece (A),
dominantly at low and medium speed ranges for finishing Dental Burs
latch- than the latch-type instruments, providing a further improve- shapes, dimensions, and
 to as shank. Except in the case of the larger, more massive
instruments, the neck normally tapers from the shank diam-
0.0925 1.250 eter to a smaller size immediately adjacent to the head. The
main function of the neck is to transmit rotational and trans-
lational forces to the head. At the same time, it is desirable for
0.0925 0.520 the operator to have the greatest possible visibility of the
3) themanipulative
cutting head and the greatest friction-grip
freedom. angle
For thishandpiece shank
0.0628

+
0.500

Fig. 6-18 Characteristics and typical dimensions (in inches) of three

common instrument shank designs for straight handpiece (A), latch-
angle handpiece (B), and friction-grip angle handpiece type (C).
reason, the neck dimensions represent a compromise between
•developed for use with high-speed handpieces.
the need for a large cross-section to provide strength and a
•designed
small cross-section to improve to be
access and held in the handpiece by friction
visibility.
the shank and chuck.
between

Head Design Chapter 6—Instruments and Equipme

The head is the working part of the instrument, the cutting
held in the handpiece by a metal chuck that accepts a range edges or points that perform the desired shaping of tooth to as shank. Except in
of shank diameters. Precise control of the shank diameter is structure. The shape of the head and the material used to instruments, the neck n

=
not as crucial as for other shank designs. Straight handpiece
instruments are now rarely used for preparing teeth except for
caries excavation. They are commonly172
ishing and polishing completed restorations.
used, however,Chapter for 6—Instruments
fin-
construct it are closely related to its intended
technique of use. The heads of instruments show greater
variation in and Equipment
design for Tooth
and construction
main portions. For this reason, the characteristics of
Connection
than
0.0925

Preparation
application and

either of the other

0.0925 0.520
the
1.250 eter to a smaller size im
main function of the n
lational forces to the he
the operator to have
cutting head and the g
The more complicated shape of the latch-type shank reflects head form the basis on which rotary instruments are usually
to device reason, the neck dimen
the different mechanisms by which these instruments are held classified. 0.0628 0.500
in the handpiece. Their shorter overall length permits substan- • AIR PRESSURE (20-55 psi)
Many characteristics of the heads of rotary instruments the need for a large cr
tially improved access to posterior regions of the mouth com- could• WATER FLOW RATE
be used for classification. Most important Fig. 6-18 Characteristics
among theseand typical dimensions (in inches) of three small cross-section to i
• POWDER FLOW RATE common instrument shank designs for straight handpiece (A), latch-
pared with straight handpiece instruments. Handpieces that is •the division into bladed instruments and abrasive instru-
Chapter 6—Instruments PARTICLE and Equipment SIZE (25-250for !m)Tooth Preparation angle handpiece 173 (B), and friction-grip angle handpiece type (C).
use latch-type burs normally have a metal bur tube within ments. Material
• PARTICLE TYPE ofandconstruction,
HARDNESS head size, and head shape are Head Design
which the instruments fit as closely as possible, while still additional
• TIP DIAMETER characteristics that are useful for further subdivi-
permitting easy interchange. The posterior portion of the to as shank. Except in the case of the larger, more massive The head is the workin
•sion. Bladed and
TIP GEOMETRY (e.g.,abrasive
round) instruments exhibit substantially
shank is flattened on one side so that •the end of"the
DISTANCE 3-5 mm instru- instruments,
•different
the neck performances,
ANGLE OFclinical
normally tapers from held
ATTACK (60-90 to surface) even when operated under
theinshank diam-
the handpiece by a metal chuck that accepts a range edges or points that p
0.0925
ment fits into a D-shaped socket at the bottom of the bur tube, eter nearly
1.250 to a smaller
identical sizeconditions.
immediately Thisadjacent
appears ofto to the
shank
result head.from The
diameters. differ- Precise control of the shank diameter is structure. The shape o
• SUBSTRATE " Enamel, main• MOTION function of mechanism
themm/s
neck is to
causing the instrument to be rotated. Latch-type instruments ences in (e.g.,
the 12 oftransmit
cutting that rotational
notareasinherent and trans-
crucial asinfor theirother shank designs. Straight handpiece construct it are closely
dentin, cementum, amalgam,lational forcespattern)
scanning to the head. At the same time, it is desirable
instruments are for now rarely used for preparing teeth except for technique of use. The
are not retained in the handpiece by a chuck but, rather,
composite, casting alloy, by a designs.
0.0925
retaining latch 0.520
that slides into the groove found at the shank the operator
or ceramic
• DURATIONto(e.g., have2-20the greatest possible
seconds) visibility
caries excavation. of theThey are commonly used, however, for fin- variation in design and
end of the instrument. This type of instrument is used pre- cutting head and the greatest manipulativeishing freedom. and For this completed restorations.
polishing main portions. For th
Fig. 6-15 Schematic representation reason,Dental
oftherange ofBurs
neck dimensions
variables represent
associated with a compromise The more between
complicated shape of the latch-type shank reflects head form the basis on
dominantly 0.500
0.0628 at low and medium speed ranges for finishing
procedures. At these speeds, the small
any type of air abrasion equipment.
amount of potential the need
The
Theforcleaning
term aburlargeis
NECK
or cutting
applied
action is to
cross-sectionto all
a provide
rotary strength
the different
cutting instruments and a that by which these instruments are held
mechanisms classified.
function of kinetic energy imparted to the actual to surface, and access
this is and visibility.

+ of three and small

Fig. wobble
6-18 Characteristics
inherent inand the typical dimensions
clearance between (in the
inches)
instrument cross-section
have bladed cutting improve
heads. This includes ininstruments
the handpiece. intendedTheir shorter overall length permits substan- Many characteristics
affected by variables concerning the particle size, air pressure, angulation Fig. 6-16 Example of air abrasion equipment used for tooth cleaning
common instrument shank
the handpiece bur tubedesigns for straight handpiece
is controlled by surface,
the lateral(A), latch- tially improved access to posterior regions of the mouth com- could be used for classi
with type pressure
of substrate, and formethod
finishing metal restorations
of clearance. ➤ Intermediate
(Courtesy of B.and surgical
showing removal
the portion
Prophy of tip bone
andof an instrument
handle attached by a that connects
flexible cord to the
angleexerted
handpiece (B), and
during friction-grip
cutting angle handpiece
procedures. At higher type (C). the latch-
speeds, andDesigninstruments primarily pared with straight handpiece instruments. Handpieces that is the division into bla
Kunselman [Master’s Head
thesis, 1999], School of Dentistry, University of Northintended
Caro- for
controltooth unitpreparation.
with the reservoir of powder and source of water (left).
type shank design is inadequate to provide lina, ChapelaHill, true-running
NC.) the head use
(Courtesy
latch-type
toofthe DENTSPLY
burs
shank. normally have
International, York, PA.)
a metal bur tube within ments. Material of cons
instrument head, and as a result, an improved shank design is The head is the working part of the instrument, which the the instruments
cutting fit as closely as possible, while still additional characteristi
heldrequired
in the handpiece by
for these speeds. a metal chuck that accepts a range edges Historical
or points Development
that perform the of
desiredDentalshaping
permitting Burs of tooth
easy interchange. The posterior portion of the sion. Bladed and abra
of shank Thediameters.
friction-gripPrecise
shank control
designofwas thedeveloped
shank diameter for useiswith structure. The earliestThe shapeburs were of the head andThey
hand-made. theshankmaterial
wereisnot used
flattened
only expen-toon one side so that the end of the instru- different clinical perfo
not as crucial ashandpieces.
high-speed for other shank designs.
This design is asmaller
limitedinhandpiece
Straight amount of enamel
overall length constructor dentin
sive it are
but isclosely
also involved.
variablerelatedAlthough
in to its intended
dimension ment
and application
fits into a and
performance. D-shaped The
Shank
socket at the bottom of the bur tube,
Neck Head
nearly identical conditi
instruments
than the are now rarely
latch-type used for preparing
instruments, promoted
providing teeth
a further for caries
except for excavation,
improve- technique
shapes, air of
abrasion
use. The
dimensions, cannot andproduce
heads of instruments
nomenclature of show
causing the greater
modern instrument
burs are to be rotated. Latch-type instruments ences in the mechanism
caries
ishing
The
excavation.
ment
and
in access
polishing
They

=
are commonly
to the
completed
posterior regions
restorations.
well-defined
used,
sible
shank is a simple cylinder manufactured to close dimensional
more complicated
tolerances.
the different
As the name
originallymechanisms
were designed
shapeimplies,
by which
to be these
held in
however,
of the mouth.
the finest
of the latch-type
friction-grip
tive
with
shank
cutting
instruments
the handpiece
stream
preparation
for
conventional
reflects
walldirectly
fin- The variation
rotary
main
of abrading
instruments
width
are held that is far
and margin
in related
cutting
portions.
design details
For
and
to those
techniques.
that
15 this reason,
arethe
construction
of pos-
Generally,
firstthan
the
duced in 1891. Early burs were made of steel. Steel burs

by fric- classified.
particles
headperform
form thewell,
greater atthan
rapidly
still
basis
higher
generates
on which
cutting
the speeds
width of
➤ an rotary
human effec-
Neck
or luted
Fig.either
are
machine-made
instruments
dentin
when cutting
end
normally
at
notofretained
6-17
instruments.
characteristics
retaining
low
dominantly
theburs
Normal
of
latch
other
the
that
are instrument.
of speeds,
the
enamel. When
usually
tapers
in the handpiece
designation
intro-
slides
but dullfrom
at lowburs
of three
into
This type
the
shank
by parts
a chuck
groove
of but,
found
of instrument
to head.
and medium speed ranges for finishing
rotary
at
rather,
cutting
the
by a
shank
is used pre-
designs.

Dental Burs
in the handpiece. Their shorter overall lengthcement
tion between the shank and a plastic or metal chuck. Newer permits margins
substan- or the errorsMany tolerable in most
characteristics caries
of ➤ the Main
excava-
heads function:
of specialized
rotary
are dulled, the reduced effectiveness in cutting creates increasedprocedures. transmit
designs
instrumentsAt for
these rotational
particular
speeds, clinical
the small and
applications
amount transitional
of or to fit
potential The term bur is applied
tiallyhandpiece
improved designs
access tohave posterior chuckstions.
metalregions theRoughening
ofthat mouth
close tocom- makeof surfaces
a could tobebeand
heat bonded,
used luted, or repaired
for classification.
vibration. Most important
force to
particular
wobbleamong
head.
handpieces,
inherent these in the butclearance
much ofbetween
the variation also resultsand
the instrument have bladed cutting hea
pared with straight
positive contacthandpiece
with the instruments.
bur shank. is an Carefuladvantage
Handpieces that
dimensionaland can occur
is the intraorally
division
Carbide into
burs,bladed or extraorally,
which instruments
were introduced from
andthe individual
abrasive
in handpiece
1947, have preferences
instru-
bur tube ison
largely the part of
controlled bydentists.
the lateral Since the
pressure for finishing metal rest
use control
latch-type onburs
the normally
shanks ofhave a metal
these depending
instrumentsbur tube isonwithin
the situation.
important ments. Roughening
Material
replaced steelofby airfor abrasion
construction,
burs ➤tooth by size,introduction
Provides
head
preparation. and visibility
exerted headduring
Steel of high-speed
shape
burs and
are
cutting
now easetechniques
areprocedures. of in clinical
Atoperation.
higher practice,
speeds, the latch-a and instruments prima
which the instruments fit as closely as itself
possible,
because for high-speed use, even minor variations in shank is not a
while substitute
still for acid-etching
additional techniques.
characteristics Roughen-
that are useful
used mainly for finishing procedures. Carbide burs perform rapid
for
type evolution
further
shank of
subdivi-
design technique
is and
inadequate an accompanying
to provide a prolifera-
true-running
permitting
diametereasy can interchange.
cause substantial The variation
posterior inginimproves
portion
instrument bonding.
of perfor-Acid-etching
the sion.better
Bladed alone
thanandsteel or after
burs roughen-
abrasive all speeds, tion
instruments
at exhibit of
instrument
and new
their instrument
substantially
head, andisas
superiority designs have
a result, an occurred.
improved Nevertheless,
shank design is
shank is flattened on one with side insertion, ing,
so that theretention, however,
end of the always
instru- produces
different a better bond
clinical than airAll
performances, abrasion evenburs the
when number
operated
required of
for instruments
under
these speeds.essential for use with any one type Historical Develo
mance and problems 8 and removal. greatest at high speeds. carbide have heads of cemented
ment fits into a D-shaped socket at the bottom alone. of the bur tube, nearly identical conditions. This appears
carbide in which microscopic carbide particles, usually tung- of
to handpiece
result
The from is comparatively
differ-
friction-grip shank small,
design especially
was developedin the
for case
use of
with The earliest burs were h
causing the instrument to be rotated. Latch-type Air abrasion
instruments techniques rely
encessten on mechanism
in carbide,
the the transfer ofcutting
are heldoftogether kinetic inthat high-speed
are inherent
high-speed
a matrix of cobalt turbine
in their
handpieces.
or handpieces.
nickel. This design is smaller in overall length sive but also variable
Neck
are not Design
retained in the handpiece by a chuck energy but,fromrather, a stream
by a ofdesigns.powder particles on the surface of
Carbide is much harder than steel and less prone to dulling than the latch-type instruments, providing a further improve- shapes, dimensions, an
retaining latch in
thatFig.
slides into tooth structure or a restoration to produce a fractured surface
As shown 6-17, thethe groove
neck is thefound at the shank
intermediate portion during cutting. ment in access to the posterior regions of the mouth. The
Common Design Characteristics
directly related to those
end ofof the instrument. This type of layer, resulting
instrument is used in roughness for bonding or disruption for
pre- shank is a simple cylinder manufactured to close dimensional duced in 1891.15 Early
an instrument that connects the head to the shank. It Dental In most
Burs burs, the carbide head is attached to a steel shank
dominantly at low and medium speed ranges cutting.for Thefinishing
energy transfer event is affected by many things, Despite
tolerances. the great As variation
the nameamong rotary
implies, cutting instruments,
friction-grip instruments perform well, cutting h
 of increased runout. Although steel necks reduce the risk of A tapered fissure bur is a portion of a slightly tapered cone
fracture during use, they may cause severe• problems SUBSTRATE " if Enamel,
bent. with the (e.g.,
small end of the cone directed away from the bur
Either type can be satisfactory, and other design dentin, cementum, amalgam,
factors are
• MOTION
shank. This
scanning
12 mm/s
shape
pattern) is used for tooth preparations for indirect
Bur Classification Sy
composite, casting alloy,
varied to take maximal advantage of the properties or ceramic of the • DURATION (e.g., 2-20 seconds)
restorations, for which freedom from undercuts is essential for To facilitate the descriptio
material used. successful withdrawal of patterns and final seating of the res- burs, it is highly desirable
Fig. 6-15 Schematic representation of range of variables associated with
NECK any type of air abrasion equipment. torations. Tapered
The cleaning fissure
or cutting HEAD
actionburs
is a can have a flat end with the tip
designation, which represe
function of kinetic energy imparted corners to theslightly rounded.
actual surface, and this is design by some simple cod
Bur Classification Systems affected by variables concerning the particle size, air pressure, angulation
Among these basic shapes, variations Fig. 6-16 Example of air abrasion equipment used for tooth cleaning traditionally have been d
are possible. Fissure
Neck diameter
To facilitateistheimportant
description,functionally
selection, and
withbecause;
surface, type of substrate, and method of clearance. (Courtesy
manufacture of1999], School
and inverted cone burs
➤ Itof is
may
B. the working
showing the Prophypart tip andof theattached
handle instrument, the
by a flexible cord cutting
to the
numerical code for head si
Kunselman [Master’s thesis, of Dentistry, University of North Caro-havecontrol
half-round
unit withor thedomed
reservoirends.
of powder and source of water (left).
burs, it is highly desirable to have some agreed-on shorthand
lina, Chapel Hill, NC.) Taper and cone angles may edges or
Thepoints.
vary.(Courtesy ratio
of DENTSPLYof International,
head length York, PA.) eter round bur; 57 = 1-mm
➤ small neck diameter-
designation, results
which represents in a weak
all variables instrument
of a particular head to diameter may be varied. In addition to shape, other features = 0.8-mm diameter inver
design by some simple code. In the United States, dental burs may be varied, such as the number of blades, spiral versus plexity of the system, it is st
unable to resist lateral forces. developed and used simila
traditionally have been described in termslimited of anamount arbitrary axial patterns for blades, and continuous versus crosscut
➤ large neck diameter - may interferea with visibility
of enamel
and
or dentin is involved. Although
Shank Neck Head sification systems such as th
numerical code for head size and shape (e.g., 2 = 1-mm
promoted diam-excavation,
for caries bladeairedges.
abrasion cannot produce
the use of the
eter round 57 =of
bur;part the diameter
1-mm bur head nextfissure
well-defined
straight to the bur;neck
preparation
34 wall and margin details that are pos- Fig. 6-17 Normal designation of three parts of rotary cutting Dental Federation (Federa
= 0.8-mm diameter inverted cone bur).16sible with conventional
Despite the com- rotary cutting techniques. Generally, ➤ Shape instruments.
and the material used to construct it are International Standards O
andplexity
may of restrict access for coolants.
the system, it is still in common use. the finest stream of abrading
Other countries Sizes
particles still generates an effec- rate designations for shap
developed and used similarly arbitrary systems.
tive cutting width that is far greater than the width of luted
Newer clas- In the United States, the
closely
number
related
designating
tobur its size
intended
also
application and(usually a number giving
cement margins or the errors tolerable in most caries excava- specialized designs for particular clinical applications or to fit
sification systems such as those developed by theRoughening
tions. International traditionally
of surfaces to be bonded, has served
luted, astechnique
or repaireda codeparticular
for head of handpieces,
use. This
design. butnum-
much of the variation also results
millimeter) (e.g., round 01
17,18
Dental Federation (Federation Dentaire Internationale)
is an advantage and and can bering system fororburs
occur intraorally was originated
extraorally, fromby the S.S.preferences
individual White Dental on the part of dentists. Since the cone 008).
International Standards Organization (ISO) tend to on
depending usethe sepa-
situation.Manufacturing
Roughening by Company ➤
air abrasioninbyHead design
1891 introduction forms
for their firstofmachine-made the basis instrument
high-speed techniques in clinical practice, a
rate designations for shape (usually a shape itselfname)
is not a and
substitute
size for acid-etching
burs. It wastechniques.
extensiveRoughen- logical, rapid
andclassification,
so other evolution such
domesticof technique
as; bladed
manufac- and an accompanying
instrument prolifera-
or abrasive
(usually a number giving the head diameter ing improves
in tenths bonding.
of a Acid-etching
turers found aloneitorconvenient
after roughen- to adopttion it of
fornewtheirinstrument
burs as well. designsAs have occurred. Nevertheless,
Shapes
ing, however, always produces a better bond than air abrasion
millimeter) (e.g., round 010; straight fissurealone. plain8 010; inverted a result, for more than 60 years, aofgeneral
instrument.
the number of instruments essential for use with any one type The term bur shape refers
uniformity existed
handpiece is comparatively small, especially in the case of head. The basic head shap
cone 008).17,18 Air abrasion techniquesfor relyburon numbers
the transfer in ofthekinetic
United high-speed
States. Table 6-1 handpieces.
turbine shows the
correlation of
energy from a stream of powder particles on the surface of bur head sizes with dimensions and shapes. The straight fissure, and tapere
tooth structure or a restoration tabletoincludes
produce anot only many
fractured surfacebur sizes that are still in common spherical. This shape cust
Shapes layer, resulting in roughness for bonding or disruption
use but also others that have become obsolete.for Common Design Characteristics entry into the tooth, extens
cutting.
The term bur shape refers to the contour or silhouette of the The energy transfer event is affected by many things, Despite
The original numbering system grouped burs by 9 shapes the great variation among rotary cutting instruments, of retention features, and
including powder particle, pressure, angulation, surface com- they share certain design features. Each instrument consists of An inverted cone bur is a
SHAPE
head. The basic head shapes are round, inverted
straight fissure, and tapered fissure (Fig. 6-19).
spherical. This shape customarily has been
A
cone,
round
pear,
bur is
and
round
11 sizes.
burs)
common error made by operators of air abrasion units is
usedthefor
The
position, and clearance angle variables (Fig. 6-15).2The most4
were
1

added
and
later
1

ROUND BUR
designations
when smaller
(both
instruments
very small
three parts: (1) shank, (2) neck, and (3) head (Fig. 6-17). Each with the apex of the cone d
were
has its own function, influencing its design and the materials
holding tip initial
at the wrongincluded
distance from in thethesystem.
surface for Alltheoriginal
used burfordesigns had continu-
its construction. The term shank has different
entry into the tooth, extension of the preparation,desired preparation ous blade
action. Greater distances edges. Later,
significantly reducewhen the crosscut
meanings bursaswere found
applied to to be instruments and to hand
rotary
➤ Bur shape refersfeatures,
of retention to the and
contour
caries or silhouette
removal. energyof thestream.
of the head. 9
Themore
Short distanceseffective for cutting
may produce unwanted dentin instruments.
at low speeds, crosscut ver-
An inverted cutting tapered
actions, conesuch as whensionsonly surfacebur stain removal introduced. This modification
basic head shapesconeare;bur is a portion of a rapidly
is being attempted.
of many sizes
➤ wereSpherical
with the apex of the cone directed toward the bur shank. HeadThe potential
was indicated for unwanted
by adding cutting
500isto theShanknumber of the equivalent
Design
a significant problem when employing an air-polishing
noncrosscut size.
device (e.g., Prophy Jet) to clean the surfaces of dentin and A No. 57 with crosscut
The shank is thedesignated
was part that fitsNo. into the handpiece, accepts the
enamel.10-13 When used properly, 557. Similarly,
however,a units900 prefixdesigned was used
rotary to indicate
motion from a head the design
handpiece, and provides a bearing
for air polishing tooth surfaces intended can for end cutting
be quite efficient
➤ Usedonly.
and Except
surface fortodifferences
control the inalignment
blade and concentricity of the
effective (Fig. 6-16). design, a No. 957, No. 557, and No.for57initial
instrument. bur Theallentry
had
shankthe into
same
design the
and dimensions vary with the
head dimensions. These changes occurred handpiece gradually
for which over it is time
intended. The American Dental
without disrupting the system. tooth,The extension
Association
sizes in(ADA) ofSpecification
common preparation
use in No. 23 for and dental excavating Round Inverted
burs includes five classes of instrument shanks.14 Three of cone
Rotary Cutting Instruments 1955 are shown in Table 6-2. The these
system
(Fig.
changed straight
6-18)—the
rapidlyhandpiece shank, the latch-
The individual instruments thereafter,
intended but where
for use
caries
withthedental
numbers type
removal.
are stillhandpiece
angle used, the designs
shank, and the friction-grip angle hand-
Fig. 6-19 Basic bur head shap
and dimensions
handpieces are manufactured in hundreds of sizes, shapes, and remain the same.piece shank—are commonly encountered. The shank portion comprehensive dental assisting, St.
types. This variation is, in part, a result of the need for of the straight handpiece instrument is a simple cylinder. It is
Round Inverted Pear- Straight Tapered
cone shaped fissure fissure Modifications in Bur Design
Fig. 6-19 Basic bur head shapes. (From Finkbeiner BL, Johnson CS: Mosby’s As available handpiece speeds increased after 1950, particu-
comprehensive dental assisting, St. Louis, 1995, Mosby.) larly after the high-speed turbine handpieces were introduced,
 Although most carbide burs have the joint located in the The end of the head either is continuously curved or is flat straight
2 fissure,
4 and tapered fissure (Fig. 6-19). A round b
posterior part of the head,straight
others arefissure,
sold thatandhavetapered
the joint fissure
with (Fig.
rounded6-19). A round
corners where the bur is and round
sides burs) were spherical.
flat end intersect. added laterThiswhen smaller
shape instruments
customarily has were
been used for in
located within the shank and spherical. Thisnecks
have carbide shape and customarily
heads. has been
An elongated pear used for initial
bur (length three times theincluded
width) is in
advo-the system.
entry All original
into the tooth,bur designs of
extension hadthecontinu-
preparation, prepara
Carbide is stiffer and stronger than steel, but it is also
entry into the tooth, extension of themore cated for tooth preparations
preparation, preparation for amalgam. ous blade edges. Later, when crosscut
brittle. A carbide neck subjected to a sudden blow or shock A straight fissure bur is an elongated cylinder. Some dentists of retention features,burs were found
and caries to be
removal.
of retention features,
fractures, whereas a steel neck bends. A bur that is even slightlyand caries removal. more
advocate this shape for amalgam tooth preparation. Modified effective for cutting
An inverted cone bur is a portion of aver-
dentin at low speeds, crosscut rapidly tapered
bent produces increased vibration An inverted cone bur
and overcutting is a portion
as a result burs ofofthis
a design
rapidly withtapered cone tip angles
slightly curved sionsareof many bur
available. with thewere
sizes apexintroduced. This modification
INVERTED CONE of increased runout. Although withsteel
the necks
apex reduce
of thethe coneriskdirected
of A tapered
towardfissure
the bur PEAR-SHAPED
bur is a portion
shank. Head of a slightly
wastapered
indicated
of the cone directed
cone by adding 500 to the number of the equivalent
toward the bur shank. H
fracture during use, they may cause severe problems if bent. with the small end of the cone directed away from the bur
Either type can be satisfactory, and other design factors are
noncrosscut size. A No. 57 with crosscut was designated No.
shank. This shape is used for tooth preparations for indirect
varied to take maximal advantage of the properties of the restorations, for which freedom from undercuts 557.is essential
Similarly,for a 900 prefix was used to indicate a head design
material used. successful withdrawal of patterns and final seating intended
➤ The end of the head is either of thefor
res-end cutting only. Except for differences in blade
➤ Portion of a rapidly tapered torations. Tapered fissure burs can have a flatdesign,
end withatheNo.tip 957, No. 557, and No. 57 bur all had the same
corners slightly rounded. continuously curved or is flat with
cone with the apex Burof Classification
the cone Systems Among these basic shapes, variations arehead dimensions.
possible. Fissure These changes occurred gradually over time
To facilitate the description, selection, and manufacture of and inverted cone burs may rounded corners
have half-round without where
or domed ends. the sides
disrupting the system. The sizes in common use in
directed toward the burs,bur shank.
it is highly desirable to have some agreed-on shorthand Taper and cone angles may vary. The ratio 1955 arelength
of head shown in Table 6-2. The system changed rapidly
designation, which represents all variables of a particular head to diameter may be varied.and flat end
In addition intersect.
to shape, other features
thereafter, but where the numbers are still used, the designs
design by some simple code. In the United States, dental burs may be varied, such as the number of blades, spiral versus
➤ Designed to develop traditionally
a flat havefloor
been described in terms of an arbitrary axial patterns for blades, and continuous versus crosscut remain the same.
and dimensions
numerical code for head size and shape (e.g., 2 = 1-mm diam- blade edges. Round Inverted Pear- Straight Tap
and provide undercuts eter roundin bur; tooth
57 = 1-mmRound
diameter straight Inverted
fissure bur; 34 Pear- Straight➤ Tapered
Used in amalgam or gold foil preparations. cone shaped fissure fis
= 0.8-mm diameter inverted cone bur). Despite 16
cone the com- shaped
Sizes
fissure fissure Modifications in Bur Design
preparations for retention.
plexity of the system, it is still in common use. Other countries Fig. 6-19 Basic bur head shapes. (From Finkbeiner BL, Johnson CS: M
developed and used similarly Fig. arbitrary
6-19 Basic bur head
systems. Newershapes.
clas- (From Finkbeiner
In the United BL, Johnson
States, the CS: Mosby’s
number As available
designating bur size also handpiece speedsdental
comprehensive increased
assisting, after 1950,
St. Louis, 1995,particu-
Mosby.)
comprehensive
sification systems such as those developeddental
by theassisting, St. Louis, traditionally
International 1995, Mosby.)has served as a code for head design. larly after the high-speed turbine handpieces were introduced,
This num-
Dental Federation (Federation Dentaire Internationale) and bering system for burs was originated by the S.S. White Dental
International Standards Organization (ISO) tend to use sepa- Manufacturing Company in 1891 for their first machine-made
rate designations for shape (usually a shape name) and size burs. It was extensive and logical, so other domestic manufac-
(usually a number giving the head diameter in tenths of a turers found it convenient to adopt it for their burs as well. As
millimeter) (e.g., round 010; straight fissure plain 010; inverted a result, for more than 60 years, a general uniformity existed
17,18
cone 008). for bur numbers in the United States. Table 6-1 shows the
correlation of bur head sizes with dimensions and shapes. The
table includes not only many bur sizes that are still in common
Shapes use but also others that have become obsolete.
The term bur shape refers to the contour or silhouette of the The original numbering system grouped burs by 9 shapes
head. The basic head shapes are round, inverted cone, pear, and 11 sizes. The 1 2 and 1 4 designations (both very small
straight fissure, and tapered fissure (Fig. 6-19). A round bur is round burs) were added later when smaller instruments were
FISSURE spherical. This shape customarily has been used for initial
entry into the tooth, extension of the preparation, preparation
included in the system. All original bur designs had continu-
ous blade edges. Later, when crosscut burs were found to be
MATERIALS
of retention features, and caries removal. more effective for cutting dentin at low speeds, crosscut ver-
An inverted cone bur is a portion of a rapidly tapered cone sions of many bur sizes were introduced. This modification
➤ Straight fissure: Is an elongated
with the apex of the cylinder.
cone directed toward the bur shank. Head was indicated by adding ➤ 500In togeneral,
the numberthere are 3 types of materials used in manifacture
of the equivalent
noncrosscut size. A No. 57ofwith burs. These
crosscut are:
was designated No.
557. Similarly, a 900 prefix was used to indicate a head design
intended for end cutting only. Except for differences in blade
design, a No. 957, No. 557, -and Steel
No. 57burs
bur all had the same
head dimensions. These changes occurred gradually over time
without disrupting the system. - Carbide
The sizes inburs
common use in
1955 are shown in Table 6-2. The system changed rapidly
thereafter, but where the numbers are still used, the designs
and dimensions remain the-same. Diamond abrasive instruments
Round Inverted Pear- Straight Tapered
➤ Tapered fissure: It is tapered sided cone shaped fissure fissure Modifications in Bur Design
cylindrical but sides Fig.
tapering
6-19 Basic towards
bur head shapes. (From Finkbeiner BL, Johnson CS: Mosby’s As available handpiece speeds increased after 1950, particu-
comprehensive dental assisting, St. Louis, 1995, Mosby.) larly after the high-speed turbine handpieces were introduced,
tip and is used for indirect preparations.
STEEL BURS TUNGSTEN CARBIDE BURS
➤ These were the first developed burs. ➤ Designed to withstand heavy stresses and increase shelf life.

➤ Designed for slow speed < 5000 rpm. ➤ Superiority is greatest at hight speeds.

➤ Usually a bur has eight blades with positive rake angle

➤ Cut metal and dentin very well but can produce
microcracks in the enamel so weaken the cavosurface margins.
for active cutting of dentin. But this makes steel burs
fragile, so they do not have a long life.

➤ Used for cutting soft carious dentin and finishing

procedures.

BUR DESIGN BUR DESIGN

➤ Normally a cutting bur has 6,8 or 10 blades. Finishing bur has Each blade has two sides:
12-40 blades. !the rake face (toward the direction of cutting) and
!the clearance face
30 blades
And three important angles:
8 blades !the rake angle,
!the edge angle, and
➤ Actual cutting of the bur takes place at the end of the blade. !the clearance angle.
BUR DESIGN BUR DESIGN
•The rake angle is the most important design The clearance angle:
characteristic of a bur blade. •provides a stop to prevent the bur edge from digging into
the tooth structure excessively, and
•A rake angle is said to be negative when the rake face •reduces the radius of the blade back of the cutting edge to
is ahead of the radius (from cutting edge to axis of bur). provide adequate clearance space for the chips formed
•Increasing the edge angle reinforces the cutting edge ahead of the following blade.
and reduces the likelihood for the edge of the blade to
fracture.

DIAMOND ABRASIVE INSTRUMENTS DIAMOND ABRASIVE INSTRUMENTS

➤ Cutting occurs at numerous

points where individual hard
particles protrude from the
matrix rather than along a
continuous blade edge.
➤ Diamond instruments have
had great clinical impact
because of their long life and
great efectiveness in cutting
enamel and dentin.
DIAMOND ABRASIVE INSTRUMENTS DIAMOND ABRASIVE INSTRUMENTS

Diamond finishing instruments use even finer diamonds (10–38

μm) to produce relatively smooth surfaces for final finishing
with diamond polishing pastes.

SPECIAL SETS POLISHING DISCS

➤ Used in finishing and polishing composite, ceramic and glass ionomer dental
restorations.
➤ Discs are color coded to allow for easy identification of grit sequence.

Composite Finishing
Inlay Onlay Set
Set
POLISHING DISCS COMPOSITE POLISHING KITS

10-12.000 RPM 2-10.000 RPM

• Dura-Green silicon carbide stones for adjusting

• Dura-White aluminum oxide stones for finishing
• CompoSite silicone points are impregnated with aluminum oxide for polishing

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