DMD5310 Foundations in Restorative Dentistry 1
Terms in this set (62)
What Constitutes "Damaged"
Instruments that haven't been maintained and sharpened regularly
Scissors which no longer cut properly
Amalgam carriers which no longer work or are irreparably clogged
Burs or diamond instruments which no longer cut satisfactorily - replace those instruments in the bur blocks so that the bur and diamond kit is always complete!
What is the function of the Curved Hemostat?
1. Placing and removing wedges
2. Picking up small objects
3. Removing matrix bands
4. Grasping and removing tissue tags and parts of teeth
5. Holding articulating paper
6. Placing and removing scalpel blades and stuck burs
7. Any other function where a forceps may not provide a firm enough grip
What is the function of Iris Scissors?
Cutting light materials
What should the Iris scissors NOT be used for?
These scissors should not be used for cutting any metal material - matrix bands, finishing strips - or paper, heavy plastics, etc.
What is the function of Curved Crown and Collar Scissors?
Cutting heavy materials:
Stainless Steel crowns
Metal finishing strips
Plastics and Acrylics
Cardboard and heavy paper
Locking Cotton Forceps
Picking up and holding small items - cotton pledgets, retraction cord, wedges, cotton rolls, etc.
Shaping and carving composite and amalgam
Flat blade and Acorn: Burnishing matrix bands , shaping and carving composite and amalgam
Gold Knife Interproximal Carver:
Trimming restorative materials interproximally
Large Cleoid Discoid:
Carving amalgam and wax
Small Cleoid Discoid:
Carving amalgam and wax
Carving amalgam and wax; shaping composite
Small and Large Ball Burnishers:
Burnishing matrix bands and amalgam
Large & Ex. Large Amalgam Condenser:
Packing amalgam into cavity preparation; sometimes used with composites
Small Amalgam Condenser:
Packing amalgam into preparation; sometimes used with composite
Removing cement, calculus, excessive restorative material
Anodized Plastic Instrument - Long blades:
Placing and shaping composite (non-stick)
Anodized Plastic Instrument Short blade:
Placement and shaping of composite (non-stick)
Anodized Plastic Instrument - Large Blade/Plugger:
Placement and shaping of composite (non-stick)
Smoothing cavo-surface margins and axial walls (Note: MT267 point is away from instrument handle; MT277 point is closest to instrument handle - this facilitates working in distal and mesial box forms.
chisel shaped cutting surface to smooth axial walls
Fischer's UC Packer:
instrument for packing retraction cord
(unique looking one)
diagnostic instrument - caries detection, adequacy of restoration, enamel defects, measure periodontal pockets, mm ruler when needed
What kind of mirror is in our kit?
#5 Front Surfaced Mouth Mirror
What kind of forceps are in our kits?
Articulating Paper Forceps
Amalgam Carrier - Small/Medium:
Picks up amalgam and dispenses amalgam into cavity preparation (Note: tips need to be emptied while amalgam is still plastic - DO NOT ALLOW AMALGAM TO SET IN TIPS
Cement Spatula (small) and Placement Instrument:
Mix cements, bases, etc., and place with small ball end as needed
Assists in loading the amalgam carrier
Most rotary instruments fit in dental handpieces with:
1. Friction Grip - High Speed
What are burs made of and how are they used?
Burs are milled from steel or carbide stock with cutting blades of all shapes and sizes. Tungsten carbide is by far the most popular stock used because the burs are longer lasting, sharper and maintain a sharp cutting edge longer that steel. Some burs are made by welding a carbide tip on a steel shank
Burs are used for enamel and dentin cutting as well as finishing and polishing tooth and restorative materials
Carbide lab burs are for cutting stones, acrylics and metals
Diamonds are made by bonding diamond particles to a milled shaft or shank. Diamonds also come in many sizes and shapes. Originally diamonds were used almost exclusively for tooth reduction for crowns and fixed prosthodontics. Now, because of the advent of numerous shapes and diamond particle sizes, diamond instruments are used for every type of restorative procedure from cutting and reducing tooth structure to fine polishing of restorations and porcelain - operators preference.
Cylinder cross cut fissured
Round end long pear shape
Dental diamonds come in many of the similar shapes of carbide burs
Diamonds became popular for crown preparation because they appeared to cut faster and smoother than carbides - in a high speed handpiece
The diamond cut isn't as aggressive as a carbide bur of the same shape and diameter and therefore is easier to control when precision cutting is desired
amonds come in the following approximate grit sizes*
Fine (46μ𝑚) (---)
Medium (107μ𝑚) (8---)
Course (151μ𝑚) (6---)
Diamond numbering code (Komet):
6=grit (Course), 8=grit (fine)
379=shape of diamond
023=diameter of instrument
have a flat end cutting surface with rounded corners. They can be cylinder or tapered shaped
In our kit, what shaped diamonds do we have?
In the kit we have round end taper, football, cylinder, narrow taper, KR and K diamonds.
The "K" diamonds
The "K" diamonds have a tip designed especially for cutting a chamfer margin on crown preps. It is not round or flat but shaped more like home base but with rounded corners.
What does the H1 stand for?
H1=type of bur=round
What does RA stand for?
RA=stands for "Right Angle" or another name for latch handpiece
What does .005 etc stand for?
.005 etc.,=indicated diameter of bur
¼=common name for bur "quarter round"
Komet USA Numbering system
Komet USA has a its own numbering system for burs and diamonds. However, they do list the "US" designation in the bracket. Diamond types and sizes are the same as "US" labeling except for the prefixed of 8, -, 6, 5 which designate grit size.
How are instruments held?
Instruments are held in most instances with a traditional "pen grasp". That allows for good tactile sense and the application of additional forces at the instruments working end when needed.
What should an instrument never be doing in a patient's mouth?
One should never place a "floating" instrument into a patient's mouth. Note in the pictures that both hands are resting on a fulcrum point - finger to tooth
If a doctor is "heavy Handed" what may the patient complain about?
Note the finger rests. Sometimes, if the doctor is "heavy handed" the patient will complain about the pressure on the teeth which are being used as fulcrums - Learn to rest but to not be heavy handed.
Where do we use the Straight Handpiece?
We seldom use the straight handpiece in the mouth. One common exception is to section lower 3rd molars. More often we use the straight handpiece outside of the mouth for adjusting restorations and dentures and polishing.
When using a thumb grasp we use opposing thumbs or fingers as fulcrums/rest positions. At times, we can use the appliance we are adjusting for our rest.
ALWAYS USE A FULCRUM OR REST POSITION!
Standard Pen Grasp
At times a standard pen grasp is the preferred instrument manipulation. However, again, ALWAYS HAVE A REST POSITION TO STABILIZE THE USE OF THE INSTRUMENT AND HANDPIECE!
Maintenance of Hand instruments
Do not drop - dropping results in instrument bending, dulling of cutting surface, and instrument breakage
Sharpening - Sharpening of the hand instrument with cutting surfaces is a special skill and one which may not be addressed appropriately. For now, if there is a question of instrument sharpness (reduced functionality), see a member of the faculty so that appropriate measures can be taken to return the instrument to proper function
Do not use the instrument for procedures for which it was not intended. Ex: Do not use the spatula as a screwdriver! Break it or bend it and you get to buy a new one
Guard you instrument with your life! Lost instruments - enough said!
Maintenance - Burs & Diamonds
Do not drop hand piece - bent burs or diamonds are trash bait.
Burning burs and diamonds by applying too much force when cutting ivorine teeth kills the instrument, or if in the mouth, the tooth. Use light forces keeping the bur and diamond constantly moving. These instrument will wear out and will need to be replaced. Diamonds can be cleaned with the ceramic chips to extend their life.
Replace dull or damaged burs and diamonds. Do not attempt to do projects with dull instruments.