MINISTRY OF HEALTH OF UKRAINE

BOGOMOLETS NATIONAL MEDICAL UNIVERSITY

Operative Dentistry Department

«Approved»

at the meeting of the Operative Dentistry department

Report № 11 of January 12, 2016

Head of department __________ prof. А.V. Borysenko

GUIDELINES

FOR INDEPENDENT WORK OF STUDENTS

WHILE PREPARING FOR THE PRACTICAL LESSON

Academic discipline Propaedeutics of operative dentistry

Module № 1 Propaedeutics of operative dentistry

Content module № 1 The basic dental tools and equipment. The anatomical

structure of the permanent teeth

Lesson Focus Dental tools, drills, tips, their using.

Disinfection and sterilization of dental equipment and

instruments. Tools.

Course ІІ

Faculty Dental

Number of hours 1

Compiler: prof. Lynovitskay O.V.

Methodist: ass.prof. Kolenko Y.G.

Kyiv – 2016

Занятие №2

2

DENTAL TOOLS, DRILLS, TIPS, THEIR USING. DISINFECTION AND STERILIZATION OF DENTAL EQUIPMENT AND

INSTRUMENTS. TOOLS. I. Relevance of the topic Treatment of most dental diseases is impossible without special equipment and tools. Knowledge of the structure and the ability to use dental instruments is an integral part of the work of a dentist. The study of this part of the phantom course of therapeutic dentistry is of paramount importance. In this case, the work of a dentist is associated with risk of infection and the possible transfer of a variety of infections since it is in contact with body fluids and tissues of patients (oral and gingival fluid, blood, etc.). To prevent the spread of infection from patient to dentist and from patient to patient, it is necessary disinfection and sterilization of dental instruments and equipment. Dentist must know the basic techniques of sterilization in dentistry, the rules of aseptic and antiseptic, as well as to be able to control the quality of disinfection and sterilization of dental equipment and instruments. II. Educational objectives of the session Total: learn the structure of the arms drills, dental tools, drills, tips, their purpose, methods of use and sterilization, as well as the basic methods of sterilization and forms of control of its efficiency in the dental reception. Specific: Preview (α-I): - With different types of drills sleeves; - With different types of terminals; - With dental instruments; - The rules of aseptic and antiseptic; - With the basic methods of disinfection in dentistry; - With the basic methods presterilizing treatment in dentistry; - The basic methods of sterilization in dentistry. Know (α-II): - The structure and rules of operation of the drill sleeves; - The appointment, the structure and rules of operation of different types of tips; - The structure and the appointment of dental instruments, their group; - The structure and purpose of the different types of elections, their use; - The main methods of sterilization of dental instruments; - The rules of aseptic and antiseptic; - The main disinfectants approved for use in hospitals dental profile; - Modern methods of disinfection in the dental clinic; - Modern methods of sterilization in the dental clinic; - Forms of monitoring the effectiveness of the sterilization; To be able to (α-III, α-IV): - To use different types of drills sleeves; - Use different dental handpieces; - Use of dental instruments; - The right to choose the drills depending on the clinical problem. - Disinfection of the main and minor dental instruments; - Disinfection of surfaces and air in the dental office; - Disinfection of hands of medical personnel in the dental admission; - To carry out the basic cleaning presterilizing and small dental instruments; - Sterilization of the main and minor dental instruments; - Sterilization of dental handpieces; - To carry out monitoring of the effectiveness of sterilization in the dental clinic.

Занятие №2

3

Develop (α-V) creative abilities of students, aimed at the formation of epidemiological thinking professional liability dentist to conduct disinfection and sterilization in the dental reception when using dental instruments and handpieces in the process of studying phantom course of therapeutic dentistry, the ability to solve new problems of modern medicine. III. Objectives of personality development (educational purposes) Pay attention to the professional skills of students in the application of dental instruments and handpieces and the main modern methods of sterilization under statmologicheskogo reception. Teach careful use of dental instruments, burs, handpieces, and their selection of professional conduct disinfection, cleaning and sterilization in the dental hospital. IV. Interdisciplinary integration

Discipline To know Able Previous disciplines

Physics

General printsiples of-Tkhe motor structure. Tae Basik Loves of-fisiss, vnih ape John Uceda medicine.

Be able to explain the rotational movement in motors, turbines

Bioorganic chemistry inorganic chemistry

The basic chemical reaction mechanism of action of chemicals on protein structures

organize and provide disinfection and sterilization medical treatment institutions dental Profile

Microbiology, Virology and Immunology

Types of microorganisms, their stability in the environment and impact on the human body. Ways of transmission of infections.

Pharmacology Pharmacological characterization of preparations for disinfection

Intra integration Different types of drills sleeves Different types of dental handpieces Different types of dental instruments Different types of elections

To know the structure and purpose of the sleeves drills, dental tools and tips, burs

Be able to explain the purpose of the sleeves drills, dental tools, tips, burs

dental office equipment. Different types of dental handpieces Different types of main and small dental instruments

Identify some of the main and minor dental instruments and handpieces.

organize and provide disinfection and sterilization medical treatment institutions dental Profile

V. The contents of lessons topics

Занятие №2

4

Preparatory course – working place

Propeudeutics dental

surgery

Dental set of

instruments

Drilling machine Illuminator

Dental handpieces:

straight, angular

Burs, instruments

Phantom

Set of plastic and

natural (extracted

teeth by indications)

Chairs 2-3 Dental materials

Занятие №2

5

Dental chairs

An arm –chair

with manual

spiral elevator

An arm-chair with

foot pneumatic

pump

An arm-chair with

hydraulic pedal

elevator

An arm-chair with

electric mechanic

hydro drive

An arm –chair with photosensory

program electronic control

Занятие №2

6

Dental drilling machine

Foot Electric Pneumatic

Dental drilling machines

Standard

foot non-

collapsible

Standard, foot,

collapsible

complex

Combined,

foot and

with motor

Standard with electric

motor

Hanging wall with

electric motor

Turbine

Up-to-date dental

sets

Portable

Universal dental sets

Занятие №2

7

Занятие №2

8

Universal dental set

Dental chair

Dentist’s remote control

Instruments block Control block

Low speed motors Pedal Control panel управління

Занятие №2

9

High speed motors

Other instruments:

- scaler - polymerization lamp,

etc.

Assistant’s unit:

- suction apparatus; - Vacuum ; - syringe “water -air”; - polymerization lamp(dentist’s lamp

Hydroblock:

- spittoon;

- basin;

- glass filler;

- bracket fastening of an assistant’s unit

Illumination block

Compressor

oily Non-oily

piston

spiral

Занятие №2

10

Up-to-date dental sets

Economist class

Business class

Elite class

Performer III

(A-DEC)

PERFORMER RADIUS

2132 (A-

DEC)

A-DEC 500 LUX (A-DEC)

DEC)

Dentist’s table

Dentist’s chair

Занятие №2

11

Занятие №2

12

VI. Plan and organizational structure of classes

№ The main stages of employment, their features and content

Learning objectives in the levels of assimilation

Monitoring and training methods

Materials of methodical

maintenance

Distribution of time (in minutes)

I. Preparatory phase

1 Arrangements .

– Hello, check the presence of the students and the necessary training materials, appearance, etc.

Academic journal 2 min

2 Setting learning goals and motivation

– – "Learning Objectives", "Relevance of the topic"

2-3 min

3 Control of initial level of knowledge, skills and abilities:

20 min

3.1. Drill sleeve, its function, types, structure and operating rules.

ІІ Individual theoretical survey. Solution II assimilation level of typical tasks. The decision of test tasks of mastering II level. Written theoretical control.

Questions. Tables, figures, slides. Set of tools. Typical tasks of mastering II level. Tests II mastering level. Written theoretical tasks.

3.2. Dental tip: its purpose, types, structure and operating rules. 3.3. Dental tools: the group structure and purpose. 3.4. The structure and purpose of the different types of elections, their use 3.5. General concepts of disinfection and sterilization of medical instruments 3.6. Characteristics of disinfectants 3.7. Processing mode of medical instruments 3.8. Quality control presterilizing processing and sterilization

II. The main Etap 4 Formation of professional skills and abilities:

90 min

Занятие №2

13

4.1. To view the different types of drills sleeves ІІІ The method of formation of skills: professional training in dealing with unusual clinical situations.

Dental equipment and tools. Algorithms for the formation of practical skills. Indicative card (professional algorithms) for the formation of new professional skills. Fake Equipment. Text atypical case studies.

4.2. To view the different dental handpieces 4.3. To familiarize with dental tools 4.5. Make the right choice hog.

4.5. Master the technique of disinfection of medical instruments

4.6. Master the technique of processing medical instruments presterilizing

4.7. Master the technique of sterilization of medical instruments

4.8. To be able to carry out quality control before sterilization processing and sterilization of medical instruments

IIІ. The final stage

5 Control and correction level of professional skills

III Methods of control skills: individual control skills or their results. skills testing methods: atypical decision of situational problems, test control.

The results. Text case studies Level IV. IV level tests

16 min

6 Summing up lessons (theoretical, practical, organizational) – Assessing the success of a student (diagnosis of the level of knowledge, skills and abilities).

– 2 min

7 Homework – – Indicative map for independent work with literature.

2 min

Занятие №2

14

VII. Materials of methodical maintenance of employment VII.1. control materials for the preparatory phase of exercises VII.1.1. -II)Theoretical questions ( 1. The structure and rules of operation of the drill sleeves. 2. Purpose, structure and rules of operation of different types of tips. 3. The structure and the appointment of dental instruments, their groups. 4. The structure and purpose of the different types of elections, their use. 5. Basic methods of sterilization of dental instruments. 6. What is the aseptic and antiseptic? 7. Definition of the term disinfection. Forms and methods of disinfection? 8. Disinfectants, which are approved for use in hospitals dental profile? 9. The processing modes of medical instruments? 10. The definition of the term presterilizing processing. Forms and methods? 11. The definition of the term sterilization. Forms and methods? 12. Quality control presterilizing processing and sterilization of medical instruments? VII.1.2. -I)Tests ( Test task №1. With the help of the device is fixed in the forward tip of the forest? a) the sleeve b) of the collet c) the spindle d) axis Answer: b). Test task №2. What tools are making the amalgam in a cavity? a) Loader; b) plugger; c) Tribrach; g) trowel. A: c). Test task №3. Wear what is the cause of poor fixation of boron in the angular tip? a) bearing; b) a sleeve; c) axis; g) zaschepki. Answer: d). Test task №4. Removal or destruction of infectious agents in medical devices, and in their channels and cavities that can be done in different ways - this? a) Sterilization b) Antiseptic c) Disinfection g) Asepsis d) presterilizing clearing A: c) Test task №5. disinfection method is the most common? a) Chemical b) Physical c) Combination d) Biology e) Mechanical Answer: a) Test task №6. Exemption of any object or material from all kinds of micro-organisms (including bacteria and their spores, fungi, viruses and prions), or their destruction - is it? a) Sterilization b) Antiseptic

Занятие №2

15

c) Disinfection g) Asepsis d) presterilizing clearing Answer: a) VII.1.3. -II).Tests ( №1. What tools are used for filling cavities? a) a spatula, b) probe, c) mirror, g) excavator d) plugger, e) ironing board. Answer: a, e, f. №2. Find logically connected between a pair of boron destination and its color-coded:

Colour code Assignment bur 1. Black

A. For Finishing tooth tissue after treatment

2. Green B. Universal 3. No C. For the quick removal of hard tooth tissue in orthopedic

practice 4. Red D. For grinding composite fillings 5. Yellow E. For the rapid removal of dental hard tissues in therapeutic

practice 6. White F. For the final polishing of composite fillings

The correct answer is: 1-B, 2-A, 3-B, 4-A, 5-F, 6-F. No. 3. Find the correct sequence of the process of the sterilization process:

№ Stage 1. A package

2. B. control of sterilization 3. C. drying 4. D. disinfection 5. E. presterilizing cleaning tools with blood, grease, dirt 6. F. proper sterilization 7. G. Storage of sterilized instruments and dressings 8. H. control over the quality of processing presterilizing

The correct answer is: 1-D, 2-D, 3-C, 4-H, 5-A, 6-E, 7-B, 8-M. №4. Find the correct sequence of steps of sterilization of dental handpieces: № п/п Stage

1. A. lubrication

Занятие №2

16

2. B. Cleaning the outer surface 3. B. loaded into an autoclave 4. G. disassembly 5. D. purge 6. E. sterilization

The correct answer is: 1-D, 2-D, 3-D, 4-A, 5-B, 6-E. VII.1.4. -II).Typical tasks ( A. What tools should be used for the examination of the oral cavity? Answer: For inspection of the oral cavity is used dental mirror, dental tweezers, angled or straight tube, syringe water, Puster gun or "water-air". Dental mirror is used to inspect the teeth and the mucous membrane; it will return reflection object under study. Mirror also carried pulling the lips, cheeks, tongue. Dental forceps make drugs in a cavity, determine the mobility of the teeth, and carried percussion teeth. The probe examined cavities determine the sensitivity of the bottom of the cavity and the depth of the periodontal pocket. Water for Injection is used to determine the sensitivity of the tooth pulp - reaction to cold and hot water, and also for oral irrigation with medical solutions. Gun "air-water" is used to study the sensitivity of dental hard tissue - reaction to air and water and to dry the cavities. Q. What tools are used for cavities and why is recommended to have two spatula - metal and plastic? Answer: when filling cavities used a glass plate (used for mixing her filling materials), a spatula (metal plastic), plugger, trowels (to make the filling material in a cavity and condensation), the matrix metal and celluloid (used in contact defects ). Metal spatula mix the cement and plastic composite materials. C. Methods of setting azopiramovoy sample? Answer: The working solution azopirama process observed object, rub the swab reagent or using a pipette, apply it 2 drops of reagent. In the contaminated blood products appears violet, turns quickly in pink and lilac. D. How is pre-sterilized cleansing manually? Answer: The manual cleaning process includes: 1. Soak in detergent solution with full immersion products unassembled with obligatory filling all channels and cavities on 15-60hv Depending on the funds. 2. Cleaning of each product in the wash liquor via their brush or cotton-gauze tampon, cloth napkins for 0.5-1 minutes. 3. Rinse under running water (0.5-1.0 m). Implemented in containers (bath, sink) with devices for jet water supply in the provided instructions to the means employed for a time. Sink for rinsing instruments should not be used for the washing of the hands of medical personnel. 4. Rinsing with distilled water for 0.5 minutes. 5. Drying by hot air at a temperature of 85 ° C until complete disappearance of the moisture in the air in the sterilizer vent open; in dry-Ovens - when the door is not completely closed.

Занятие №2

17

VII.2. Materials of methodical maintenance of the main phase of lessons

VII.2.1. Indicative map for the formation of professional skills

Task

To master the

ability to work

using the

universal

dental set

The sequence of performing

1.To assess the dental chair work

Warning as for self-control

It moves vertically(is lifted

and lowered) to provide

the height, comfortable for

doctor’s work. The chair’s

back can also be lifted and

lowered( to provide the

necessary slope or lying

position to a patient).Head-

rest provides patient’s head

position horizontally or

vertically. Chair’s control is

on the chair’s back ,

doctor’s or assistant’s

remote control , doctor’s

pedal or additional pedal to

control the chair.

Занятие №2

18

2.To assess doctor’s remote

control:

-instruments block;

-control block;

a)pedal;

b)panel control.

.

There may be two variants

of handpieces location:

hoses on top or hoses from

below. The turbine

handpiece is turned on

with the help of the pedal,

either with rotation speed

regulation or with it

micromotor and other

handpieces.

It may consist of the chair’s

control elements, speed

indication of instruments

rotation, air pressure

indication, negatoscope ,

i.e.

Занятие №2

19

3. To assess assistant’s remote

control:

- salivary ejector;

-vacuum cleaner;

-syringe ”water-air”;

-polymerization lamp

It is necessary for saliva

and other fluids utilization

from the patient’s mouth

into sewerage system.

Vacuum system is for

watery fog elimination

which appears during work

of handpieces with cooling

spray.

It is for drying by air flow

and mouth irrigation with

water or watery-air

mixture.

It is necessary for

polymerization of

photopolymeric filling

materials

Занятие №2

20

4.To assess hydroblock:

-spittoon;

-glass basin

It is necessary for saliva and

other fluids utilization into

sewerage system equipped

with washing off system.

It is for filling a glass with

water to rinse the oral

cavity.

5. To assess the illumination

block

It is for lighting an

operation field during

manipulations. It consists of

halogen illumination lamp

and bracket, which gives a

possibility to elevate, lower

and turn horizontally and

keep a lamp in proper

position.

6. To assess the compressor It is the source of

condensed air necessary to

make the handpieces ,

salivary ejector, watery-air

pistol, to act i. e.

Занятие №2

21

7. To assess the doctor’s tray It is for location of

instruments, devices and

apparatuses during work. It

has wheels for comfortable

moving.

8. To assess the doctor’s chair It is composed of soft seat,

semimoon, semicircular

back which rotates at the

chair axis, wheels for easy

moving of the chair, fixed

appliance which makes

impossible the chair to

move after a doctor takes

working position.

Занятие №2

22

VII.3. control materials for the final stage

VII.3.1. Atypical case studies (-IV).

№1. Boron is not fixed in the handpiece. What is the reason and how to

troubleshoot?

A: The bad fixation of boron in the handpiece occurs when there is insufficient

pressure on the button is pressed, whereby the collet spindle cheeks are not

compressed and therefore, boron is not fixed. It is necessary to enhance the

delivery of the collet to the forward end position to extend the pressure button and

impose on it one or two goals.

№2. When rotating in the forward tip of boron noted strong vibration. What is the

cause of vibration and how to fix it?

A: The cause of the vibration of boron in the forward tip is wear and tear of the

body recess, the housing sleeve and the body portion of the spindle. In this spindle

with boron creates vibration. To eliminate the vibration necessary to unscrew the

connecting sliding sleeve and remove the protective sleeve. There will access the

external sliding sleeve on which the ratchet nut and lock nut control regulating gap.

They should move into 1-2 mm, which will allow the spindle to enter into the

housing recess and create a vibration.

No. 3. Boron in the angular tip is not fixed or fixed, but does not rotate. What is the

reason for this phenomenon, and how it is eliminated?

A: angular tip boron is not fixed during wear zaschepki. Boron is not rotating, if

boron is not brought to the end of the cartridge gear, whereby boron zaschepka

head overlaps boron hub. In the first case, you should replace zaschepku a new

one, in the other - to enter the forest to the end of a gear cartridge and secure

zaschepku.

№4. A nurse holds a control sample amidopirinovoy quality presterilizing

processing tools. It caused 3 drops on one of the tools (drops caused the cutting of

the scissors), which have been in this game and have been processed, and has not

received any coloring. What can be concluded? It can be considered complete

presterilizing processing this party tools?

Занятие №2

23

A: The reagent should be applied to places where the jaws are connected, or where

there is a thread on the working parts of the tool; it is necessary to repeat the

correct study for 2-3 instruments.

№5. A nurse held presterilizing cleaning tools. It is a tool to rinse in running water

for 1 minute, it sank into the detergent at 50 ° C for 15-17 min, washed in each

detergent tool with a brush for 1 min, rinsed in running water instruments for 5-10

minutes , rinse them with distilled water and dry in a dry-Ovens. What else needs

to be done before installation tools on the trays for its sterilization in a dry-Ovens?

The answer: it is necessary to conduct tests on the quality of presterilizing

processing.

№6. During the communication and external examination of the patient, the dentist

suspected in a patient addict. What information carries this assumption? Is it

necessary to take precautions in the assistance to the patient? What kind?

A: significantly increases the risk of HIV infection the doctor, since this patient is

at risk. According to the treatment of the patient is necessary to strictly follow the

rules of aseptic and antiseptic. Dental instruments and handpieces after taking the

patient should be carefully handled with strict adherence to all stages of

sterilization.

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Электронные источники

Занятие №2

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1. http://sestrinskoe-delo.ru/ 2. http://ru.wikipedia.org/ 3. http://www.mosdental.ru/Pages/Page18.html 4. http://ru.wikipedia.org/wiki/Никель-титановые_вращающиеся_инструменты