unit 18.7 identifying dental instruments.ppt

7/27/2019 Unit 18.7 Identifying Dental Instruments.ppt

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Identifying Dental Instrumentsand Preparing Dental Trays

Unit 18.7

Dr. Hale

Medical Technologies

Jr. Program


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Methods for Setting Up Dental Trays1. Correct preparation for assisting with dental

procedures includes setting up trays of

instruments and supplies2. Various methods are used to set up trays for

specific dental procedures

3. Instruments and supplies used are determinedby the procedure that will be performed and

the personal preference of the dentist.


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4. In some areas, trays are set up immediately

before use

a. Assistant prepares room: cleans, appliesbarriers, and so forth

b. Seats and drapes patient

c. Sets up tray with supplies and sterilizedinstruments


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5. In other areas, preset trays are used

a. Contents of trays are determined by dentist

b. Trays are set up for oral examinations,amalgam, composite, surgical extractions, and

other similar procedures

1) Oral examination: patients teeth cleaned and

examined, dental radiographs or X-rays may betaken

2) Amalgam and composite


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aa. Two main restorative materials used to

repair carious lesions or tooth decay

bb. Doctor removes damaged tooth structureand creates an opening called a cavity

preparation

cc. Amalgam, silver restorative material, orcomposite, an esthetic restorative material,

is placed in the cavity preparation


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Cavity PreparationRadiographs and pictures of lower first Molar

showing three canal orifices

Mesial-Buccal and Mesial-Lingual canals


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Lesion before cavity preparation

Cavity prep showing dentin

Completed restoration


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3) Surgical extraction:

removal of a damaged

tooth


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c. Patient is seated and draped

d. Sterilized procedure tray is obtained and

placed in roome. If additional instruments or supplies are

needed, they can be added to the prepared tray


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6. Color coded trays

a. Instruments are color coded with tiny

bands to denote use for specific proceduresb. Examples: red for amalgam, blue for

composite, and so forth

c. Full set of color coded instruments placedon tray

d. Sterilized as one unit


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Examples of Color-Coded Trays


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Organization of Trays

1. Items on trays should be organized and in

proper sequence

2. Usually arranged in order of use3. After instrument is used, returned to same

place on tray in case it is needed again

4. Easier for assistant to locate instruments andincreases overall efficiency


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Main Parts of a Dental Hand Instrument

1. Blade, nib, or point

a. Blade is cutting portion of an instrument

b. Nib is the blunt, serrated, or smooth working endof a condensing instrument

c. Point is the sharp end used to explore and detect

2. Shank: portion that connects shaft or handle to the

blade, nib, or point3. Shaft: handle of the instrument, usually hexagonal to

provide a better grip


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Standard Instruments

1. Mouth mirror

a. Used to view areas of oral cavity, reflect

light on dark surfaces, and retract lips, andso forth for better visibility

b. Used in every basic tray set up

c. Available in various sizes and with plain ormagnifying ends


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2. Explorer

a. Used to examine the teeth, detect carious

lesions, and note other oral conditionsb. Available in many shapes and sizes

c. May be single or double ended


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3. Cotton pliers

a. Used to carry objects such as cotton pellets

or rolls to and from the mouthb. Some lock, some do not lock

c. Also called operating pliers or college

pliers


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Examples of Cotton Pliers


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Cotton Pliers


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4. Scalers

a. Used to remove calculus (tartar) and debris

from the teeth and sub-gingival pocketsb. Available in many shapes

c. Used mainly for prophylactic (cleaning) or

periodontal (gingiva) treatments


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5. Periodontal probes

a. Used to measure the depth of the gingival

sulcus (space between the tooth and freegingiva)

b. Has round, tapered blade with a blunt tip

marked in millimeters (mm)


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Periodontal probe


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6. Excavators

a. Group of instruments used mainly for

removal of caries and refinement ofinternal opening in a cavity preparation

b. Spoons

1) Used to remove soft decay from cavity

2) Cutting instruments with small curve orscoop at the working end


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c. Hoes

1) Used primarily on anterior teeth to remove

caries and to form line angles2) Have one or more angles to shaft, with last

length forming the blade

3) Also used in scraping, planning, and directthrust cutting motions


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Dental Hoes


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d. Hatchets

1) Used to refine internal line angles

2) Used to smooth and shape a cavitypreparation

3) Used to remove hard-type caries


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Dental Hatchets


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7. Chisels

a. Used for cutting and shaping enamel

b. Enamel hatchet

1) Similar to other hatchets but blade is

larger and heavier

2) Blade is beveled on only one side


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c. Gingival margin trimmer

1) Special chisel for placing bevels on

gingival enamel margins ofproximoocclusal cavity preparations

2) Chisel blade is placed at an angle to the

shaft, not straight across like a hatched3) In addition, the blade is curved, not flat like

a hatchet


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Examples of

Gingival Margin Trimmers


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Gingival Margin Trimmers


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8. Cleoid-discoid carver

a. Double ended instrument

b. Also available as cleoid or discoid singleended

c. Discoid is disc shaped, with cutting edgearound the blade

d. Discoid is disc shaped, with cutting edgearound the blade


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Hollenbach Carver


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9. Plastic filling instruments (PFIs)

a. Double ended instrument with packing end and

cutting end

b. Used to shape and condense a restorative material

while it is still malleable or capable of being

shaped or formed

c. Also used with cements before setting occurs

d. Most have a small condenser at one end and a

paddle like blade at the other end


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10.Amalgam instruments

a. Used mainly with amalgam restorations

b. Amalgam carrier1) Used to carry small masses of freshly

mixed amalgam to the cavitypreparation

2) Available as lever type or plunger typecarrier


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Amalgam Carriers


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c. Amalgam carver

1) Used to carve or shape freshly placedamalgam t restore tooth to natural anatomy

2) One example is Hollenback carver

d. Condenser plugger

1) Used for condensing and packing amalgaminto prepared cavity

2) Ends may be serrated or plain


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Condenser Pluggers


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e. Matrix retainer and band

1) Retainer is used to hold band in place

2) Matrix band is short strip of steel or othermetal not affected by mercury

3) Used to form a wall around a cavity soamalgam can be packed into place

4) Plastic matrix strips are used withcomposite restorative material


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Matrix Retainer & Band Placement


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11.Burnishers

a. Contain working points in shape of balls or

beaver tailsb. Used primarily to burnish (adapt) the

margins of gold restorations to a better fit

c. Also used to polish other metals


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Burnishers


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12.Plastic composite instruments

a. Set of plastic instruments used with composite

b. Metal instruments can discolor composite13.Surgical instruments

a. Very numerous depending on type of oral surgery

performed

b. Main instruments used in surgical extractions


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c. Other specific instruments and supplies suchas chisels, hemostats, needle holders, andsuture materials might also be used

d. Surgical forceps

1) Also called extracting forceps

2) Used to extract or remove teeth

3) Different ones each for specific tooth to beextracted


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Surgical Forceps


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e. Periosteal elevators

1) Used for lifting the mucous membrane andtissue covering the bone

2) Double ended instrument with a blade ateach end

f. Root elevators

1) Various types, shapes, and sizes

2) Used to loosen tooth out of its socket


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Periosteal Elavators


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Root Elevators


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g. Root tip picks

1) Straight or contra-angled

2) Used to remove small tips from a socket such

as a root tip or piece of bone

h. Rongeur forceps

1) Used to trim or cut bone tissue

2) Tips of forceps may be round or square3) Tough sharp blade extends around both sides and

end of the tips


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Rongeur Forceps


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i. Lancet

1) Similar to scalpel and blade

2) Used to lance and incise or cut tissuej. Bone/surgical chisels

1) Used for cutting bone structure in oralcavity

2) Some used by hand, others require use ofsurgical mallet


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Types of

Bone Chisels


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Guidelines for Preparing Surgical Trays

1. Use only items that are usually needed

2. Placing instruments and supplies that areneeded occasionally on the tray can decreaseefficiency and crowd the items

3. Certain items usually stored in assistants cart

a. Drape and clips

b. Dental bases, cements, and restorativematerials


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c. Extra cotton products or dressings

d. Instruments used for specific problems or

procedures


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2. Amalgam restoration tray

a. Used for amalgam restoration

b. Include basic instruments and suppliesc. Add amalgam carriers, condenser pluggers,

carvers


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3. Composite or esthetic restoration tray

a. Used for placement of composite or

esthetic restorationb. Include basic instruments and supplies

c. Add plastic composite instruments, fine

brush


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4. Surgical extraction tray

a. Used to remove or extract teeth

b. Include basic instruments and supplies

c. Instruments added vary depending on type of

extraction

d. Usually add extracting forceps, root-tip elevators,

root-tip picks, periosteal elevators, Rongeurforceps, lancets, bone chisel, and a needle holder

with suture materials


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Surgical Extraction Tray


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Basic Principles

for Preparing Dental Trays

1. Lay out general patient equipment such as

records, X-rays, patient drape and clips

2. Prepare handpieces for usea. Make sure all in good working order

b. Add sterile tips, barriers, and so forth

3. Place basic instruments and supplies on tray


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8. Review procedure and check tray to be sure

all items present

9. Remember that equipment, supplies, andinstruments used will vary from doctor to

doctorfollow your doctors preferences


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unit 18.7 identifying dental instruments.ppt

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