Identifying Dental Instruments and Preparing Dental Trays Unit 18.7 Dr. Hale

1. Identifying Dental Instrumentsand Preparing Dental TraysUnit 18.7Dr. Hale Medical Technologies Jr. Program

2. Methods for Setting Up Dental Trays 1. Correct preparation for assisting with dental procedures includes setting up trays of instruments and supplies 2. Various methods are used to set up trays for specific dental procedures 3. Instruments and supplies used are determined by the procedure that will be performed and the personal preference of the dentist.

3. 4. In some areas, trays are set up immediately before use a. Assistant prepares room: cleans, applies barriers, and so forth b. Seats and drapes patient c. Sets up tray with supplies and sterilized instruments

4. 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: patient’s teeth cleaned and examined, dental radiographs or X-rays may be taken 2) Amalgam and composite

5. aa. Two main restorative materials used to repair carious lesions or tooth decay bb. Doctor removes damaged tooth structure and creates an opening called a cavity preparation cc. Amalgam, silver restorative material, or composite, an esthetic restorative material, is placed in the cavity preparation

6. Cavity Preparation Radiographs and pictures of lower first Molar showing three canal orifices Mesial-Buccal and Mesial-Lingual canals

7. Lesion before cavity preparation Cavity prep showing dentin Completed restoration Amalgam Condensers

8. 3) Surgical extraction: removal of a damaged tooth

10. c. Patient is seated and draped d. Sterilized procedure tray is obtained and placed in room e. If additional instruments or supplies are needed, they can be added to the prepared tray

11. 6. Color coded trays a. Instruments are color coded with tiny bands to denote use for specific procedures b. Examples: red for amalgam, blue for composite, and so forth c. Full set of color coded instruments placed on tray d. Sterilized as one unit

12. Examples of Color-Coded Trays

13. Organization of Trays 1. Items on trays should be organized and in proper sequence 2. Usually arranged in order of use 3. After instrument is used, returned to same place on tray in case it is needed again 4. Easier for assistant to locate instruments and increases overall efficiency

14. 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 end of 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 point 3. Shaft: handle of the instrument, usually hexagonal to provide a better grip

15. Standard Instruments 1. Mouth mirror a. Used to view areas of oral cavity, reflect light on dark surfaces, and retract lips, and so forth for better visibility b. Used in every basic tray set up c. Available in various sizes and with plain or magnifying ends

16. 2. Explorer a. Used to examine the teeth, detect carious lesions, and note other oral conditions b. Available in many shapes and sizes c. May be single or double ended

18. 3. Cotton pliers a. Used to carry objects such as cotton pellets or rolls to and from the mouth b. Some lock, some do not lock c. Also called operating pliers or college pliers

19. Examples of Cotton Pliers

20. Cotton Pliers

21. 4. Scalers a. Used to remove calculus (tartar) and debris from the teeth and sub-gingival pockets b. Available in many shapes c. Used mainly for prophylactic (cleaning) or periodontal (gingiva) treatments

23. 5. Periodontal probes a. Used to measure the depth of the gingival sulcus (space between the tooth and free gingiva) b. Has round, tapered blade with a blunt tip marked in millimeters (mm)

24. Periodontal probe

25. 6. Excavators a. Group of instruments used mainly for removal of caries and refinement of internal opening in a cavity preparation b. Spoons 1) Used to remove soft decay from cavity 2) Cutting instruments with small curve or scoop at the working end

27. c. Hoes 1) Used primarily on anterior teeth to remove caries and to form line angles 2) Have one or more angles to shaft, with last length forming the blade 3) Also used in scraping, planning, and direct thrust cutting motions

28. Dental Hoes

29. d. Hatchets 1) Used to refine internal line angles 2) Used to smooth and shape a cavity preparation 3) Used to remove hard-type caries

30. Dental Hatchets

31. 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

33. c. Gingival margin trimmer 1) Special chisel for placing bevels on gingival enamel margins of proximoocclusal cavity preparations 2) Chisel blade is placed at an angle to the shaft, not straight across like a hatched 3) In addition, the blade is curved, not flat like a hatchet

34. Examples of Gingival Margin Trimmers

35. Gingival Margin Trimmers

36. 8. Cleoid-discoid carver a. Double ended instrument b. Also available as cleoid or discoid single ended c. Discoid is disc shaped, with cutting edge around the blade d. Discoid is disc shaped, with cutting edge around the blade

37. Hollenbach Carver

38. 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

39. 10.Amalgam instruments a. Used mainly with amalgam restorations b. Amalgam carrier 1) Used to carry small masses of freshly mixed amalgam to the cavity preparation 2) Available as lever type or plunger type carrier

40. Amalgam Carriers

41. c. Amalgam carver 1) Used to carve or shape freshly placed amalgam t restore tooth to natural anatomy 2) One example is Hollenback carver d. Condenser plugger 1) Used for condensing and packing amalgam into prepared cavity 2) Ends may be serrated or plain

42. Condenser Pluggers

43. e. Matrix retainer and band 1) Retainer is used to hold band in place 2) Matrix band is short strip of steel or other metal not affected by mercury 3) Used to form a wall around a cavity so amalgam can be packed into place 4) Plastic matrix strips are used with composite restorative material

44. Matrix Retainer & Band Placement

45. 11.Burnishers a. Contain working points in shape of balls or beaver tails b. Used primarily to burnish (adapt) the margins of gold restorations to a better fit c. Also used to polish other metals

46. Burnishers

47. 12.Plastic composite instruments a. Set of plastic instruments used with composite b. Metal instruments can discolor composite 13.Surgical instruments a. Very numerous depending on type of oral surgery performed b. Main instruments used in surgical extractions

48. c. Other specific instruments and supplies such as chisels, hemostats, needle holders, and suture 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 be extracted

49. Surgical Forceps

50. e. Periosteal elevators 1) Used for lifting the mucous membrane and tissue covering the bone 2) Double ended instrument with a blade at each end f. Root elevators 1) Various types, shapes, and sizes 2) Used to loosen tooth out of its socket