Types and purposes of dental instruments

Modern hand instruments, when used correctly, provide excellent results for both the doctor and the patient. It should be noted that some of these results can only be achieved using hand tools, not rotary power tools. The shape of the preparation dictates the specific circumstances in which hand instruments must be used, while the accessibility of the preparation may require different conditions.

Hand-held cutting tools are made from two main materials, carbon steel or stainless steel.

In addition, some of them have carbide inserts that add hardness to the cutting edges. Carbon steel is harder than stainless steel, but is susceptible to corrosion if not protected. Stainless steel retains its shine in most cases, but loses its edge sharpness much more quickly than carbon steel. The latter, despite its hardness and wear resistance, is brittle and cannot be used in all tools.

Other alloys containing nickel, cobalt or chromium are also used, but dental preparation instruments are not typically made from such alloys.

Types and purposes of dental instruments

The work of a dentist uses both a universal set of medical devices and specialized instruments necessary to perform highly targeted manipulations. There is a generally accepted classification of dental instruments:

• for examination of the oral cavity;
• for treatment and filling of teeth;
• for the preparation of filling and other compositions;
• for removing teeth and their roots;
• for removing dental plaque;
• for processing fillings and root canals.

The listed devices are universal and necessary for general dental procedures. In addition to them, dentistry uses ordinary and surgical instruments intended for highly specialized dentists: orthodontists, orthopedists, periodontists, hygienists, and technicians.

Dental instruments for oral examination

Diagnostic devices are included in the basic kit that every dentist needs. Their main purpose is to examine the patient’s oral cavity to identify problems and find further ways to solve them. In addition, they are necessary in the process of treatment and removal of teeth, during prosthetics.

Every dentist should have in his arsenal:

Selection of instruments for preparation of dental fissures during invasive sealing

Despite the constant development and introduction of new instruments and restoration materials into dental practice, improvement of methods and technologies for their use, many unresolved problems remain in practical therapeutic dentistry. One of them is the effective prevention and treatment of the initial stages of caries of chewing teeth by the method of invasive sealing of fissures with flowable composites.

A promising direction in this area is the use of special burs for therapeutic and prophylactic fissurotomy, which are created taking into account the shape of the fissure for minimal excision of tooth tissue. The most famous in our country are carbide fissurotomy burs. However, given the shape of the cavity resulting from preparation with such burs, the quality of its filling with filling material is questionable, even when using flowable composites.

In this regard, the purpose of our study was a comparative assessment of the quality of filling cavities in the fissure area of ​​chewing teeth with a flowable composite, depending on the configuration of the working part of the bur used for fissurotomy. We conducted a comparative study of carbide burs with a pointed tip of the working part and cone-shaped diamond burs with a rounded tip of the working part with a diameter of 1.2 mm (Fig. 1).

Rice. 1. Fissurotomy burs of various designs: a - carbide fissurotomy bur; b - cone-shaped diamond bur with a rounded top.

Each type of bur was used to prepare the fissures of 25 premolars removed for medical reasons (Fig. 2a).

Rice. 2. The main stages of the study: a - preparation of fissures of removed premolars; b — filling the cavity with a flowable composite; c — making sections of teeth.

After preparation, adhesive preparation of the cavities was carried out using the total etching technique (Table No. 1).

Table No. 1. List of tools and materials used during the study

All cavities were then filled with light-curing flowable composite (Figure 2b).

Filling was performed with one portion of material. The distribution of the composite in the cavity was carried out with a sharp dental probe. For photopolymerization of the material, a high-power activating lamp with a broadband emission spectrum was used. After this, we made longitudinal sections of all filled teeth, passing through the bottom of the cavity (Fig. 2c).

The marginal adherence of the material to the walls and bottom of the cavity was assessed visually with an optical magnification of 3.5 times, tactilely using a dental probe and by staining sections with a caries detector (Fig. 3).

Rice. 3. Assessment of marginal fit: a - visually; b — probing the filling/tooth boundary; c — staining of thin sections with a caries detector.

In the course of analyzing the results of the study, we found that when performing fissurotomy using cone-shaped diamond burs, high-quality, uniform filling of the cavity with composite material was obtained in 96% of cases (Fig. 4).

Rice. 4. Results of analysis of the quality of filling cavities with flowable composite in the studied groups of teeth: a, b - complete, uniform filling of the cavity with flowable composite; c, d - defects in filling the cavity with a flowable composite.

When using carbide burs with a pointed tip of the working part, high-quality filling of the cavity with composite material was recorded only in 44% of cases. In 56% of observations, filling defects were noted in the area of ​​the cavity bottom and a violation of the marginal fit of the composite.

We explain such a high frequency of violation of the marginal seal by the discrepancy between the shape of the cavity when performing fissurotomy with peak-shaped burs with a pointed tip and the fluidity of the filling material. Based on the data obtained, we recommend using cone-shaped burs with a rounded tip of the working part with a diameter of at least 1.2 mm for carrying out therapeutic and prophylactic fissurotomy using flowable composites as a filling material (Fig. 5, 6).

Rice. 5. Cone-shaped diamond bur with a rounded tip of the working part with a diameter of 1.2 mm (D.845.012.FG, Frank Dental).

Rice. 6. Performing fissurotomy with a cone-shaped diamond bur with a rounded tip of the working part.

Dental instruments for dental treatment

Tools for dental treatment are varied. They differ in names, functional purposes, and the material from which they are made. The choice of the right tools depends on what problem the patient came to the doctor with. The same instruments can be used by a dentist to treat a wide range of diseases.

In addition to the basic set of instruments used in the treatment of diseased teeth, dentistry uses a number of additional devices for carrying out highly targeted actions, for example, prosthetics.

Dental instruments for prosthetics

Prosthetics of any complexity requires an individual approach and takes a lot of time. Each stage of the procedure uses its own set of instruments.

Dental instruments for filling teeth

The filling procedure using cement or amalgam requires the use of special instruments, with the help of which:

• The tooth cavity in which the filling will be placed is prepared.
• The future tooth is modeled.

In modern dental practice, the following instruments are used for filling teeth:

During the filling process, not only the main, but also auxiliary devices can be used: matrix holders, channel fillers, strips.

Dental instruments, classification

Dentists' instruments can be classified into the following groups:

1. For use in examination and diagnosis;
2. Used directly for dental treatment;
3. With which the doctor removes deposits from the teeth;
4. Instrumentation for dental prosthetics;
5. Devices for tooth extraction;

The basic composition of the instruments that the dentist uses during examination: a tray, a dental mirror, various types of tweezers and probes.

Devices used in treatment include polishing and diamond heads, discs, and burs.

When filling and getting rid of softened tissues, the dentist uses an excavator, a plugger and a host of other devices.

There are special instruments for the dentist's actions in root canals.

Auxiliary instruments for treatment are matrices, strips, brushes for lubricating the tooth surface with liquid, etc.

The instruments used to remove deposits from teeth primarily include: curettes, enamel knife, root file, scalers.

There are many types of instruments for dental prosthetics. The main ones are: impression trays, all kinds of spatulas, a micrometer, instruments used to determine the central closure of teeth.

Tools for pulling out teeth include anatomical forceps. Some of them are intended for the upper jaw, others for the lower jaw.

The group described above also includes devices for removing roots; they are called elevators and can be angular, straight or bayonet-shaped.

Instruments used to separate gums before extracting a tooth are also considered instruments used in tooth extraction.

Other instruments of this type include a syringe with anesthetic, various curettes, clamps, and needle holders.

Dental surgeon tools for teeth removal

Tooth extraction is one of the most common procedures faced by patients in dental clinics. The tools of a dental surgeon are extremely diverse. The main ones among them are elevators and tongs.

In addition to all of the above, when removing incisors, canines and molars, you may need tools for separating the gums from the jaw, tweezers for transferring and holding dressing material, needles of various thicknesses and lengths, clamps and forceps for holding a surgical needle.

Types of forceps

The instrument is used to extract teeth using the lever principle. Its main parts are: handle, lock and cheeks. With the help of the last section, the coronal part of the element to be removed from the oral cavity is fixed. The doctor holds the instrument by the handle and rotates it in the required direction. The lock is part of the connection between the cheeks and the handle. To remove different types of units, separate types of forceps are used, differing in design features and sizes.

Forceps for extracting units on the lower jaw

The following types of forceps are used in the process of removing lower teeth:

• Beak-shaped. Designed to remove units with intact coronal part. The cheeks in these instruments are located at an angle of 90 degrees to the handle. The cheeks can be either converging or non-converging.
• To remove wisdom teeth. They have curved cheeks that can penetrate hard-to-reach areas of the row.

Beak-shaped forceps for removing teeth on the lower jaw.

Forceps for removing teeth on the upper jaw

There are several types of tools for extracting the upper elements:

• Bayonet or universal. With their help, you can eliminate almost any affected unit of the upper jaw. Depending on the width of the cheeks, instruments are divided into narrow, medium and wide. The axes of the handles and cheeks of bayonet-shaped pliers are parallel to each other.
• Direct. Designed to eliminate milk units or elements located in the front. The working part of the tools and their handle are located on the same line.
• S-shaped. Necessary for extraction of chewing units of the upper jaw. The cheeks of the forceps do not touch each other. There are several types of the instrument in question: left-handed and right-handed. One part of the cheek has a rounded shape, the second ends with a spike.
• To remove top eights. The cheeks and handle of the tool are located on the same axis. Both cheeks are rounded at the ends, and their inner part has indentations. This design ensures convenient penetration of the forceps into the oral cavity. During extraction of the upper eights, there is no damage to the lower wisdom teeth.

Elevators

Main structural elements: working part, handle, connecting rod. Depending on the width of the working part, all tools are divided into wide, medium and narrow. The devices also differ in the principle of operation - from themselves and from themselves.

There is a groove on one side of the working part of the elevators, and a convex part on the other. And also instruments are divided into straight and convex. The first type of device is used to remove single-root elements or to separate the roots of multi-root units from above and below. Angled structures are used to remove teeth whose roots have not been preserved.

The tooth is removed using an elevator using the lever principle. During the operation, the surgeon holds the alveolar process with the thumb and index finger of his left hand, and with his right hand he inserts the elevator into the periodontal space, which becomes larger under the influence of the instrument. During manipulation, the periodontal fibers of the affected element are torn.

The elevator is inserted with rotational movements to a depth of 4–6 mm. Thanks to the efforts made by the dentist, the tooth is squeezed out of the alveolus. Similar manipulations are carried out to remove semi-retracted (partially exposed to the surface of the gum) and retracted (located in the thickness of the gum) elements.

A chisel or bur is used to remove the upper or lower front incisors, after which the dentist uses instruments to extract the roots. The remains of the root system are removed using narrow tweezers (for the upper jaw) or an angular elevator (for elements of the lower row).

Tools for removing plaque from teeth

Very often, patients turn to the dentist who want to get rid of deposits on the surface of their teeth and gums. For these purposes, tools are produced under the following names:

• Curettes. Instruments that have different shapes, which facilitates their penetration into any part of the oral cavity.
• Hooks of different shapes and sizes. Used to clean the tooth surface and gums from deposits.
• Excavators. Necessary for removing temporary fillings, pieces of food, as well as deposits that form above or below the gum, in the periodontal canals.
• Attachments for pneumatic or ultrasonic scalers. Effective in removing deposits above the gums, as well as in cleaning the area between the teeth. A device such as a scaler should not be used in the presence of subgingival deposits.
• Enamel knife. Used for polishing and giving the ideal color to tooth enamel.
• Root file. A dental instrument used in the final stage of a dental plaque removal procedure. It is used to grind the surface of the root.

It is not so easy to list all the main dental instruments used in modern medical practice. The number of devices that every specialist should have in their arsenal is steadily increasing, as treatment methods are constantly being improved, new approaches to practical activities are being developed, and the quality of services provided is growing. It is important to correctly navigate and understand the variety of existing tools, using new technologies and developments.

Where is it profitable to buy dental instruments?

You can always buy high-quality dental instruments profitably in Moscow in the Dental Market online store.

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