BASIC GUIDE TO DENTAL INSTRUMENTS

1 BASIC GUIDE TO DENTALINSTRUMENTSC armen , , Dip. Ad. Ed., PG Cert ODED ental Nurse TutorDublin DENTAL School and HospitalRepublic of Ireland 2006 by Blackwell Publishing LtdBlackwell Munksgaard, a Blackwell Publishing CompanyEditorial Offices:Blackwell Publishing Ltd, 9600 Garsington Road, Oxford OX4 2DQ, UKTel: +44 (0)1865 776868 Blackwell Publishing Professional, 2121 State Avenue, Ames, Iowa 50014-8300, USATel: +1 515 292 0140 Blackwell Publishing Asia, 550 Swanston Street, Carlton, Victoria 3053, AustraliaTel: +61 (0)3 8359 1011 The right of the Author to be identified as the Author of this Work has been asserted inaccordance with the Copyright, Designs and Patents Act rights reserved. No part of this publication may be reproduced, stored in a retrieval system,or transmitted, in any form or by any means, electronic, mechanical, photocopying, recordingor otherwise, except as permitted by the UK Copyright, Designs and Patents Act 1988,without the prior permission of the author has no financial interests and no formal links with any of the companies whoseproducts are referred to in this published 2006 by Blackwell MunksgaardISBN-10: 1-4051-3379-1 ISBN-13: 978-1-4051-3379-1 Library of Congress Cataloging-in-Publication DataScheller, GUIDE to DENTAL INSTRUMENTS / Carmen ; : 978-1-4051-3379-1 (pbk.)

2 : alk. paper)ISBN-10: 1-4051-3379-1 (pbk. : alk. paper)1. DENTAL INSTRUMENTS and apparatus Handbooks, manuals, etc. I. Title.[DNLM: 1. DENTAL INSTRUMENTS Handbooks. WU 49 S322b 2006] 0028 dc222005029604A catalogue record for this title is available from the British LibrarySet in 9 on Sabonby SNP Best-set Typesetter Ltd., Hong KongPrinted and bound in Singaporeby COS Printers Pte LtdThe publisher s policy is to use permanent paper from mills that operate a sustainable forestrypolicy, and which has been manufactured from pulp processed using acid-free and elementarychlorine-free practices. Furthermore, the publisher ensures that the text paper and cover boardused have met acceptable environmental accreditation further information on Blackwell Publishing, visit our to Use This BookviSection 1: Infection Control in the DENTAL Surgery1 Section 2: DENTAL Radiography15 Section 3: BASIC Instruments31 Section 4: INSTRUMENTS and Sundries Used in Moisture Control39 Section 5: Local Anaesthesia47 Section 6: INSTRUMENTS Used for Rubber Dam Placement57 Section 7: Handpieces, Burs and Rotary Attachments65 Section 8: INSTRUMENTS Used in BASIC Restorative Procedures83 Section 9: Matrix Bands and Matrix Retainers111 Section 10: INSTRUMENTS Used in Endodontic Treatment125 Section 11: Elevators143 Section 12: Extraction Forceps149 Section 13: Surgical Instruments161 Section 14: Measuring Devices189 Section 15: Impression Trays195 Section 16.

3 Orthodontic Instruments201 Section 17: INSTRUMENTS Used in Periodontal Procedures235 Section 18: INSTRUMENTS Used in Removable and Fixed Prosthodontics 251 Appendix269 Index271To my family, Mom, Dad and Clayton, for giving me the strength to follow mydreams, and to Padraig for being a big part of that would like to thank the many people who helped with the development of this instru-ment GUIDE : Margaret Crosswaite, Tina Gorman, Helen Phipps, Joan Brennan, JoyMarkey and Ann Bradley for the constant guidance, encouragement and advice; O Sullivan, Dr. Frank Quinn, Dr. Therese Garvey, Dr. Johanna Glennon andDr. Maria Jennings for their advice, encouragement and editing of relevant chapters;Catherine Waldron and Anne O Byrne for their assistance; Dr. Barry Harrington, whohelped me at the early stages of this project; Professor David Coleman, who suppliedthe photography equipment needed to take some of the photos; the staff at the CentralSterile Services Department (Dublin DENTAL School and Hospital) who were alwayshelpful in finding the best INSTRUMENTS for photography purposes; and Dr.

4 FrankQuinn who supplied some excellent clinical you to the following companies and people who supplied photographs:American Eagle INSTRUMENTS Ash InstrumentsDynaflexGarrison DENTAL SolutionsHenry Schein IrelandHu-FriedyJ. Morita Europe GMBHKerrKodakLaerdal Medical LtdLearning and Teaching ScotlandLM INSTRUMENTS OyL&R ManufacturingDr. Anthony MaganziniMiltexOrmco EuropeOwandy DENTAL ImagingPremier DENTAL Products CompanyDr. Frank QuinnRoydent DENTAL ProductsSDIS eptodontSirona DENTAL SystemsSybron EndoTotal CareUltrasonicsW&H (UK) LTDY oung DentalHOW TO USE THIS BOOKAs the DENTAL profession evolves, there is an increasing demand for supplementary mat-erial that can keep up with advancing trends. Hands on practical experience is essen-tial for anyone in the DENTAL profession, and this needs to be supplemented with writteninformation to reinforce our practical illustrated manual has been prepared for students working and studying in thedental profession.

5 It may be used as a study aid or kept in the DENTAL surgery as a ref-erence GUIDE . This manual is intended to complement other methods of learning, , lecture notes etc., and is not meant to be a comprehensive resource. The100 items used in the National Examining Board for DENTAL Nurses in the UnitedKingdom are included in this book, and the current (at time of publishing) spotter items list is included in the many DENTAL INSTRUMENTS look similar, and can be confusing to a student,the false friends sub-sections identify INSTRUMENTS that may resemble the particularinstrument. This manual is not intended to be a complete representation of all dentalinstruments, but it does include examples from each DENTAL discipline. As many dentalinstruments are multi-functional and are referred to by more than one name, wherepossible, these are given beside the name of the instrument.

6 Complete set-ups havebeen included at the end of most sections for various procedures. The DENTAL profes-sional may have to modify these lists, depending on operator section is dedicated to a specific discipline or division of dentistry. Some ins-truments feature in many sections, and these have been included in the set-up sub-sections of the relevant sections. Infection control is a fundamental requirement in the DENTAL surgery, and as such the first section is dedicated to this area. This sectionaims to introduce the principles of health and safety, which must always be at the fore-front of a DENTAL professional s mind. Contact the legislative bodies for appropriateregulations and legislation relevant to your INSTRUMENTS in this GUIDE are not to scale, and during photography some coloursmay have been 1 INFECTION CONTROL INTHE DENTAL SURGERYIt is the responsibility of the DENTAL team to ensure that the appropriate and correct pro-cedures are carried out in relation to infection control to protect the patients, the publicand GUIDE to DENTAL InstrumentsINFECTION CONTROL IN THE DENTAL SURGERYF igure (a)(c)(b)PROTECTIVE WEARFIGURE a, b, cName(a) Mask (b) Safety glasses (c) Face shieldsFunction, precautions and directions for use To protect the DENTAL team from micro-organisms, debris, splatter and chemicals A mask is worn to protect the mucous membranes of the nose and mouth.

7 It filtersout small particles Should always be changed between each patient or before if it is visibly soiled Should be worn during patient care, sterilisation, disinfection, cleaning proceduresand during laboratory work Safety glasses and/or face shields are worn to protect the mucous membranes of theeyes Should be disinfected between patients A face shield can be used instead of safety glasses, but a mask must still be worn Should be large enough to cover the eye area completely and provide protectionfrom the top and side. With some safety glasses additional top and side shieldshave to be added to be used for this purpose Safety glasses are available to fit over prescription eye wear Must be shatterproofVarietiesDifferent types of masks and glasses availableInfection Control in the DENTAL Surgery3 INFECTION CONTROL IN THE DENTAL SURGERYINFECTION CONTROL IN THE DENTAL SURGERY4 BASIC GUIDE to DENTAL InstrumentsFigure (a)(b)

8 FIGURE glovesFunction and directions for use To protect the DENTAL team from direct contact with micro-organisms, debris, splatter and chemicals Worn during patient care when coming in contact with contaminated objects and chemicals, and when working intra-orally Always change between patients Do not wash gloves Replace damaged and ripped gloves immediately Always wash and dry hands thoroughly prior to donning gloves It is important to make sure gloves fit properlyVarieties Made from many different materials, latex, vinyl, nitrile. Available packaged as sterile surgical gloves Rubber utility gloves/heavy duty gloves are used during sterilisation proceduresWORK SURFACESFIGURE a, bNameNon-permeable barriersFunction and features Used to cover surfaces to prevent contamination Must be impermeable Single use; to be disposed of in the contaminated wasteVarietiesMany different types and sizes availableInfection Control in the DENTAL Surgery5 INFECTION CONTROL IN THE DENTAL SURGERYINFECTION CONTROL IN THE DENTAL SURGERY6 BASIC GUIDE to DENTAL InstrumentsFigure (a)(b)ITEMS USED FOR IDENTIFICATION AND ORGANISATION DURING STERILISATIONFIGURE identification ringsFunction and feature Used to organise and identify INSTRUMENTS AutoclavableVarieties Many different types and sizes available Coloured autoclavable tape can also be usedFIGURE a, b, cNameInstrument cassettesFunction(s) Used to organise and identify INSTRUMENTS during sterilisation and disinfection Can double as an instrument tray during proceduresVarietiesMany different types and sizes available.

9 Including plastic and metal typesInfection Control in the DENTAL Surgery7 INFECTION CONTROL IN THE DENTAL SURGERYF igure (Continued)(c)INFECTION CONTROL IN THE DENTAL SURGERY8 BASIC GUIDE to DENTAL InstrumentsFigure (a)(b)FIGURE tapeFunction and features Used to secure instrument wrap or pouches prior to sterilisation Will change colour once exposed to a certain temperature, but this does not indi-cate whether sterilisation has occurred Can be written on to indicate the contents of the packageVarietiesMany different types and sizes availableFIGURE a, bNameSterilisation pouchFunctions and features Used to wrap INSTRUMENTS prior to sterilisation Aids in organisation of INSTRUMENTS One side may be transparent to allow for viewing of the pouch contents (Figure a, b) Coloured markings indicate that a certain temperature has been reached during the sterilisation cycle INSTRUMENTS will remain sterile in pouch until it is punctured or openedVarietiesMany different types and sizes availableSTERILISATION EQUIPMENTFIGURE and directions for use Uses steam under high pressure to achieve sterilisation Follow manufacturer s directions for use Consult local legislation and guidelines in regards to appropriate sterilisation proceduresVarietiesMany different types and sizes availableInfection Control in the DENTAL Surgery9 INFECTION CONTROL IN THE DENTAL SURGERYINFECTION CONTROL IN THE DENTAL SURGERY10 BASIC GUIDE to DENTAL InstrumentsFigure (a)(b)

10 MANUAL CLEANING AIDSFIGURE brushesFunctions, features and precautions Manual cleaning is never recommended except when ultrasonic cleaning is not effective in removing debris Used along with a soapy cleaner to remove debris prior to sterilisation Allows cleaning inside suction tubes Long handle allows a greater distance between the operator and the contaminatedobject Should always be used submersed in water to reduce splatter Always wear heavy duty utility gloves while using bottle brushesVarietiesMany different types and sizes availableFIGURE a, bNameBur brushesFunction and precautions Manual cleaning is only recommended when ultrasonic cleaning is not effective inremoving debris Used along with cleaner to remove debris prior to sterilisation Allows for the cleaning of burs with small, hard-to-clean flutes Always wear rubber utility gloves/heavy duty gloves while using bur brushesVarietiesMany different types and sizes availableInfection Control in the DENTAL Surgery11 INFECTION CONTROL IN THE DENTAL SURGERYINFECTION CONTROL IN THE DENTAL SURGERY12 BASIC GUIDE to DENTAL InstrumentsFigure CONTROL IN THE DENTAL SURGERYI nfection Control in the DENTAL Surgery13 FIGURE cleanerFunction(s) and directions for use Used along with a soapy cleaner Uses sound waves to reduce bioburden and debris from INSTRUMENTS prior to sterilisation Follow manufacturer s instructions for solution types and length of time needed forcleaningVarietiesMany different types and sizes availableFIGURE (s)