INSTRUMENTS IN OPERATIVE DENTISTRY

CONTENTS
INTRODUCTION HISTORY CLASSIFICATION INSTRUMENTS FOR TOOTH STRUCTURE REMOVAL o HAND INSTRUMENTS NON-CUTTING INSTRUMENTS CUTTING INSTRUMENTS o SHARPENING OF HAND INSTRUMENTS o POWERED CUTTING EQUIPMENT o ROTARY INSTRUMENTS INSTRUMENTS FOR RESTORING PROCEDURES

INTRODUCTION
Operative dentistry is an art and science, which requires a high degree of precision for a successful outcome. The armamentarium of operative dentistry has grown tremendously over the years resulting in a highly successful and predictable outcome.

The need for a distinctive instrument in every single step of each treatment procedure is responsible for the huge armamentarium we have today. The judicious usage of hand cutting instruments along with

mechanical ones is the key for a successful conservative therapy.

The aim of this compilation is to provide complete information regarding design principles, concepts and operating procedures of various instruments both hand cutting and mechanized used in operative dentistry.

HISTORY OF DENTAL INSTRUMENTS rehistoric man used sharp pieces of flint for trephineing holes in bones. !ippocrates in "#$ %.&. described a drill driven by a cord wound around d a shaft. &elsus '(# %.&. )#$ *.+, described two kinds of drillers or -Terebra.. One with a guard to prevent it from sinking deep into the tissues and the other one was similar to a carpenters drill. /n (*.+. &ladius 0alenius a celebrated physician reports of *rchigenes an eminent surgeon of *sia minor and practicing in 1ome successfully treated tooth ache by opening the tooth with a trephine.

0alen '2"$ )($$ *.+, modified &elsuss -Terbra. and called it -Terebraabatista. or -3odiolus.. 4ubrication was done with olive oil or milk or by dipping in cold water.

*bulcasis '5"6 ) 2$2" *.+, described a boring instrument -/ncisura.. erre 7auchard -7ather of +entistry. in his book -The

&hirurgien +entiste - in 28(9 described the first dental rotary instrument of modern times. /t was known as the -%ow +rill. could be rotated at "$$rpm and was later on modified into the -:crantons drill. which could cut by rotating in either direction.

/n 29"2 dental chair was introduced. /n 29"9 ;ohn 4evis made a hand held drill. +r. <est &ott in 29=6 used -7ingerings. with drills. Taft called them -%ur +rills.. >&hevalier drill stock. was hand powered like an egg?beater.

Tomes in 29#5 described three types of burs.

2. Rose head: a short shank bur inserted in a crutch rotated between thumb and inde@ finger supported at the base of the thumb. (. Long hand bur: teeth are cut for same distance along the shaft and it is mounted in a handle. ". 4ong steel shaft with too cutting blades.

&harles 3erry in 296( used a -+rill :tock. which had a fle@ible cable drive. 0eorge 7ellows !arrington in 296# used -&lock work drill. or -!arringtons Arado. which is the first motor driven drill. *t first burs were hand cut and ground and were e@pensive. *merica in 296$s began mass production of burs from carbon steel. The earliest burs had limited lateral and end cutting action. The diameter varied form 2B"(. to 2B#.. These were particularly used for small and medium sized varieties. These carbon steel burs were called -:mall milling cutters..

/n 2982 3orisons foot engine was introduced. 1otation of cutting instrument was made possible by a long belt running over a series of pulleys to the back of a straight hand piece. <hen the angle hand piece was needed it would be attached to the shaft of the straight hand piece. * speed of 8$$ rpm was obtained.

/n 298" &o@eter used an electric engine with a speed of 2$$$ rpm. This is the predecessor of the modern micromotor. This was held in hand and connected to a coil. The motor was open and the spindle of the motor was connected with the hand piece.

/n 298= the electric motor hand piece was invented by :.: white and later he also pioneered the invention of various carbon steel burs and hand pieces.

/n 299" rotary power from an electric engine was transferred to the straight hand piece by a belt that ran over a series of pulleys and a three? piece e@tension cord arm. * variable rheostat was used as a foot control. 1otary cutting instruments were inserted into the chucking mechanism at the front of the handpiece. The desired angle hand piece is attached to the front of the straight hand piece and a shaft and gears inside the angle section produce rotation of the working instrument.

/n 2952 Adward 0. *cheson an *merican invented and produced carborundum and carborundum tools were introduced. /n 25$2 hand piece with forward 'clockwise, and reverse 'anticlockwise, direction of rotation and burs for each type movement were brought into use.

/n 252$ Amile !uet a %elgian perfected an electric engine to give a speed of 2$,$$$ rpm. /n 25"# diamond abrasives were introduced and <.! +rendel introduced the process of galvanized bonding of diamond powder to copper blanks and used at a speed of #,$$$ rpm. /n 25=8 Tungsten carbide was introduced and :.: <hite in 25=9 made tungsten carbide burs which were used at a speed of 2(,$$$ rpm. /n 25=5 <alsh and :ymons used diamond points at a speed of 8$,$$$ rpm.

/n 25#$ ball bearings were used in contra angel handpieces. /n 25#2 air abrasive technique was introduced. /n 25#" Celson produced a !ydraulic driven turbine angle handpiece of speed, 6$,$$$ rpm. /n 25## age?chayes introduced first belt?driven angle handpiece to operate successfully at speeds over 2$$,$$$ rpm.

/n 25## Turbo?jet was designed as a compact mobile unit that required no outside plumbing or air connections. Only a source of

electricity was need. * sound proof cabinet contained a motor, water pump, water reservoirs and necessary plumbing for water circulation. <ater was conveyed to and from the hand piece by co?a@ial type plastic tubing. The small inner tube carried water under high pressure to rotate a turbine in the handpiece head and the larger outer tube returned the water to the reservoir for re circulation.

/n 256$ ultrasonics were used for hard tooth structure removal. /n 2562 air turbine straight handpiece was introduced. /n 256( air turbine angle handpiece with air bearings were introduced. 3ost modern angled handpieces also include fireoptic lighting of the cutting site.

INSTRUMENTS FOR TOOTH STRUCTURE REMOVAL HAND INSTRUMENTS The term instrument refers to a tool device or on implement used or a specific purpose or type of work.

HAND INSTRUMENTS NON-CUTTIN INSTRUMENTS A@amining instruments 1estoring instruments CUTTIN INSTRUMENTS 7or tooth structure removal 7or trimming restoration