Section 1: Infection Control in the Dental Surgery 1 Section 2: Dental Radiography 15 Section 3: Basic Instruments 33 Section 4: Instruments and Sundries Used in Moisture Control 41 Section 5: Local Anaesthesia 49 Section 6: Instruments Used for Rubber Dam Placement 61 Section 7: Handpieces, Burs and Rotary Attachments 69 Section 8: Instruments Used in Basic Restorative Procedures 87 Section 9: Matrix Bands and Matrix Retainers 115 Section 10: Instruments Used in Endodontic Treatment 129 Section 11: Elevators Section 12: Extraction Forceps Section 13: Surgical Instruments Section 14: Measuring Devices Section 15: Impression Trays Section 16: Orthodontic Instruments Section 17: Instruments Used in Periodontal Procedures Section 18: Instruments Used in Removable and Fixed Prosthodontics

Name,types,function, procedure,family
Family = elevators,burs

Variations, identification,working principle,false friends
Type: Contra-angled
Attachment: Dental unit
Precautions 
Speed
Mechanism 
functions
Alternative method for instrument for function 

Instrumentation

(a) Mask (b) Safety glasses © Face shields Protective gloves

Non-permeable barriers

Coloured identification rings

Instrument cassettes

Autoclave tape Sterilisation pouch Autoclave

Bottle brushes

Bur brushes Ultrasonic cleaner Assistina

DENTAL RADIOGRAPHY (a) Intra-oral X-ray machine Occlusal radiograph Peri-apical radiograph Bite-wing radiograph (b) Extra-oral X-ray machine Panoramic radiograph/OPG Cephalometric radiograph

Lead apron and thyroid collar Conventional Intra-oral Radiograph Film Indirect Digital Radiograph Film – phosphor plates

Digital radiography aids: (a) Digital Sensor in an XCP film holder (b) Barrier wrapped around sensor and XCP film holder XCP film holders

Automatic processorX-ray viewer

• • [[#Mouth Mirror#Functions|Functions]]
  • [[#Mouth Mirror#Characteristics|Characteristics]]
    • [[#Characteristics#Types|Types]]
    • [[#Characteristics#Parts|Parts]]
  • [[#Mouth Mirror#Image(types,parts, function,ideal)|Image(types,parts, function,ideal)]]

BASIC INSTRUMENTS

These are basic instruments that are universal to almost every procedure in dentistry.

Parts Working end of instruments Shank of an instrument Handle of an instrument

Mouth mirror and handle (a) Sickle/contra-angled probe (b) Nabers probe Periodontal probe Briault probe (a) College tweezers (b) Locking college tweezers Metal ruler

INSTRUMENTS AND SUNDRIES USED IN MOISTURE CONTROL Properties of dental materials can be altered by moisture.

Disposable saliva ejector/low-volume suction High-volume suction tip

Garmer cotton wool roll holders Disposable dry aid/dry guard (a) Disposable cotton wool rolls (b) Cotton pellets

Metal air/water syringe/3-in-1 syringe

Local anaesthesia

Self-aspirating local anaesthetic syringe, Local anaesthetic syringe

Disposable needle Glass disposable local anaesthetic cartridge

Intraligamentary syringe Intraligamentary syringe Safety syringe Needle stick protector Sharps’ disposal container

Rubber dam punch Rubber dam clamps Rubber dam clamp forceps Rubber dam frame: (a) Metal type (b) Plastic type Rubber dam material

Handpiece

Air turbine handpiece/fast handpiece/high-speed handpiece/air rotor handpiece Straight handpiece Electric motor Conventional handpieces/slow-speed handpieces/low-speed handpieces

Burs

describe a dental bur Five key characteristics: (1) Grip of shank (2) Composition of head (3) Shape of head (4) Function (5) Handpiece that it fits

Restorative

Spoon excavators Gingival margin trimmers (Figure 8.4a, b) Distal (Figure 8.5a, b) Mesial Enamel chisel Enamel hatchet Disposable applicators Calcium hydroxide applicator

Mixing spatulas: (a) Stainless steel Weston spatula (b) Stainless steel broad bladed spatula © Anodised aluminium spatula

Dispensing wells

Flat plastic instrument/plastic instrument

dappen dish (a) Glass dappen dish (b) Disposable plastic dappen dishes

Carrier (a) Metal amalgam carrier (b) Plastic amalgam carrier

Plugger (a) Universal Hobsons plugger (b) Mortonson-Clevedent plugger

Carver (a) Cleoid Discoid carver (b) Hollenback 31/2 carver © Wards carver

Burnisher (a) Ball burnisher (b) Beavertail burnisher © Acorn burnisher (d) T-ball burnisher (e) Egg ball/football burnisher

Amalgam well Amalgam capsule
Amalgamator Amalgam Safe-R container

Shade guide Composite material Composite gun

Composite flat plastic (a) Teflon type (b) Anodised aluminium type

Teflon-tipped super pluggers Modelling instrument Acorn burnisher (Figure 8.28) Contact former Halogen curing light (a) LED (light-emitting diode) curing light (b) Radiometer Amber shield Composite polishing/finishing strip

(a) Miller’s articulating forceps (working end) (b) Miller’s articulating forceps in closed position

Articulating paper Straight blunt scissors Beebee crown scissors/shears

Matrix

Matrix material (a) Celluloid strip (b) T-band matrix (straight and curved) © Stainless steel matrix band (universal)

Sectional matrix BiTineTM ring Hawe Supermat Matrix

(a) Wooden wedges (b) Plastic wedges

Light-reflecting wedges

(a) Tofflemire matrix retainer (b) Siqveland matrix retainer

Endodontics

DG16 probe/root canal explorer Barbed broaches Gates Glidden drills Peeso reamer drills Endodontic K files/root canal hand files NiTi (Nickel titanium) rotary instruments Disposable irrigating syringe and disposable needle Lentulo spiral filler/rotary paste filler Finger spreader Endodontic plugger

Accessories Absorbent paper points Gutta percha points Endodontic ring Endodontic block Endodontic rulers

Apex locator Electric pulp tester

ELEVATORS

Elevators are used to loosen and ‘elevate’ the teeth in their sockets prior to extraction. PARTS OF AN ELEVATOR TYPES OF ELEVATOR (a) Warwick James elevator – straight (b) Warwick James elevators – left and right Luxator/Luxating elevator Couplands chisel Cryers elevators – left and right

EXTRACTION FORCEPS

Extraction forceps are used along with elevators to extract teeth. Each extraction forcep is designed for a particular area of the mouth

PARTS AND FUNCTION

TYPES(identification and use) Bayonet extraction forceps

Maxillary right permanent molar extraction forceps

Maxillary left permanent molar extraction forceps

Maxillary premolar extraction forceps

Maxillary straight extraction forceps/maxillary permanent incisor extraction forceps/maxillary permanent anterior extraction forceps

Greyhound extraction forceps/maxillary root extraction forceps

Mandibular permanent premolar extraction forceps

Mandibular permanent molar extraction forceps

Mandibular root extraction forceps

Cowhorn extraction forceps

Mandibular deciduous anterior extraction forceps

Maxillary deciduous molar extraction forceps

Mandibular deciduous molar extraction forceps

Surgical Instruments

Towel clip McKesson mouth prop Mouth spreader/gag Kilner cheek retractor Austin retractor Bowdler Henry rake retractor Minnesota retractor Howarths periosteal elevator

(a) Stainless steel scalpel handle (b) Disposable scalpel handle and scalpel blade

Disposable scalpel blade Mitchells trimmer Spoon curette/surgical curette (a) Curved surgical scissors (b) Straight surgical scissors

(a) Bone rongeurs (b) Bone nibblers

Bone file

a)Metal autoclavable surgical suction tips b)Plastic disposable surgical suction tip

(a, b) Mosquito artery forceps – straight (a, b) Mosquito artery forceps – curved Haemostat

(a) Mayo needle holder (b) Castroviejo needle holder

Toothed dissecting forceps/tissue dissecting forceps

Various sutures

Suture scissors

(a) Disposable irrigating syringe and disposable needle (b) Assembled disposable irrigation syringe and disposable needle

Nail brush Kidney dish Galley pot

Periodontal surgery Blake’s gingivectomy knife handle Messing gun (a) Gingivectomy knives (b) Kirkland © Orban Goldman-Fox Buck Ochsenbein chisel

Implant

Implant kit Implant drills Implant/screw/fixture/post Cover screw Healing abutment/healing cap/sulcus former (a) Ankylos, (b) Biomet 3i and © Nobel Biocare Pick up (impression) coping Transfer (impression) coping Implant analogue

Abutment Crown Torque wrench Implant driver Oro-pharyngeal airway/guedel airway Pocket mask

Impression

Metal perforated type trays Plastic type/stock tray variations: anterior, posterior, quadrant Universal sectional impression tray Custom tray/special tray Triple tray

Orthodontics

Removable orthodontic appliance (Hawley retainer) Fixed orthodontic appliances (a) Rapid palatal expander (b) Metal fixed appliance ©Ceramic fixed appliance

Orthodontic archwire variations= size,shape, diameter and material Headgear and face bow Elastic separators Orthodontic band (a) Metal orthodontic bracket (b) Ceramic orthodontic bracket Elastomeric modules Ligatures Patient relief wax (bee’s wax)

Separator placing pliers Johnson contouring pliers Nylon band seater Mershon band pusher Posterior band remover Bracket holder Weingart pliers Ligature tucker/ligature director Mathieu ligature pliers Coon’s ligature pliers

Distal end cutter Ligature cutter Triple beak pliers Omega pliers Nance pliers Light wire pliers Tweed pliers How(e) pliers Mitchell trimmer Adams spring forming pliers Adams universal pliers Mauns heavy duty wire cutter

Cheek retractor Introral mirrors Bracket guide

Periodontal procedures

Probes Williams periodontal probe BPE/CPITN probe Furcation probe

Jacquette scaler Push scaler Sickle scaler

Periodontal hoes Universal curette Gracey curettes

Implant scalers Ultrasonic scaler tip

(a) Sharpening stone (b) Plastic test stick Disposable prophy angle attachments

Prophy ring

FPD,RPD

Fox’s occlusal plane guide Willis bite gauge Paint scraper Le Cron carver Wax knife

Red ribbon wax Modelling wax

Bite registration paste Greenstick composition

Green occlusal indicating wax Crown forms: (a) Stainless steel crown form (b) Polycarbonate crown form © Acetate/clear crown form (celluloid)

Beebee crown scissors/shears Johnson contouring pliers Crown remover Cord packer/gingival retraction cord instrument

Gingival retraction cord Pre-fabricated/pre-formed post-kit Wooden-handled impression spatulas Fish-tail spatula Plaster spatula

Set-up and procedures

Fissure sealants • Mouth mirror and handle (p. 34, 35) • Sickle/contra-angled probe (p. 36, 37) • College tweezers (p. 39, 40) • Disposable saliva ejector (p. 42, 43) • Garmer cotton wool roll holders (mandibular sealants) (p. 44, 45) • High-volume suction/low-volume suction (p. 42, 43) • Prophy handpiece (p. 74, 75) • Bristle brush (p. 84) and rubber cup (p. 85) • Flour of pumice to clean the tooth surface prior to sealant (do not use prophy paste as fluoride interferes with sealing procedure) • Acid etch, sealant material • Applicator brush (p. 90, 91) • Glass dappen dish (p. 94, 95) • Curing light (p. 108, 109)

Local anaesthetic • Preferred type of local anaesthetic syringe • Disposable local anaesthetic cartridge • Disposable needle in desired length and gauge • Needle holder (in case of needle breakage in the mouth) (p. 183, 184) • Topical anaesthetic • Topical anaesthetic applicator • Disposable saliva ejector (p. 42, 43)

Set-up for placement of rubber dam • Rubber dam material in desired thickness, stamping template • Rubber dam punch • Rubber dam clamp forceps • Selected rubber dam clamps • Rubber dam frame • Blunt scissors/‘Beebee’ crown scissors/shears (p. 112, 113) • Flat plastic instrument or another choice of blunt instrument (to help orientate rubber dam without puncturing) (p. 94, 95) • Dental floss • Gauze or napkins • Lubricant (to aid in stretching the rubber dam material over the rubber dam clamp) • Stabilising ligatures

The following instruments are common to all restorations • Mouth mirror and handle (p. 34, 35) • Sickle/contra-angled probe (p. 36, 37) • College tweezers (p. 39, 40) • High and low volume/disposable saliva ejector suction tips (p. 42, 43) • Instruments for local anaesthetic set-up (see Section 5, p. 49) • Instruments for rubber dam set-up (see Section 6, p. 61) • Spoon excavator • Enamel chisels and gingival margin trimmers • Air turbine handpiece (p. 70, 71) • Conventional handpiece (p. 74, 75) • Various burs (see Section 7, p. 69) • Various base and liner materials • Flat plastic instrument • Air/water syringe/3-in-1 syringe (p. 46, 47) • Wooden wedges/plastic wedges (p. 120, 121) • Miller forceps and articulating paper • Dental floss Amalgam restoration • Amalgam carrier • Amalgam pluggers • Amalgam carvers • Amalgam burnishers • Matrix retainer and appropriate matrix material (see Section 9, p. 115) • Amalgam well/glass dappen dish Composite restoration • Shade guide • Teflon tipped flat plastic instrument • Celluloid strip/clear transparent matrix strip (see Section 9, p. 116, 117) • Composite polishing/finishing strip • Mandrel and pop-on sandpaper discs • Light-curing unit • Amber shield • Composite polishing and finishing burs (see Section 7, p. 69) Posterior composites • Clear proximal matrices (see Section 9, p. 116, 117) • Light-reflecting wedges (p. 120, 121) • Sectional matrices and BiTineTM rings (see Section 9, p. 124, 125) • Contact formers

TOFFLEMIRE MATRIX RETAINER AND STAINLESS STEEL MATRIX BAND SET-UP SECTIONAL MATRIX AND BITINE RING SET-UP HAWE SUPERMAT MATRIX SET-UP

The following instruments are common to all the below listed set-ups: • Mouth mirror and handle (p. 34, 35) • Sickle/contra-angled probe (p. 36, 37) • College tweezers (locking type optional) (p. 39, 40) • High and low volume/disposable saliva ejector suction tips (p. 42, 43) • Instruments for local anaesthetic set-up (see Section 5, p. 49) • Instruments for rubber dam set-up (see Section 6, p. 61) • Sterile cotton pellets (p. 44, 45) • Air turbine handpiece (p. 70, 71) • Conventional handpiece (p. 74, 75) • Various burs (see Section 7, p. 69) • Radiographs and appropriate film and holders (suitable for use with the rubber dam and clamp in position) (see Section 2, p. 15)

Root canal treatment (first appointment is the same as a pulpectomy): removal of the pulp, cleaning and disinfection of the canal and obturation (may take multiple visits). • DG16 probe/endodontic probe • Barbed broaches • Gates Glidden drills • Endodontic K files • Ruler • Spiral fillers • Finger spreaders • Irrigation syringe, needle and irrigation fluid • Paper points • Gutta percha and heat source • Mortonson-Clevedent plugger (p. 96, 97) • Sealing material and desired filling material (temporary or permanent)

Pulpotomy: removal of the infected or exposed portion of the pulp. • Calcium hydroxide • Temporary filling material

Apicectomy: may be needed when root canal treatment has failed. Involves removal of the infected apex and the surrounding infection and replacement with desired filling material. • Sterile bib and barriers • Surgical suction tip • Scalpel handle and disposable scalpel blade (pp. 174 and 175) • Periosteal elevator, surgical curette • Spoon excavator (p. 88, 89) • Straight handpiece and burs (see Section 7, p. 72, 73) • Ultrasonic unit with appropriate tip (p. 264, 265) • Irrigation syringe, needle, irrigant (saline) and galley pot • Desired filling material, mixing slab, messing gun, small pluggers and a burnisher • Set-up for suturing (see Section 13, p. 169)

Basic Dental Instruments

Mouth Mirror

Functions

To provide indirect vision To retract lips, cheeks, and tongue To reflect light into the mouth

Characteristics

Front surface mirrors—Accurate, distortion-free image Double-sided mirrors—Used to retract tongue or cheek and view intraoral cavity simultaneously Flat surface mirrors—Used in disposable mirrors Concave mirrors—Magnify image Range of sizes Commonly used sizes: no. 4 and no. 5; refer to diameter of mirror Single ended Different mirror handles available (see p. 8)

Types

Parts

Image(types,parts, function,ideal)

Explorers

Function To examine teeth for decay (caries), calculus, furcations, or other abnormalities Characteristics Pointed tips; sharp, thin, flexible Single or double ended • Double-ended models—May have the same style on working ends or different styles of working ends; may also have explorer on one end and periodontal probe on the other end (for periodontal probe, see Chapter 16). Variety of sizes and types: Orban Pigtail Shepherd’s hook

Cotton Forceps (Pliers)

Function To grasp or transfer items and/or material into and out of the oral cavity Characteristics Plain or serrated tips Pointed or rounded tips Thin or thick tips Locking forceps (see Chapter 11) Range of sizes available

Instrument Handles

Function To hold (grasp) instrument Characteristics Single or double ended Removable working ends (replaceable and interchangeable) attach to handle Examples Mouth mirror, scaler Nonremovable working ends also available (commonly used) Larger diameter models—Help lighten grasp and maximize control Alternating diameter models—Lessen stress associated with carpal tunnel syndrome Lighter weight models—Minimize fatigue Variety of sizes, styles, and textures: Small, round ¼-inch stainless steel Standard, hollow -inch stainless steel Lightweight, ⅜-inch slip-resistant pattern Satin steel model—Lightweight, ergonomically designed

Tray Setup

Basic From Top to Bottom Mouth mirror, explorer (pigtail explorer pictured), cotton forceps (example of color-coded instruments in a cassette)

Enamel-Cutting Instruments

Parts of an Instrument . Handle Grasping end of instrument Variety of sizes and styles Handle styles (refer to pp. 8 & 9) . Shank Connects handle to working end of instrument May be straight or may have one or more angles to accommodate specific areas of the mouth . Working End May have cutting edge, blade, bevel, point, nib, or beaks

Three-Numbered Instrument 3 Numbers on handle indicate width, length, and angle of blade.

Four-Numbered Instrument 4 Numbers on handle indicate width of blade, angle of cutting edge, length of blade, and angle of blade.

Enamel Hatchet

Functions

To cut, clean, and smooth walls in cavity preparation To remove enamel not supported by dentin

Characteristics

Used with push motion Cutting edge on same plane as handle Single or double ended Is a three-numbered instrument

Enamel Hoe

Function

To clean and smooth floor and walls in cavity preparation

Characteristics

Used with pulling motion Cutting edge or blade nearly perpendicular to handle Is a three-numbered instrument

Straight Chisel

Function To plane and cleave enamel in cavity preparation Characteristics Used with push motion Single-bevel cutting edge Single or double ended

Wedelstaedt Chisel

Function To plane and cleave enamel in cavity preparation Characteristics Used with push motion Curved blade on working end Single-bevel cutting edge Single or double ended Is a three-numbered instrument

Binangle Chisel

Function To plane and cleave enamel in cavity preparation Characteristics Used with push motion Two angles in the shank Single or double ended Is an example of three-numbered instrument

Angle Former

Function To accentuate line and point angles in internal outline and retention in cavity preparation Characteristics Cutting edge at an angle Single or double ended Is a four-numbered instrument

Gingival Margin Trimmer—Mesial and Distal

Function To bevel cervical walls of mesial and distal retention areas Characteristics Mesial: To create bevels on the mesial cervical margin of the preparation Distal: To create bevels on the distal cervical margin of the preparation Curved blade Cutting edge at angle to blade Double ended (one end curves to the right; the other to the left) Is a four-numbered instrument

Spoon Excavators

Function To remove carious dentin Secondary functions: To remove temporary crowns To remove temporary cement in temporary restoration To remove permanent crown during try-in Characteristics Concave design, spoon-shaped with cutting edge Range of sizes: Large—Curved blade—also referred to as Black Spoon Small—Round blade Single or double ended

Local Anesthetic

Anesthetic Aspirating Syringe

Function To administer a local anesthetic Characteristics Parts: Threaded tip Harpoon Piston rod Barrel of syringe Finger grip Finger bar Thumb ring Syringe assembled with needle and anesthetic cartridge

Short Needle

Function To administer anesthetic by infiltration injection on maxillary arch Characteristics Parts: Cartridge end of needle Needle hub Injection end of needle Lumen of the needle Bevel of the needle Protective cap Seal on cap Needle guard 1 inch long for infiltration injection End of needle inserts into the anesthetic cartridge Anesthetic solution is ejected through the lumen of the needle Variety of gauges: • Gauge number—Identifies diameter (thickness) of needle • Larger gauge number—Indicates thinner needle (e.g., 30 gauge is thinner than 25 gauge)

Long Needle

Function To administer anesthetic by block injection on mandibular arch Characteristics Parts: Cartridge end of needle Needle hub Injection end of needle Lumen of the needle Bevel of the needle Protective cap Seal on cap Needle guard 1⅝ inches long for block injection End of needle inserts into the anesthetic cartridge Anesthetic solution is ejected through the lumen of the needle Variety of gauges: • Gauge number—Identifies diameter (thickness) of needle • Larger gauge number—Indicates thinner needle (e.g., 30 gauge is thinner than 25 gauge)

Anesthetic Cartridge

Function To hold liquid anesthetic for local injection in the oral cavity Characteristics Parts: Rubber diaphragm—Syringe needle is inserted into the diaphragm to penetrate into the cartridge. Aluminum cap holds the rubber diaphragm in place. Glass cartridge (also referred to as a carpule) Indicates type of anesthesia Color-coded band indicating type of anesthetic (required by the American Dental Association, June 2003) Silicon rubber plunger—Harpoon of syringe inserts into silicon rubber plunger. Composition of solution in cartridge—Contains 1.7 to 1.8 mL of anesthetic solution Plunger slightly indented from rim of glass

Recapping Device

Function To hold needle sheath for one-hand recapping after injection Characteristics Jenker—Low center of gravity for stability in recapping Needle cap holder attached to cassette Helps prevent needle stick accidents Different styles of needle stick protectors available

Computer-Controlled Local Anesthetic Delivery System (The

Wand/STA Single Tooth Anesthesia System) Functions To administer a local anesthetic To improve ergonomics and precision of dental anesthetic delivery Characteristics Lightweight wand handpiece held in a penlike grip. Presterilized bonded handpiece (not a traditional dental syringe) Foot-activated control delivers local anesthetic. Computer controls available flow rates of local anesthetic, making them consistent. Aspiration test can be activated at any time by releasing the pressure cycle on the foot rheostat. Can be used for all dental injections and intraligamentary (PDL) injection.

Nitrous Oxide and Analgesic Tanks

Function To use as an analgesic to relax patients for dental procedures To be inhaled through a mask placed over the nose Characteristic Blue tank is N2O Green tank is O2 Nitrous oxide is a chemical compound with the formula N2O. It is an oxide of nitrogen. Room temperature, N2O is a colorless, nonflammable gas, with a slightly sweet odor and taste Nose piece has tubing attached to a scavenger system that evacuates excess N2O that patient does not breath.

Nitrous Oxide Nasal Mask

Functions To place mask over the patient’s nose for the delivery of N2O To evacuate excess N2O that is not breathed in by the patient Characteristics Tubing for N2O Tubing for scavenger system to evacuate excess N2O Disposable masks available in different scents Different size masks available for children and adults.

Nitrous Oxide and Oxygen Flowmeters

Function To monitor the N2O and O2 that is administered to the patient Characteristics % N2O adjustment knob: Controls the % of N2O Total flow adjustment knob: Controls the combined flow of O2 and N2O or O2 flow only when the % of N2O knob is set to zero Digital display readout of N2O and O2 using knobs for adjustment of gas flow. Tubing from the tanks go to flowmeters and tubing from flowmeters go to the face mask that delivers the gases to the patient. All masks have tubing attached to a scavenger system: An appropriate evacuation/HVE system that evacuates the excess gas that the patient does not inhale.

Tray Setup

Local Anesthetic Syringe From Left to Right Anesthetic aspirating syringe, long needle, short needle, anesthetic cartridges, needle stick protector (Jenker) (top right), individually packed topical anesthetic (bottom right)

Practice notes

Needle insertion should not like insert pen cap.insert it like a gravity First check nitrogen gas and Attach needle hub to as

Evacuation Devices, Air/Water Syringe Tip, and Dental Unit

High-Volume (Velocity) Evacuator (HVE) Tip

Function To evacuate large volumes of fluid and debris from the oral cavity Characteristics Stainless steel evacuator tip Plastic evacuator tip—Disposable plastic Straight or slightly angled at one or both ends Also available in plastic that may be sterilized Practice Notes Evacuator Tip attaches to high-velocity tubing on dental unit. HVE Tip is used on most tray setups.

Low-Volume (Velocity) Saliva Ejector Tip

Function To evacuate smaller volumes of fluid from the oral cavity Characteristics Disposable plastic for single use only Can be bent for placement under tongue and in other areas of mouth or can be used straight Variety of styles

Isolite—Illuminated Dental Isolation System

Functions To retract tongue and evacuate fluid from patient’s mouth To provide light to the working area of the mouth To gently hold patient’s mouth open during use To serve as a barrier to the airway, protecting the patient from inadvertent aspiration of dental material Characteristics Isolite is attached to high-velocity evacuation port of the vacuum system. No special devices are required to operate system installed on the dental unit.

Low-Volume (Velocity) Mandibular Evacuator

Functions To evacuate smaller volumes of fluid from the oral cavity To use on mandibular arch To retract tongue during evacuation Characteristics Blade for retraction of tongue is covered for patient comfort Adjustable device to place under patient’s chin to hold evacuator in place Disposable plastic for single use only (may be referred to as a Linqua-fix) Also available in metal, referred to as a Svedopter, must be sterilized.

High-Volume (Velocity) Surgical Evacuation Tip

Function To evacuate fluid from oral cavity and surgical site Characteristics Stainless steel, autoclavable plastic, disposable plastic: Stainless steel evacuation tip Plastic disposable tip Narrowed tip accommodates surgical site.

Air/Water Syringe with Removable Tip

Function To rinse and dry specific teeth or entire oral cavity Characteristics Air/water syringe is also referred to as a three-way syringe. Characteristics of buttons on air/water syringe: left button expels water only; right button expels air only; pressing both buttons at the same time will result in a spray by combining air and water. Types of tips: Disposable plastic syringe tip for single use Metal syringe tip Seal-Tight tip seals water passage from getting into the air passage of the tip.

Self-Contained Water Unit and Waterline Treatment Tablets

Functions To assist in the quality of water entering the dental unit that supplies water to handpieces, air/water syringe, and cuspidor cupfill To assist when there is a possibility of contamination to the water supply to the dental unit Characteristics Water system may be mounted in different areas of the dental unit. Different size bottles are available.

Dental Delivery System

Function To deliver dental care to patients Characteristics Ergonomically structured chair for patient, operator, and assistant Chair adjustment device for height and reclining patient Light with adjustable intensity - LED light with curing option for composite restorations Tubing for high and slow speed handpieces, air/water syringe, low- and high-velocity vacuum systems Rheostat for running handpieces with water toggle switch option Tray for placing instrument setups Computer screen available for patient information and digital images.

Dental Assistant Delivery System

Function To deliver dental care to patients as a chairside assistant Characteristics Saliva ejector attached to the low-volume evacuation system tubing Air/water syringe and tip attached to the tubing High-volume evacuator tip attached to the tubing Light curing device attached to the unit with protective shield Bracket table for instrument setups Chair adjustment device for height and reclining dental chair

Dental Stools

Function To use providing treatment to a patient Characteristics Operator chair—adjustable back support is movable forward and backward Operator and Assistant chair—adjustable seat height Adjustable torso support Assistant chair—adjustable foot ring under seat for feet support

Dental Handpieces

High-Speed Handpiece

Functions To use with bur to cut tooth structure, to cut bone, to remove decay, and to modify or remove restorations Example Cavity preparation for restoration or crown To use with bur for adjusting crowns and bridges for final fit Characteristics Handpiece is run by air pressure at a maximum speed of 450,000 rotations per minute (rpm). On high-speed handpiece, bur generates extreme amount of heat. Instrument sprays water/air or air on bur for cooling purposes to prevent damage to pulp. Different styles of securing bur are available: Power lever chuck Push-button chuck Conventional chuck—Need to secure bur and loosen bur in handpiece with wrench.

Fiberoptic High-Speed Handpiece

Functions To illuminate tooth during preparation for restoration To provide light intraorally during use of handpiece To use with bur to cut tooth structure, to cut bone, to remove decay, and to modify or remove restorations Example Cavity preparation for restoration or crown To use with bur for adjusting crowns and bridges for final fit Characteristics Light(s) at head of handpiece Lights up working area while handpiece rotates Same characteristics as high-speed handpiece

Slow-Speed Motor with Straight Handpiece Attachment

Functions To use with slow-speed attachments To use straight attachment with long-shank straight bur Characteristics Slow-speed motor Straight handpiece attachment (with bur attached) Maximum speed of 30,000 rpm; used as adjunct to high-speed handpiece Straight attachment—Used outside oral cavity, usually in a laboratory setting Contra-angle or prophy angle attachments—Designed for intraoral use Handpiece must be engaged in either forward or reverse.

Slow-Speed Motor with Contra-Angle Handpiece Attachment

Functions To use with burs for intraoral and extraoral procedures to remove decay, polish amalgam restorations, refine cavity preparation, adjust provisional and permanent crowns and bridges, adjust occlusal restorations, adjust partials and dentures, and to provide prophylaxis treatment Characteristics Contra-angle attachment Slow-speed motor Push-button device to secure bur—Using friction grip bur Latch-type attachment—Using latch-type bur Top: latch open; Bottom: latch closed Contra-angle attaches to straight handpiece or to Slow-Speed Motor. Types of Contra-Angle Attachments: • Latch type—Latch-type bur, prophylaxis polishing cup or brush. Bur is secured by swivel of latch-type device in back of handpiece. • Friction grip—Friction grip bur. Bur is secured by pushing back of handpiece.

Prophy Slow-Speed Handpiece/Motor with Disposable

Prophy Angle Attachment Function To polish teeth with prophylaxis/prophy cup or brush attachment Characteristics Disposable prophy angle attachment (with rubber polishing cup) Prophy Slow-Speed Handpiece/Motor Prophy angle attaches to handpiece/motor. Ergonomic shape for natural hand positioning Lightweight design to reduce hand and wrist fatigue

Rechargeable Prophy Slow-Speed Handpiece/Motor- RDH Freedom™

Function To polish teeth for prophylaxis with prophy cup and/or brush Characteristics Foot Pedal-Wireless-Cordless rechargeable To operate Foot Pedal and control speed of handpiece RDH Freedom™ Cordless Rechargable Prophy Handpiece. Parts: Sheath—Handpiece Attachment Motor Cradle to hold the handpiece Types of Prophy Angle Attachments: Disposable prophy cup—For polishing all surfaces of teeth Disposable prophy brush—For polishing occlusal surfaces and deep grooves on lingual surfaces of anterior teeth

Disposable Prophy Angle Attachments for Slow-Speed Handpiece/Motor

Function To polish teeth for prophylaxis Characteristics Attaches to straight or prophy slow-speed handpiece/motor Types: Disposable prophy angle attachment with prophy cup. Prophy cup—Variety of flexibility and designs available for polishing all surfaces of teeth. Disposable prophy angle attachment with tapered brush—For polishing occlusal surfaces and deep grooves on lingual surfaces of anterior teeth.

Prophy Angle Slow-Speed Handpiece/Motor

Function To polish teeth for prophylaxis Characteristics Prophy angle slow-speed handpiece/motor is one piece. Disposable screw-type prophy cup or brush attaches to prophy angle slow-speed handpiece/motor. Lightweight design to reduce hand and wrist fatigue Ergonomic shape for natural hand positioning Attachments: Flat-end brush Tapered-end brush Prophy cup—Variety of flexibility and designs available

Electric Handpiece Unit and Handpiece Attachments

Functions To use with bur for intraoral cavity preparation To use with endodontic nickel-titanium rotary instruments To use with bur for trimming of provisional crowns To use with bur for adjusting permanent restorations, crowns, and bridges Characteristics Electric Handpiece Unit Electric Handpiece Attachments Electric Handpiece Motor Speed of handpiece can be set to specific rpms.

Surgical Electrical Handpiece Unit and Handpiece

Attachments Functions To use with depth drills for implants To use with sterile water for cooling drilling system Characteristics Straight and contra-angled (pictured) handpiece attachments available Maximum speed of 40,000 rpm Lower speed (e.g., 10–50 rpm) used for implant Fiberoptic light available for these handpieces

Air Abrasion Unit and Handpiece Attachment

Functions To use for class I through class VI cavity preparation To use for preparation of occlusal surface for sealants Characteristics Handpiece attachment uses high pressure of alpha-alumina particles through small device that removes decay or prepares pit and fissures for sealants or restoration. Minimal use of anesthesia is required

Air Polisher

Function To polish teeth by directing a high-pressure jet of pressurized air, water and mild polishing agent of sodium bicarbonate Characteristics Combination of slurry of water and powder cleans or debrides the tooth surface utilizing the Air Polisher Tip Foot Pedal that controls the Air Polisher Air Polisher has a self-contained water reservoir. Air Polisher is connected to the dental unit water supply tubing.

Handpiece Maintenance System

Function To flush internal air/water coolant lines on high- and slow-speed handpieces To remove debris within handpiece and prevent buildup To lubricate handpiece Characteristics Cover encloses system Under cover connection for handpieces—Lift cover to access Start button Filter system Universal adaptor for many styles of handpieces Cleans and lubricates before bagging to sterilized Keeps aerosols contained and filters exhaust and air from unit

Laser Handpiece Unit and Laser Handpiece Attachment

Function To cut, vaporize, or cauterize soft tissue Examples To remove lesions or tumors To reduce excess tissue To control bleeding Characteristics Works by means of a highly concentrated light source SIROLaser (pictured) operates at a wavelength of 980 nanometers and has a power output varying from 0.5 to 7 watts

Dental Unit

Functions To provide a delivery system for handpieces and air/water syringe To provide delivery system for air/water syringe To provide intraoral camera To provide a device for moving dental chair up, down, forward, and backward Characteristics Delivery systems provide at least two tubings—one for high-speed handpieces and one for slow- speed handpiece. Above illustrates two tubing unit. Special mechanism required for fiberoptic handpiece

Burs and Rotary Attachments for Handpieces

Bur

Function To be used in a high- or low-speed handpiece Characteristics Parts: Head: Part of bur that cuts, polishes, or finishes • Available in a variety of shapes and sizes Neck: Part of bur that tapers to connect shank to head Shank: Part of bur that is inserted into the handpiece • Length and style of shank vary depending on handpiece used. • Bur with straight, long shank fits into straight slow-speed handpiece. • Bur with latch-type shank fits into contra-angle slow-speed handpiece (friction grip bur shown). • Friction grip bur fits into high-speed handpiece; chuck, lever, or push button tightens bur into the handpiece. • Bur with long shank used for surgical procedure

Practice notes

The shape depends upon angle of bur instertion,bur shape,bur roughness

Bur Shanks

Function To fit shank part of bur into handpiece Characteristics Fit a variety of shanks into different styles of handpieces Working or cutting end of the bur could be the same style or size, but shank could be different according to handpiece used Examples No. 2 round bur in straight shank No. 2 round bur in latch shank No. 2 round bur in friction grip shank Long shank used for surgical procedures

Round Bur

Functions To remove caries from tooth structure To open tooth for endodontic treatment To create retention in cavity preparation To use for many procedures on a tooth Characteristics Range of sizes Commonly used sizes: No. ¼ to No. 10

Pear-Shaped Bur

Functions To open tooth for a restoration To remove caries Characteristics Frequently used in preparation of composite restorations Range of sizes Commonly used sizes: No. 330 to No. 333 Bur head available in long Example No. 333L

Inverted Cone Bur

Functions To remove caries To establish retention in tooth for cavity preparation Characteristics Range of sizes Commonly used sizes: No. 331⁄2, No. 34, No. 37, No. 39 Practice Notes Bur is inserted and secured in a handpiece. Type of handpiece determines type of shank used.

Straight Fissure Bur—Plain Cut

Functions To cut cavity preparation To form inner walls of cavity preparation To create retention grooves in walls of cavity preparation Characteristics Cutting part of bur—Has parallel sides Range of sizes—Commonly used: No. 56, No. 57, No. 58 May have short or long (L) shank for adaptation to a variety of cavity preparations Examples of short and long shank friction grip burs No. 56S, No. 56L

Tapered Fissure Bur—Plain Cut

Functions To cut cavity preparation To form angles in walls of cavity preparation To place retention grooves in walls of cavity preparation Characteristics Cutting part of bur—Has tapered sides Range of sizes—Commonly used: No. 168, No. 169, No. 170, No. 171 May have short (S) or long (L) shank for adaptation to a variety of cavity preparations Examples of short and long shank friction grip burs No. 168S, No. 171L

Straight Fissure Bur—Crosscut

Functions To cut cavity preparation To form walls of cavity preparation To create retention grooves in walls of cavity preparation Characteristics Cutting part of bur—Has parallel sides with horizontal cutting edges Range of sizes—Commonly used: No. 556, No. 557, No. 558 May have long (L) shank for adaptation to a variety of cavity preparations

Tapered Fissure Bur—Crosscut

Functions To cut cavity preparation To form angles in walls of cavity preparation To create retention grooves in walls of cavity preparation Characteristics Cutting part of bur—Has tapered sides with horizontal cutting edges Range of sizes—Commonly used: No. 699, No. 700, No. 701, No. 702, No. 703 May have long (L) shank for adaptation to a variety of cavity preparations

Finishing Bur

Functions To finish composite restoration To finish restoration by restoring anatomy in tooth To equilibrate or adjust occlusion Characteristic Variety of shapes and sizes Finishing bur differs from the cutting burs as the working end or cutting end has an increased number of blades or flutes. An increased amount of blades will determine the greater amount of polishing capabilities

Diamond Bur—Flat-End Taper

Function To reduce a tooth for crown preparation when a square shoulder is needed Characteristics Range of grits—Superfine to coarse; grit designated by color band on shank of diamond bur or by letter after name of diamond bur Superfine diamond burs—Used for finishing restorations Variety of shapes and sizes

Diamond Bur—Flat-End Cylinder

Function To reduce a tooth for crown preparation when parallel walls and flat floors are needed Characteristics Range of grits—Superfine to coarse; grit designated by color band on shank of diamond bur or by letter after name of diamond bur Superfine diamond burs—Used for finishing restorations Variety of shapes and sizes

Diamond Bur—Flame

Function To reduce a tooth for crown preparation for subgingival margins Characteristics Range of grits—Superfine to coarse; grit designated by color band on shank of diamond bur or by letter after name of diamond bur Superfine diamond burs—Used for finishing restorations Variety of shapes and sizes

Diamond Bur—Wheel

Function To reduce a tooth for crown preparation on lingual aspect of anterior teeth and to reduce bulk of incisal edges Characteristics Range of grits—Superfine to coarse; grit designated by color band on shank of diamond bur or by letter after name of diamond bur Superfine diamond burs—Used for finishing restorations Variety of shapes and sizes

Mandrel—Snap On

Function To attach discs to mandrel for finishing and polishing inside or outside oral cavity (mandrel is inserted into handpiece) Characteristics Shank types: Long shank—For straight slow-speed handpiece Short latch-type shank—For contra-angle slow-speed handpiece Friction grip shank—For high-speed handpiece Plastic disposable Snap on Mandrels available

Mandrel—Screw On

Function To attach discs to mandrel for finishing and polishing inside or outside oral cavity (mandrel is inserted into handpiece) Characteristics Shank types: Long shank—For straight slow-speed handpiece Short latch-type shank—For contra-angle or right-angle slow-speed handpiece Friction grip shank—For high-speed handpiece

Sandpaper Disc with Screw-Type and Snap-On Mandrel

Functions To contour restorations To polish restorative material (extra fine grit) Characteristics Range of grits (coarse to extra fine) Darker color of disc denotes more abrasiveness Two types: Screw on Snap on (metal center) Sandpaper Disc organizer has a range of sizes and grits.

Composite Disc

Functions To contour restorations To polish or smooth restorative material (extra fine grit) Characteristics Made from synthetic material to accommodate composite restorations Range of grits (coarse to extra fine) Darker color of disc denotes more abrasiveness Variety of sizes Two types available: Snap on composite disc Composite disc with disposable mandrel

Rubber Points

Function To polish restorations, amalgam, composite, and gold Characteristics Types of polishing grits: Brown points (brownies)—Abrasive Green points (greenies)—Less abrasive than brownies White points—Polishing point Variety of shanks available for all types of rubber points: Friction grip Latch type

Laboratory Bur—Acrylic Bur

Function To cut models or trim acrylic in laboratory Characteristics Long shank—For attachment to straight handpiece Variety of sizes and shapes

Laboratory Bur—Diamond Disc

Function To contour or cut models in the laboratory Characteristic Single- or double-sided cutting edge

Magnetic Bur Block with Burs

Function To be used on dental tray setups Characteristics Magnetic to hold burs in place Holds friction grip and latch-type burs Variety of shapes and sizes available Various colors available to coordinate with color of tray

Dental Dam Instruments

Dental Dam

Function To isolate teeth for dental procedures Characteristics Sizes—4 × 4, 5 × 5, 6 × 6, or continuous roll Gauge or thickness—Thin, medium, heavy Colors—Gray, green, blue, pastels Latex free—Purple

Dental Dam Stamp

Function To mark holes on dental dam Characteristics Has 32 dots that represent the adult dentition Used as guide for punching holes in correct position

Dental Dam Punch

Function To punch holes in dental dam for each individual tooth Characteristics Designated hole size for each tooth for permanent dentition: No. 5—Anchor tooth (largest) No. 4—Molars No. 3—Premolars No. 2—Maxillary central and laterals, maxillary and mandibular cuspids No. 1—Mandibular central and laterals (smallest)

Dental Dam Forceps

Function To place dental dam clamp on tooth and to remove clamp after procedure Characteristics Beaks on forceps fit into dental dam clamp. Forceps open with spring motion. Bar between handle holds forceps in place while clamp is seated.

Dental Dam Clamp

Function To anchor and stabilize dental dam Characteristics Parts: Bow: Placed toward distal part of tooth Jaws: Have four prongs that secure clamp on tooth Holes: On jaws; designated for beaks on forceps to place clamp on tooth Prongs: Designed to secure clamp on cervical part of tooth, beyond the height of contour Winged clamps: Have extension of metal on jaws to hold dental dam away for better visibility (Wingless clamps do not have extra extension of metal.) For safety, dental floss (ligature tie) must be attached to each dental clamp before each use to allow for retrieval of clamp if dislodged and patient inhales or swallows.

Anterior Clamp

Function To anchor and stabilize dental dam Characteristics Used only on anterior teeth Example Wingless clamp Range of sizes available

Premolar Clamp

Function To anchor and stabilize dental dam Characteristics Clamp used is determined by tooth size. Range of sizes available Variety of styles Examples Wingless clamp Winged clamp

Universal Clamp—Maxillary

Function To anchor and stabilize dental dam Characteristics Used on right or left posterior molars Range of sizes available Variety of styles Examples Wingless clamp Winged clamp

Universal Clamp—Mandibular

Function To anchor and stabilize dental dam Characteristics Used on right or left posterior molars Range of sizes available Variety of styles Examples Wingless clamp Winged clamp

Dental Dam Frame

Function To hold dental dam away from teeth Characteristics Metal frame Plastic frame Plastic frame—May be left on during radiographic exposures Various styles of frames available

Preframed Dental Dam

Function To isolate teeth for dental procedures Characteristics Frame is attached to dental dam Dental dams may come pre-punched – additional holes can be punched

Tray Setup Dental Dam Left (Top to Bottom) Dental dam (latex free), dental floss, plastic dental dam frame, crown and bridge scissors (see Chapter 10) Right (Top to Bottom) Beavertail burnisher used to invert Dental Dam (see Chapter 8), dental dam forceps, dental dam clamp with stabilizing ligature tie (dental floss), Dental Dam punch

Amalgam Restorative Instruments

Tofflemire/Matrix Band Retainer

Function To hold and maintain stability of matrix band during condensation of restorative material for class II preparation Characteristics Parts: Guide slots: Straight slot; right and left slots for right or left quadrant Diagonal slot: Slides up and down on spindle; matrix band is placed in slot, and spindle secures band in place; open slots are placed toward gingiva. Spindle: Holds matrix band in retainer Spindle pin: Stabilizes band in holder Inner knob: Adjusts size of the loop of matrix band to fit around tooth and loosens band for removal Outer knob: Positioned at end of spindle that tightens or loosens matrix band in retainer

Matrix Bands

Function To replace missing proximal wall or walls of cavity preparation for condensation of restorative material for class II preparations Characteristics Variety of sizes, shapes, and thicknesses Bands designed for specific types of restorations: Universal band—For restorations on all posterior teeth except for teeth with deep cervical restorations—Example: MO, DO, MOD Bands for teeth with deep cervical restorations—Example: Premolars that have a deep cervical restoration. Example: MO, DO, or MOD Bands for larger teeth with deep cervical restorations—Example: Larger teeth such as Molars that have a deep cervical restoration. Example: MO, DO, MOD Variety of pediatric bands available for primary teeth

Matrix Band System

Function To replace missing proximal wall or walls of cavity preparation for condensation of restorative material for class II preparations Characteristics Variety of matrix band systems (pictured: AutoMatrix) Variety of sizes and shapes Bands designed for specific teeth: • Universal—Posterior teeth • Molar—Larger molars • Premolar • Pediatric—Primary teeth

Wooden Wedges

Function To hold matrix band in place along gingival margin of class II, class III, or class IV preparation Characteristics Wood or plastic Triangular, round, or anatomical shapes (shown in picture) Variety of sizes and shapes available to accommodate embrasure area

Liner Applicator

Function To place dental liner material (such as calcium hydroxide or glass ionomer) in cavity preparation Characteristics Short or long handle Single or double ended

Woodson

Functions To carry and place temporary restorative material for cavity preparation—Paddle end To condense restorative material—Plugger end To carry (paddle end) and condense a base (Plugger end) Characteristics Double ended Range of sizes available: Plugger end available in variety of sizes Paddle end available in different angles, sizes

Amalgamator and Amalgam Capsule

Functions To mix alloy and mercury into amalgam in a capsule To mix other types of restorative materials in a capsule To mix precapsulated permanent and temporary cements Characteristics Amalgamator Preloaded amalgam capsules contain alloy, mercury, and pestle to aid mixing: • Various types of capsules are available; they are activated manually by twisting or pushing or using a capsule activator. Thin membrane separates materials until mixing occurs.

Amalgam Well

Functions To hold amalgam before it is placed in preparation To hold amalgam while loading amalgam carrier Characteristic Metal (shown in picture), plastic, or glass

Amalgam Carrier

Function To carry and dispense amalgam into cavity preparation Characteristics Single or double ended: Double ended—One small end and one large end Single ended—Plunger style The inside of the hollow tubes is coated with metal or Teflon.

Condenser (Plugger)—Smooth and Serrated

Functions To pack and condense amalgam into cavity preparation To pack and condense other restorative materials To pack and condense temporary filling material Characteristics Smooth end small Smooth end large Serrated ends Round, flat, or diamond shaped Single or double ended • Double ended—One small end and one large end Back action condenser available with right-angle working ends—Accommodates difficult areas Range of sizes available

Interproximal Condenser

Functions To pack and condense amalgam into interproximal areas of cavity preparation To pack and condense other restorative materials Characteristics Ends shaped to fit mesial or distal areas of cavity preparation Smooth or serrated ends Range of sizes available

Burnishers—Football, Ball, and Acorn

Functions To smooth amalgam after condensing To contour matrix band before placement To perform initial shaping of amalgam To burnish restorative material To burnish temporary filling material Characteristics Football burnisher Ball burnisher Acorn burnisher Single or double ended–some double ended burnishers may have two different types of burnishers

T-Ball Burnisher

Functions To smooth amalgam after condensing To contour matrix band before placement To begin shaping of amalgam To burnish restorative materials To burnish temporary filling material Characteristic Single ended

Beavertail Burnisher

Functions To smooth amalgam after condensing To perform initial shaping and/or carving of amalgam To invert dental dam (refer to dental dam tray setup in Chapter 7) To burnish restorative materials To burnish temporary filling material Characteristic Single or double ended

Tanner Carver

Functions To carve occlusal anatomy into amalgam restorations To carve occlusal anatomy in other restorative and temporary filling materials Characteristics Double ended—Two ends shaped differently Ends shaped differently from those of discoid-cleoid carver

Discoid-Cleoid Carver

Functions To carve occlusal anatomy into amalgam restorations To carve occlusal anatomy in other restorative and temporary filling materials Characteristics Double ended—Two ends shaped differently: Discoid end—Disc shaped Cleoid end—Pointed Ends shaped differently from those of Tanner carver

Hollenback and Half-Hollenback Carvers

Functions To contour and carve occlusal and interproximal anatomy in amalgam restorations To contour and carve occlusal and interproximal anatomy in other restorative and temporary filling materials Characteristics Hollenback Half-Hollenback—Half the size of Hollenback carver Double ended—Working ends protrude at different angles.

Gold Carving Knife

Functions To trim interproximal amalgam restoration, recreating contour of proximal wall(s) To trim interproximal restorations with other restorative materials, recreating contour of proximal wall(s) To remove flash composite material from interproximal areas Characteristics Single or double ended Variety of designs Interproximal carving knife-Different Styles available as shown above

Articulating Paper Holder

Functions To hold articulating paper in place To check centric and lateral occlusion Characteristics Metal articulating paper holder Disposable articulating paper holder Articulating paper—blue (top) or red (bottom) Paper variety—from thin to thick

Tray Setup Amalgam Top Row (Left to Right) Amalgam well, HVE tip, burs in bur block, amalgam carrier-plunger style (very top of tray) Bottom Row (Left to Right) Mouth mirror, explorer, cotton forceps (pliers), spoon excavator, enamel hatchet, mesial gingival margin trimmer, distal gingival margin trimmer, small condenser, large condenser, acorn burnisher, Tanner carver, half-Hollenback carver, gold carving knife, Tofflemire, wooden wedges, crown and bridge scissors, articulating paper holder and articulating paper, liner applicator, dental floss, anesthetic aspirating syringe, air/water syringe tip

Composite Restorative Instruments

Sectional Matrix System

Function To replace missing proximal wall of cavity preparation for placement of composite material or other restorative materials for class II restorations Characteristics Variety of sizes and shapes to accommodate restoration: Pediatric band—Primary molar Small band—Premolar, small molar Extended small band—Premolar, molar, with deep cervical restoration Standard band—Molar restoration Large band—Deep cervical restoration Tension rings—Different sizes to accommodate restoration Placed to secure band on proximal wall Placed on tooth with dental dam forceps

Applicator

Functions To apply conditioning, primer, and bonding material to cavity preparation To use with bonding procedures, sealants, and orthodontic band brackets Characteristics Types: Disposable One-piece Applicator—Several colors available for application of different materials; working end bends; various styles, sizes Microbrush Applicator—Disposable, various styles, sizes

Well for Composite Material

Function To hold material: etchant, primers, bonding, and composite Characteristics Disposable (pictured) or autoclavable Well with protective light cover Labels on each well—Designate different materials Variety of styles and colors available

Composite Placement Instrument

Functions To carry composite material to the cavity preparation To place, condense, and carve composite material in cavity preparation Characteristics Plastic composite instrument—Plastic that can be sterilized Metal composite instruments—Titanium nitride coating Double ended Different angles on ends Ends shaped differently, one to accommodate initial placement of material (paddle end) and the other end to condense, contour, and carve material Variety of sizes, shapes, and angles available

Composite Burnisher

Functions To form occlusal anatomy in composite restorations To achieve final contouring of anatomy, pits, fissures, and grooves Characteristics Double ended—Different angle on either end Composite Burnisher: Titanium nitride coating—Creates hard, smooth, nonstick surface that resists scratching, sticking, or discoloration of composite material Acorn Burnisher (for composite restorations): Gold titanium nitride coating—Creates hard, smooth, nonstick surface that resists scratching, sticking, or discoloration of composite material Practice Notes Composite Burnisher is used on composite tray setups.

Curing Light—Battery Operated

Function To harden light-cured materials: bonding agents, composite, sealants, buildup material Characteristics Battery operated—Includes battery charger with extra battery

Protective Shield for Curing Light

Function To protect eyes during curing stage of light-cured material Characteristics Orange color—Blocks harmful light to operator/assistant and patient’s eyes Protective shields also available on curing light (see Curing Light, page 242) Paddle Shield style Protective eyeglasses available for operator, assistant, and patient

LED and Halogen Radiometers

Functions To accurately test the visible light output for the LED and halogen curing lights To determine the accuracy of the LED and halogen lights that cure dental materials Characteristics White—Halogen Radiometer Blue—LED Radiometer

Finishing Strip

Function To finish and smooth interproximal surface of restoration Characteristics Abrasive textures available: synthetic or sandpaper material Different grit consistencies available Different grit consistency is on either end of strip—see color difference.

Tray Setup Composite Procedure—Class III and Class IV Composite Restorative Top Row (From Left to Right) High-volume evacuator (HVE) tip, well for composite material, burs and mandrel or discs in bur block, shade guide Bottom Row (From Left to Right) Mouth mirror, explorer, cotton forceps (pliers), spoon excavator, composite placement instrument (titanium nitride coating), composite placement instrument (plastic), gold carving knife, liner applicator, three different colors of applicator brushes, wooden wedges, clear Mylar matrix strip and clamp to hold matrix, crown and bridge scissors, articulating paper holder and articulating paper, dental floss, anesthetic aspirating syringe, air/water syringe tip

Tray Setup Composite Procedure—Class I, Class II, and Class V Composite Restorative Top Row (Left to Right) Articulating paper holder and articulating paper, well for composite material, shade guide Bottom Row (Left to Right) Mouth mirror, explorer, cotton forceps (pliers), spoon excavator, composite placement instrument (titanium nitride coating), composite placement instrument (plastic), composite burnisher (gold– titanium nitride coating), gold carving knife, liner applicator, three different colors of applicator brushes, high-volume evacuator (HVE) tip, anesthetic syringe, dental damn forceps used for tension rings, (under forceps: matrix band, wooden wedges, tension rings, burs, mandrel/discs in bur block), dental floss, air/water syringe tip Bottom of Tray Finishing strip

Fixed Prosthodontics Restorative Instruments

Facebow

Functions To establish the centric relationship of the maxillary teeth to the mandibular teeth To establish the position of the teeth when the temporal mandibular joint is aligned correctly Characteristics Recording and establishing the centric occlusion assists in fabricating fixed prosthodontic restorations Apply compound tabs or dental impression material on bite fork Recording and establishing the centric occlusion assists in fabricating fixed and removable prosthodontic appliances

Shade Guides/Digital Color Imaging

Functions To select a shade for permanent fixed restorations Example Crowns, veneers, bridges To select a shade for removable appliances Example Partials, dentures Characteristics Many different shade guides are available. Many different digital or computerized shade guides are available.

Gingival Retraction Cord Instrument

Function To place gingival retraction cord in sulcus area after tooth is prepared for a crown and before final impressions are taken Characteristics Smooth or serrated edges Double ended—Different angle on each end Variety of styles

Crown and Bridge Scissors

Functions To trim aluminum temporary crowns on gingival side To trim custom temporary crowns To cut gingival retraction cord To trim matrix bands To cut dental dam septum Characteristics Short cutting edges—can be straight or curved, narrow or wide Variety of sizes

Contouring Pliers

Function To crimp and contour marginal edge of temporary crown or stainless steel crown Characteristics Commonly used type: Johnson Range of sizes available

Provisional Crown–Removing Forceps

Function To remove provisional crown from tooth Characteristic Range of sizes available

CAD/CAM Machine

Functions To take a computer image of a tooth with an intraoral wand that connects to a computer To construct the anatomy, gingival margins, occlusal and mesial/distal contacts of the crown on the computer To send the information to the unit to construct the crown Characteristics Camera CAD/CAM in-office system with attached camera Crown is made of porcelain or other type materials.

CAD/CA Milling Machine

Functions To mill the crown with the image taken from the camera that connects to the CAD/CAM Characteristics Milling machine Ceramic blocks that are placed in the milling machine to fabricate the crown As shown different shades are available.

Wooden Bite Stick

Function To seat permanent crown while patient bites in centric occlusion Characteristics Soft wood Range of sizes available

Trial Crown Remover

Functions To remove permanent crown from tooth during try-in phase To remove provisional crown Characteristics Types: Maxillary trial crown remover Mandibular trial crown remover Replaceable pads—Provide nonslipping, tight grip

Tray Setup Crown and Bridge Preparation Top Row (Left to Right) Gingival retraction cord, dental floss, burs in bur block Bottom Row (Left to Right) Mouth mirror, explorer, cotton forceps (pliers), spoon excavator, curette, gingival retraction cord instrument, Woodson, crown and bridge scissors, flexible cement mixing spatula, articulating paper holder and articulating paper, provisional crown–removing forceps, anesthetic aspirating syringe, air/water syringe tip, high-volume evacuation (HVE) tip

Endodontic Instruments

Vitalometer/Pulp Tester

Function To test vitality of pulp in teeth Characteristics Two types—Electronic and digital (digital readout) Electric or battery operated

Endodontic Long-Shank Spoon Excavator

Function To reach deep into the canal to remove coronal pulp tissue, decay, and temporary cements Characteristics Long shank to reach deep into cavity preparation Double ended Range of sizes available

Endodontic Explorer

Function To locate opening of small canal orifices for endodontic procedure Characteristics Double ended Working end—Longer than regular explorer to reach opening of canals

Endodontic Locking Forceps (Pliers)

Function To grasp and lock material for transfer into and out of oral cavity Characteristic Similar to regular cotton forceps except for locking mechanism to secure material on the working end of the forceps (pliers)

Broach

Function To remove pulp tissue from canal(s) Characteristics Working end—Barbed wire protrusions on shaft grab and remove vital or nonvital pulp fibers Handles—Color coded according to size Range of sizes—Diameter increases with size.

Endodontic File—K Type

Functions To clean inside walls of canal To contour inner walls of canal Characteristics Twisted design—More twists per millimeter than reamer Used with push–pull motion Handles—Color coded according to size Range of sizes—To accommodate width of canal; diameter increases with size. Available in different lengths

Endodontic File—Hedstrom

Functions To clean inside walls of canal To enlarge and smooth inner walls of canal Characteristics Triangular cutting edge Handles—Color coded according to size Range of sizes—To accommodate width of canal; diameter increases with size. Available in different lengths

Reamer

Functions To cut and smooth dentinal walls of canal To enlarge inner walls of canal Characteristics Twisted triangular cutting edge (similar to K-type file, but cutting edge is farther apart and has fewer twists per millimeter) Used with twisting motion Handles—Color coded according to size Range of sizes—To accommodate width of canal; diameter increases with size. Available in different lengths

Endodontic Stoppers

Function To place onto an intracanal instrument such as a file or reamer to help determine length of canal Characteristics Files or reamers are measured from stopper to apex of root to determine length of canal. (Radiographs also help determine length.) Stoppers are made from rubber, silicone, or plastic.

Endodontic Stoppers Function To place onto an intracanal instrument such as a file or reamer to help determine length of canal Characteristics Files or reamers are measured from stopper to apex of root to determine length of canal. (Radiographs also help determine length.) Stoppers are made from rubber, silicone, or plastic.

Endodontic Stand

Functions To hold endodontic files and reamers To measure endodontic files and reamers with millimeter ruler etched in container; may be measured from right or left side of stand Characteristic Container closes with endodontic files and reamers for sterilization processes.

Endodontic Millimeter Ruler

Function To measure files, reamers, other instruments, and materials in millimeter increments Characteristic Variety of designs

Electronic Apex Locator

Function To electronically measure length of canal to apex of tooth Characteristics Attaches to file or reamer and is placed in canal using dry or wet environment Readout indicates length of canal—Tone or digital

Gates Glidden Bur or Drill

Functions To enlarge walls of pulp chamber To open canal orifice Characteristics Long-shank bur Elliptical or flame-shaped cutting edge Latch type—Used with slow-speed contra-angle handpiece (air driven or electric) Range of sizes—Size identified by number of grooves on shank Two lengths—Shorter for posterior teeth, longer for anterior teeth

Endodontic Irrigating Syringe

Function To carry and dispense irrigating solution into canal for cleansing during débridement of canal Characteristics Disposable Two sizes—3 mL (pictured) and 12 mL

Sterile Absorbent Paper Points

Function To dry pulp chambers of canal—New points inserted repeatedly until pulp chamber is completely dry Characteristics Size of point corresponds to width of canal Range of sizes available

Gutta-Percha

Function To fill pulp chamber after completion of canal preparation (called obturation) Characteristics Solid at room temperature; becomes soft and pliable when heated May be heated in a cartridge and then dispensed into canal Range of sizes—To correspond to size of canal

Lentulo Spiral

Function To place endodontic sealer or cement in canal for final seal before placement of gutta-percha Characteristic Latch-type shank—Used with slow-speed contra-angled handpiece (air driven or electric)

Gutta-Percha Warming Unit

Functions To heat gutta-percha outside the mouth before use To inject heated gutta-percha in thermoplastic state into prepared canals Characteristics Gutta-percha pellets—Used to load unit Delivery system—Needle attaches to gun delivering gutta-percha into canal

Endodontic Spreader

Functions To help condense gutta-percha laterally in canal To use for final filling of canal Characteristics Pointed tip Working end—Has rings in millimeter increments Two handle styles—Conventional (pictured), finger spreader Range of sizes—To correspond to size of canal

Endodontic Plugger

Functions To help condense gutta-percha vertically in canal To use for final filling of canal Characteristics Flat tip for condensing gutta-percha Working end—Has rings in millimeter increments Two handle styles—Conventional (pictured), finger spreader Range of sizes—To correspond to size of canal

Glick Instrument

Functions To condense gutta-percha into endodontically prepared teeth, using plugger end To sever excess gutta-percha after plugger end is heated To carry and place material into tooth, using paddle end Characteristics Double ended: Plugger end—May have rings in millimeter increments Paddle end

Peso File

Functions To prepare canal for endodontic post To remove portion of gutta-percha sealed in canal to make room for endodontic post Characteristics Parallel cutting edges Latch-type shank—Used with slow-speed contra-angle handpiece (air driven or electric) Range of sizes—Size identified by number of grooves on shank

Micro Retro Amalgam Carrier

Function To carry amalgam to surgical site of apicoectomy Characteristics Very small—To accommodate retro fills for apicoectomy Surgical apicoectomy procedure is performed, if needed, after an endodontic procedure is completed.

Micro Retro Mouth Mirror

Function To view surgical site of apicoectomy retro fill Characteristics Very small—To accommodate retro fills for apicoectomy Smaller sizes available

Hygiene Instruments

Universal Curettes (Curets)

Functions To remove deposits and stains from teeth To remove soft tissue lining of periodontal pocket and root planing Characteristics Blade—Two cutting edges, rounded toe, rounded back; at 90-degree angle to lower shank Flexible or rigid shank; length varies to accommodate clinical crown of tooth Single or double ended Range of sizes Curette named by designer: Barnhart ½ Ratcliff ⅜

Universal Curettes (Curet)

Functions To scale supragingival and subgingival surfaces To remove deposits and stains from teeth To remove soft tissue lining of periodontal pocket and root planing Characteristics Blade—Two cutting edges, rounded toe, rounded back; at 90-degree angle to lower shank Flexible or rigid shank; length varies to accommodate clinical crown of tooth Single or double ended Range of sizes Curette named by designer: UC/Rule ⅚ Loma Linda McCall

Langer Universal Curettes

Functions To scale supragingival and subgingival surfaces To remove deposits and stains from teeth To remove soft tissue lining of periodontal pocket and root planing Characteristics Blade—Two cutting edges, with face at 90-degree angle to lower shank Design function with three bends in the shank, improving posterior access Langer universal curettes designed with the shank design of a Gracey combined with a universal blade Single or double ended Range of sizes

Area-Specific Curettes—Anterior

Functions To scale and remove deposits from subgingival surfaces of anterior teeth To use for root planing, periodontal débridement, and soft tissue curettage Characteristics Two cutting edges (only lower cutting edge used) Blade—Rounded back and toe; at 70-degree angle to lower shank; types: standard, rigid, extra rigid Curvature of blade designed to adapt to specific teeth and surfaces Range of sizes available: ½, ¾, ⅚ Curette named by designer: Gracey, Kramer-Nevins, Turgeon

Area-Specific Curettes—Posterior

Functions To scale and remove deposits from subgingival surfaces of posterior teeth To use for root planing, periodontal deébridement, and soft tissue curettage Characteristics Two cutting edges (only lower cutting edge used) Blade—Rounded back and toe; at 70-degree angle to lower shank; types: standard, rigid, extra rigid Curvature of blade designed to adapt to specific teeth and surfaces Range of size, shape, and bends in shank Two bends in shank Examples ⅞, Three bends in shank Examples , , , Curette named by designer: Gracey, Kramer-Nevins, Turgeon

Extended Area-Specific Curettes—Anterior

Function To scale and remove deposits in deep periodontal pockets 5 mm or deeper Characteristics Two cutting edges (only lower cutting edge used) Blade at 70-degree angle to lower shank; types: standard, rigid, extra rigid Curvature of blade designed to adapt to anteriors Terminal shank redesigned—3 mm longer than standard area-specific curette Manufacturer’s trademark name usually follows ½, ¾, ⅚ numbering system Range of sizes—Commonly used types: ¾, ⅚ Double-ended curettes packaged in sets Curettes named by designer: Gracey ½

Extended Area-Specific Curettes—Posterior

Function To scale and remove deposits in deep periodontal pockets (5 mm or deeper) Characteristics Two cutting edges (only lower cutting edge used) Blade at 70-degree angle to lower shank; types: standard, rigid, extra rigid Curvature of blade designed to adapt to premolars, molars Terminal shank redesigned—3 mm longer than standard area-specific curette Range of sizes Commonly used types: , , , Double-ended curettes packaged in sets Curettes named by designer: Gracey rigid, Gracey

Mini Extended Area-Specific Curettes—Anterior

Function To scale in deep periodontal pockets (5 mm) Characteristics Blade redesigned to be half the length of extended area-specific curette Designed for narrow roots, pockets, or furcations Two cutting edges (only lower cutting edge used) Blade at 70-degree angle to lower shank; types: standard, rigid, extra rigid Curvature of blade designed to adapt to anteriors Range of sizes Manufacturer’s trademark name usually follows ½, ¾, ⅚ numbering system Curettes named by designer: Gracey ½

Mini Extended Area-Specific Curettes—Posterior

Function To scale in deep periodontal pockets (5 mm) Characteristics Blade redesigned to be half the length of extended area-specific curette Designed for narrow roots, pockets, or furcations Two cutting edges (only lower cutting edge used) Blade at 70-degree angle to lower shank; types: standard, rigid, extra rigid Curvature of blade designed to adapt to premolars, molars Range of size, shape, and bends in shank available Two bends in shank

Implant Scaler

Function To remove deposits and stains from surface of implant Characteristics Disposable tips (each tip should be sterilized before use). Instrument with disposable tip attached. Titanium-coated scaler Different designs allow scaling without scratching of titanium implants Some tips are made of Plasteel—a high-grade resin

Straight Sickle Scaler

Function To remove large amounts of deposits from supragingival surfaces Characteristics Two cutting edges on straight blade that ends in sharp point Long; two bends in shank Variety of sizes and angles Single or double ended—Two ends may be shaped differently

Curved Sickle Scaler

Function To remove large amounts of deposits from supragingival surfaces Characteristics Two cutting edges on curved blade that ends in sharp point Long, straight shank with one gentle bend Variety of sizes and angles Single or double ended—Two ends may be shaped differently Montana Jack—Sharper, thinner blades with solid resin handle for comfortable grip. Traditional Curved Sickle Scaler

Micro Mini-Five Area-Specific Curette

Function To scale into periodontal pockets and root surfaces of 5 mm or more Characteristics Blade half the length of After Five or standard Gracey curettes Shank slightly increased rigidity compared with traditional mini five Gracey curettes

Magnetostrictive Power Scaler

Function To use with water-cooled ultrasonic inserts vibrating at high frequency Characteristics Ultra-high frequency sound waves convert mechanical energy into vibrations (frequency ranges from 18 to 50 kHz). Some units (depending on manufacturer) have self-contained water reservoirs. Some units (depending on manufacturer) have an additional air/water/sodium bicarbonate slurry polishing system to remove extrinsic stains and dental plaque. A variety of sizes and designs are available.

Ultrasonic Scaler Instrument Tip—Supragingival

Functions To remove supragingival calculus from teeth To remove bacterial plaque from periodontal pockets To remove heavy debris and stains from teeth To remove excess cement from orthodontic bands after cementation and after band removal Characteristics Supragingival Tip is inserted into the tubing on the ultrasonic scaling unit Available in different lengths (called stacks): 25 kHz or 30 kHz, depending on unit Water-cooled inserts (Water systems vary with internal or external water delivery.) Variety of shapes, sizes, and designs, depending on designated and varying grips

Ultrasonic Scaler Instrument Tip—Subgingival

Functions To remove subgingival calculus from teeth To remove bacterial plaque from periodontal pockets Characteristics Subgingival Scaler Tip— is inserted into the tubing on the ultrasonic scaling unit. Available in different lengths (called stacks): 25 kHz or 30 kHz, depending on unit Water-cooled inserts (Water systems vary with internal or external water delivery.) Variety of shapes, sizes, and designs, depending on designated area and varying grips

Ultrasonic Scaler Instrument Tip—Furcation

Function To remove bacterial plaque from furcation areas Characteristics Furcation Tip is inserted into the tubing on the ultrasonic scaling unit. Available in different lengths (called stacks): 25 kHz or 30 kHz, depending on unit Water-cooled inserts (Water systems vary with internal or external water delivery.) Variety of shapes, sizes, and designs, depending on designated area and varying grips

Ultrasonic Scaler Instrument Tip—Universal

Function To remove bacterial plaque and general deposits Characteristics Universal tip is inserted into the tubing on the ultrasonic scaling unit. Available in different lengths (called stacks): 25 kHz or 30 kHz, depending on unit Water-cooled inserts (Water systems vary with internal or external water delivery.) Variety of shapes, sizes, and designs, depending on designated area and varying grips

Sharpening Stones

Function To sharpen scalers and curettes Characteristics Types of stones: India stones—Remove the most metal when used and should be followed with an Arkansas or ceramic stone Arkansas stones—Provide a polished edge (flat and cone-shaped pictured) Ceramic stones—Provide a polished edge and do not require lubrication

Battery-Operated Sharpening Device

Function To sharpen scalers and curettes Characteristics Stone moves underneath a stainless-steel guideplate, which puts the blade at factory angles. Sharpener has a power device with instrument guide channels and a vertical backstop to help control blade angulation. (Pictured: Sidekick Sharpener)

Tray Setup Hygiene From Left to Right Mouth mirror, explorer, periodontal probe, cotton forceps, curved sickle scaler, 4L/4R universal posterior, universal Langer ½, Ratcliff ¾, Gracey ⅞, Gracey , Gracey , air/water syringe tip, low-volume saliva ejector, high-volume evacuation (HVE) tip

Tray Setup Root Planing From Left to Right Mouth mirror, explorer, periodontal probe, cotton forceps, Gracey ½, Gracey ¾, Gracey ⅞, Gracey , Gracey , air/water syringe tip, low-volume saliva ejector, high-volume evacuation (HVE) tip

Preventive and Sealant Instruments and Whitening Trays

Disposables

Functions To use with all types of dental procedures To use when area in the mouth needs to stay dry Characteristics Cotton Roll Holder for mandibular arch; one cotton roll is placed on the buccal side of the teeth, and the other is placed on the lingual side of the teeth. Disposable Bite Block with ligature tie for safety as to retrieve if patient swallows bite block. Cotton Rolls Dry Aids for keeping mouth dry—small and large Dental floss 2 × 2 gauze Dry Aid is placed on the buccal mucosa—inside the cheek—opposite the maxillary second molar near the Stensen’s duct to absorb saliva originating from the parotid gland.

Fluoride Trays—Disposable

Functions To fill trays with fluoride; remineralizing enamel To help prevent decay by mineralizing the teeth Characteristic Variety of disposable trays and fluoride available Practice Note Fluoride treatment is usually given to children at their 6-month checkup appointment. Fluoride Trays are used on fluoride tray setups. Sterilization Notes Fluoride Trays should be disposed of in the garbage. Single use only.

Vacuum Former

Functions To make whitening trays, custom temporary crowns, night guards, orthodontic positioners, and mouth guards To heat plastic square for bleaching trays To vacuum form the plastic tray over the patient’s model to make the bleaching tray and devices as mentioned above Characteristics Heating element that softens the thermoplastic resin Handles to pull down plastic Vacuum to mold plastic to tray after it is pulled down

Custom-Fitted Whitening Tray

Function To lighten the color of dark or discolored teeth Characteristics Custom-fitted trays are made in the dental office with the vacuum former. Trays hold a peroxide-based gel. Different percentages of gel available Usage regimens vary according to dentist recommendations

Scissors—Short Blade

Function To precisely cut material especially for whitening trays. Characteristic Fine cutting blade

DIAGNOdent

Functions To aid in the detection of caries within the tooth structure To detect caries in the structure of the tooth before placing sealants Characteristics DIAGNOdent accurately diagnoses occlusal caries. Laser detects the caries in the tooth, and a digital display is seen on the screen.

Spectra Fluorescence Caries Detection Aid System

Functions To aid in the detection of caries To aid in the detection of caries during the restorative phase to verify that all caries have been removed. Characteristics Components • Lightweight handpiece with high resolution, auto-exposure CCD sensor • Spacer that maintains an appropriate distance between the lens tip and the tooth surface and blocks stray light during examinations • Cable to connect handpiece to computer Uses fluorescence to detect caries in fissures and smooth surfaces Doppler radar-like images provide both color and numerical indicators; in active mode, carious regions appear red, and healthy enamel appears green 120-degree button ring allows the user to freeze, unfreeze, and capture images with one finger.

Tray Setup Prophylaxis Polishing Top (Left to Right) Mouth mirror, explorer, cotton forceps, air/water syringe tip, polishing agent without fluoride, dental floss, low-volume saliva ejector, high-volume evacuator (HVE) tip Bottom (Left to Right) Prophy slow-speed handpiece with disposable prophy angle attachment with polishing cup, disposable prophy angle attachment with tapered brush

Tray Setup Sealant Very Top of Tray Syringe with etchant Top Row (Left to Right) High-volume evacuator tip (HVE), mouth mirror, explorer, cotton forceps, microbrushes, disposable articulating paper holder and articulating paper, air/water syringe tip, dry aids, low- volume evacuator for mandibular, cotton rolls in disposable holder Bottom Row (Left to Right) Disposable bite block, dental floss, sealant syringe and syringe tip, prophy slow-speed handpiece with disposable prophy angle attachment with polishing cup, disposable prophy angle attachment with tapered brush

Tray Setup Sealant Very Top of Tray Syringe with etchant Top Row (Left to Right) High-volume evacuator tip (HVE), mouth mirror, explorer, cotton forceps, microbrushes, disposable articulating paper holder and articulating paper, air/water syringe tip, dry aids, low- volume evacuator for mandibular, cotton rolls in disposable holder Bottom Row (Left to Right) Disposable bite block, dental floss, sealant syringe and syringe tip, prophy slow-speed handpiece with disposable prophy angle attachment with polishing cup, disposable prophy angle attachment with tapered brush

Tray Setup Whitening Left to Right Thermoplastic resin square, bleaching trays (maxillary and mandibular), short-blade scissors, block- out material for models, bleaching trays on maxillary and mandibular models

Orthodontic Instruments

Elastic Separators

Functions To separate teeth before banding a tooth for orthodontic treatment To place around contact area of tooth Characteristic Elastomeric separators—Various sizes for different contact areas

Elastic Separating Pliers

Function To grip and place separators around contact area of tooth Characteristic Single ended

Steel Spring Separators/Brass Wire Separators

Functions To separate teeth before banding a tooth for orthodontic treatment To place around contact area of tooth Characteristics Steel Spring Separators—Various sizes for different-sized contact areas Brass Wire Separators—Placed around contact and twisted clockwise and then cut 3 mm and tucked in order not to impinge on tissue or occlusion Placed with orthodontic hemostat or bird beak pliers

Orthodontic Band with Tubing and Hook

Functions To fit and cement or bond band around the middle third of the coronal part of the tooth To hold orthodontic arch wire in place (arch wire moves the teeth, many different shapes and sizes) To secure headgear in tubing on band Characteristics Band Tubing: Arch wire tube (top)—Holds arch wire in place Headgear tube (bottom)—Holds headgear in place Hook—Place where elastics are attached. Example: Class II, Class III pull

Band Pusher

Function To push orthodontic bands into place during try-in and cementing phases Characteristic Single or double ended

Band Pusher or Plugger with Scaler

Functions To seat or place orthodontic bands during try-in and cementing phases To remove excess material after cementation or bonding of bands Characteristics Double ended: Band Pusher or Plugger Scaler

Band Seater—Bite Stick

Function To assist seating or placing of orthodontic bands for try-in or cementing phase Characteristics Single ended Available in square tip or triangle tip (pictured)

Orthodontic Bracket

Function To hold orthodontic arch wire in place (arch wire moves the teeth) Characteristics Bracket is bonded to tooth. Hold arch wire in place Many different types available: Metal brackets Ceramic brackets (for esthetic purposes)

Bracket Placement Card

Function To place each bracket and/or band on card according to tooth placement in mouth Characteristic Tape on card holds brackets in place before they are bonded to teeth.

Posterior Bracket Placement Pliers

Functions To hold and carry bracket by placing tip of pliers into slot of bracket To place bracket on tooth for bonding Characteristic Range of sizes

Anterior Bracket Placement Pliers

Functions To hold and carry bracket by placing tip of pliers into slot of bracket To place bracket on tooth for bonding Characteristic Range of sizes

Orthodontic (Shure) Scaler

Functions To place brackets for bonding (both ends) To remove separators (scaler end) To remove elastic ligature ties (scaler end) To remove excess cement or bonding material (scaler end) To check for loose bands and brackets (both ends) Characteristics Universal instrument used for several orthodontic functions Single ended—Scaler or band pusher Double ended: Band pusher Orthodontic scaler

Arch Wire

Function To place into slots of each bracket and secure with a wire or elastomeric ligature tie on every bracket To move teeth with the force of the arch wire Characteristics Different types of arch wire available according to stage of the orthodontic treatment Nickel titanium—Flexible wire Stainless steel wire—Stiff and stronger than other types of wire Beta titanium—Combination of flexibility, strength, and memory Optiflex—Made from composite material for light force (initial stages) and esthetic purposes Different shapes and thickness in diameter available according to initial, intermediate, and advanced treatment: Round wire—Initial and intermediate stages of treatment Square, rectangular—Final stages of treatmen

How (or Howe) Pliers

Functions To place and remove arch wires To check for loose bands Characteristics All-purpose pliers for orthodontic procedures Serrated tips for better grip on wire Straight or curved beaks

Weingart Utility Pliers

Functions To place and remove arch wires To aid a variety of functions for orthodontic procedures To remove bonded brackets by squeezing bracket Characteristic Working ends—Tapered, slim tips to allow pliers to fit between brackets for ease of arch wire placement

Arch-Bending Pliers

Function To bend arch wires Characteristic Variety of styles, depending on type of arch wire used—Round, square, or rectangular

Tweed Loop-Forming Pliers (Jarabak Pliers)

Functions To bend and form loops in arch wire To bend wires for removable appliances Characteristics Grooves in beak—Help to bend and form loops in wire Variety of styles

Three-Prong Pliers

Function To contour and bend light wire Characteristic Range of sizes available

Bird Beak Pliers

Functions To bend and form orthodontic wire To remove bonded bracket by squeezing bracket Characteristics Versatile wire-bending pliers Beaks on working end meet very precisely

Distal End-Cutting Pliers

Function To cut distal end of arch wire after placement in brackets and buccal tubes Characteristic Catch and hold excess wire after wire has been cut

Ligatures Ties

Function To secure the arch wire to the band or bracket Characteristics Wire Ligature Ties Thin, flexible wire Comes in precut length or spools Kobayashi Ties Preformed hook Elastic Ligature Ties Available in different colors Comes on a stick (pictured), canes, and chains

Ligature-Tying (Coon) Pliers

Function To tie in ligature to arch wire Characteristics Channel on pliers—Locks wire ends in place as tips spread Variety of styles

Orthodontic Hemostat

Functions To hold and place separators To hold, place, and/or tie ligatures to arch wire Characteristic Multifunctional instrument for orthodontic procedures Example Mathieu pliers

Ligature/Wire Cutters

Functions To cut ligature after it has been tied to arch wire To cut ligature tie to allow removal of arch wire Characteristic Range of sizes available

Ligature Director

Function To place ligature wire around brackets after it has been tied to arch wire Characteristics Single or double ended Ends of instrument—Have notches to assist placement of ligature tie around brackets

Bracket Placement Card for Damon Self-Ligating Brackets with Self-Ligating Instrument

Functions To place each bracket on card according to tooth placement in mouth Self-Ligating Instrument Instrument—To close bracket around arch wire; ligature tie not needed Characteristic Tape on card holds brackets in place before they are bonded to teeth.

Self-Ligating Brackets with Self-Ligating Instrument

Functions To place each bracket on card according to tooth placement in mouth Instrument—To open and close bracket around arch wire; ligature tie not needed Characteristic Tape on card holds brackets in place before they are bonded to teeth.

Lip Retractors

Functions To retract lips, allowing for intraoral access for bonding brackets To retract lips for intraoral orthodontic photographs Characteristics Reusable Lip Retractors Disposable Lip Retractors Practice Note Lip Retractors are used with orthodontic procedures and other tray setups that include taking intraoral photographs.

Posterior Band Remover

Function To remove orthodontic bands from teeth Characteristics Two beak types: One beak has round cover to place on occlusal surface of tooth to prevent damage during removal of band. Cover can be replaced. Opposite beak is curved and is placed on gingival side of bracket to apply pressure and remove band from tooth.

Bracket Remover

Function To remove anterior or posterior brackets from teeth Characteristic Grasp bracket to remove it from tooth.

Adhesive-Removing Pliers

Function To remove excess adhesive after debonding of brackets Characteristics Plastic pad on round end (pad can be changed) Carbide-inserted tip on short beak—Used to remove the bulk of composite material after debonding

Invisalign and CEREC Omnicam

Function To take images with an intraoral Wand/Camera of the maxillary and mandibular arches. Images are sent to the computer. To send images to a lab to manufacuture Invisalign appliances Characteristics Wand/Camera that captures images connected to the computer Cerec Omnicam captures the images of teeth in the maxillary and mandibular arches for Invisalign orthodontic appliances that move teeth for Orthodontic procedures. Invisalign appliance Traditional orthodontics Images are send to the lab to manufacture a series of Invisalign appliances for Orthodontic movement of the teeth.

Temporary Anchorage Device (TAD)

Function To aid in the movement of teeth with skeletal anchorage assisting in orthodontic treatment Some examples of TAD: Closure of space between teeth Tooth uprighting Open bite correction To provide an anchor point to move teeth Characteristics TAD TAD (arrow) inserted for movement of teeth TADs are small titanium anchors also referred to as mini implants or mini screws. Before placement, chlorhexidine solution (an antibacterial solution) is placed on the area before anesthesia. TAD surgery procedure is referred by the orthodontist to a periodontist or a maxillofacial surgeon.

Orthodontic Tooth Separating

Top Elastic separators, spring coil separators Bottom (Left to Right) Mouth mirror, explorer, cotton forceps (pliers), orthodontic (Shure) scaler, elastic separating pliers, floss, orthodontic hemostat (Mathieu pliers), air/water syringe tip, low-volume saliva ejector tip, high-volume evacuation (HVE) tip

Tray Setup Orthodontic Cementing and Bonding Brackets Top Row (Left to Right) Bracket placement card with brackets, orthodontic bands, polishing agent without fluoride or glycerin, disposable prophy angle with polishing cup, air/water syringe tip Bottom Row (Left to Right) Mouth mirror, explorer, cotton forceps, orthodontic scaler (Shure scaler), band seater-bite stick, posterior band remover, anterior bracket placement pliers, posterior bracket placement pliers, flexible cement spatula, low-volume saliva ejector, high-volume evacuation (HVE) tip, microbrushes, disposable cheek retractors

Tray Setup Orthodontic Tying-In Arch Wire Top (Left to Right) Preformed archwire, elastic ligature ties Bottom (Left to Right) Mouth mirror, explorer, cotton forceps, orthodontic (Shure) scaler, ligature director, wire ligature ties, orthodontic hemostat (Mathieu pliers), (under orthodontic hemostat, short wire ligature ties), ligature-tying (Coon) pliers, bird beak pliers, arch-bending pliers, distal-end cutting pliers, How (Howe) pliers, ligature/wire cutters

Tray Setup Orthodontic Removing Bands and Brackets Left to Right Mouth mirror, explorer, cotton forceps, orthodontic (Shure) scaler, posterior band remover, bird beak pliers, universal curette, low-volume saliva ejector, high-volume evacuation (HVE) tip, air/water syringe tip

Universal Surgical Instruments

Mouth Prop

Function To hold patient’s mouth open during dental procedures Characteristics Placed in posterior part of mouth while patient bites down Often used for sedated patients Disposable mouth props available Range of sizes—Pediatric to large adult

Mouth Gag

Function To hold patient’s mouth open during dental procedures Characteristics Often used for sedated patients Locking device Range of sizes available

Scalpel Handle with Blades

Functions Handle: To hold blade in place Blades: To cut tissue with blade To trim interproximal restorations Characteristics Disposable Handle/Blade in one unit Scalpel Handle Blades—Disposable, variety of shapes and sizes:

Scalpel Blade Remover

Function To safely remove blade from scalpel handle Characteristics Removes all sizes of blades Autoclavable

Tissue Scissors

Function To cut tissue Characteristics Straight or curved Variety of shapes and sizes Variety of uses

Tissue Forceps

Function To hold tissue during surgical procedures Characteristics Serrated or rat-tooth tips Range of sizes available

Hemostat

Function To grasp tissue or bone fragments To hold and grasp material in and out of the oral cavity Characteristics Straight or curved Working end—Serrated and/or locking Variety of functions in other dental procedures Range of sizes available

Periosteal Elevator

Functions To separate tissue from tooth or bone To hold tissue away from surgical site Characteristics Working end—Pointed or round Range of sizes available

Surgical Curette

Functions To remove debris or granulation tissue from surgical site To remove cyst from extraction site or surgical site To perform gross tissue débridement Characteristics Single or double ended Variety of sizes and shapes Examples of commonly used types: Prichard Miller

Tongue and Cheek Retractor

Function To hold and retract tongue or cheek during surgery Characteristic Variety of styles and sizes Example of commonly used type: Minnesota (pictured)

Surgical Needle Holder

Function To grasp and manipulate suture needle during use Characteristics Working end—Different lengths, curved or straight Notched ends available (to accommodate needle) Range of sizes—Micro for microsurgery to large Variety of styles: Universal Castroviejo

Suture Needle and Sutures

Function To suture surgical site Characteristics Resorbable sutures—Gut plain, chromic gut, polyglycolic acid (PGA) Nonresorbable sutures—Silk, nylon, polyester, polypropylene Available in sterile package Variety of suture needle sizes available with different sutures

Suture Scissors

Function To cut sutures Characteristics Cutting edges—Straight or angled May have notch on end of cutting edge (shown in picture) Range of sizes

Tray Setup Universal Surgical Top Row (Left to Right) Mouth mirror, explorer, cotton forceps (pliers), scalpel with #12 blade, periosteal elevator, surgical curette (Prichard), tissue forceps, hemostat, tissue scissors, mouth prop, needle holder, suture scissors, tongue and cheek retractor, disposable high-volume surgical evacuation tip, high- volume surgical evacuation tip Bottom Row Silk suture with needle in sterile package

Periodontal Instruments and Periodontal Surgical Instruments

Periodontal Probes

Function To measure periodontal pocket depth in millimeter increments Characteristics Flat or rounded ends Millimeter-increment markings vary for each style: Color coded—Black markings for millimeter measurements Other styles—Indentations in metal for millimeter measurement-each indentation represents a millimeter. Color-ended probe with black visible markings—Replaceable tip, different tip designs, plastic tip safe for implant probing Double-ended style available with probe on one end and explorer on the other Computerized probes available

Furcation Probe

Function To measure horizontal and vertical pocket depth of multirooted teeth in furcation areas Characteristics Flat or rounded ends Single or double ended Millimeter-increment markings vary for each style: • Color coded—Black markings for millimeter measurements • Other styles—Indentations in metal for millimeter measurements

Hoe Scaler—Mesial/Distal and Buccal/Lingual

Function To remove subgingival and supragingival calculus Characteristics Mesial/Distal Hoe Buccal/Lingual Hoe scaler Used with pulling motion Straight cutting edge Single or double ended Designed to function in anterior or posterior locations • Anterior—Shorter, straighter shanks • Posterior—Longer, angled shanks

Back-Action Hoe

Function To remove bone adjacent to teeth without causing trauma Characteristics Double ended Variety of sizes and shap

Periodontal Knife—Kidney Shaped

Functions To use for bevel incision for gingivectomy To use for gingivoplasty Characteristics Variety of sizes and shapes Named by designer: Kirkland, Goldman-Fox, Buck, Solt

Interdental Knife—Spear Point

Functions To use for interdental cutting of gingiva To remove tissue Characteristics Blade angulated for easier use Named by designer: Orban, Goldman-Fox, Buck, Sanders Single or double ended Range of sizes

Interdental File

Function To crush and remove heavy deposits from subgingival and supragingival interproximal areas Characteristics Used with push or pull motion Various angles—Curved, straight, mesial/distal, and buccal/lingual

Tray Setup Periodontal Surgical Top Row—Left to Right Mouth mirror, explorer, cotton forceps (pliers), periodontal probe, furcation probe, mesial/distal hoe, buccal/lingual hoe, back-action hoe, kidney-shaped periodontal knife, interproximal knife, bone file, tissue forceps, surgical curette, periosteal elevator Bottom Row—Left to Right Tissue scissors, scalpel with #12 blade, hemostat, silk sutures with needle, needle holder, suture scissors, cheek and tongue retractor (Minnesota), mouth prop, disposable high-volume surgical evacuation tip

Oral Surgery Extraction Instruments

Straight Elevator

Functions To loosen tooth from periodontal ligaments before extraction To separate and lift tooth from socket Characteristics Single ended Range of sizes available

Luxating Elevator

Functions To cut periodontal ligaments before extraction To rock tooth back and forth before extraction Characteristics Single ended Sharp blade on working end Blade is serrated Range of sizes available

Periotomes

Functions To cut periodontal ligaments for atraumatic tooth extraction To use when dental implant placement is indicated Characteristics Thin, sharp blades—Cause minimal damage to periodontal ligaments and surrounding alveolar bone Straight or angled blades Single or double ended Range of sizes available Some manufacturers make replaceable tip.

Root Elevators

Functions To loosen root To separate and lift root from socket To use on posterior teeth Characteristics Single ended Right and left pairs Range of sizes available

T-Bar Elevators

Functions To loosen tooth from periodontal ligaments before extraction To separate tooth from alveolus To use on posterior teeth Characteristics Single ended Rounded or pointed Right or left pairs T-bar Elevators are available with different style handles Range of sizes available

Root-Tip Elevators

Function To lift and remove fragments of root Characteristics Single ended Rounded or pointed Working ends are serrated Straight or right and left pairs

Root-Tip Picks

Function To lift and remove small root tips in difficult areas Characteristics Pointed at working end Straight or right and left pairs

Rongeurs

Functions To trim and remove excess alveolar bone after extraction of teeth To contour alveolar bone after single or multiple extractions Characteristics Variety of sizes and angles Beaks have cutting edges

Bone File

Function To remove or smooth rough edges of alveolar bone Characteristics Used with push-pull motion Straight-cut or crosscut cutting end Variety of sizes, angles, and shapes

Surgical Chisel

Functions To split or section a tooth for easier removal by tapping on chisel with mallet To reshape or contour alveolar bone Characteristics Single-bevel chisel—For contouring or removing alveolar bone Bi-bevel chisel—For splitting teeth Styles—Surgical chisel, bone splitter Range of sizes available

Surgical Mallet

Functions To use with bone chisel to section tooth for easier removal by tapping on chisel with surgical mallet To use with bone chisel to reshape or contour alveolar bone Characteristic Range of sizes available

Universal Maxillary Forceps No. 10S

Function To extract maxillary molars Characteristic Straight handle

Universal Mandibular Forceps No. 16

Function To extract mandibular first and second molars Characteristics Straight handles or one curved handle Referred to as cowhorn forceps

Mandibular Forceps No. 17

Function To extract bifurcated mandibular first or second molars Characteristic Straight handles

Maxillary Right Forceps No. 88R

Function To extract trifurcated maxillary right first or second molars Characteristic Right split beak—For engaging lingual root

Maxillary Left Forceps No. 88L

Function To extract trifurcated maxillary left first or second molars Characteristic Left split beak—For engaging lingual root

Maxillary Universal Forceps—Cryer 150

Function To extract maxillary centrals, laterals, cuspids, premolars, and roots Characteristics Straight handles or one curved handle

Mandibular Universal Forceps—Cryer 151

Function To extract mandibular centrals, laterals, cuspids, premolars, and roots Characteristics Straight handles or one curved handle

Mandibular Anterior Forceps

Function To extract mandibular anterior teeth Characteristic Serrated beaks

Maxillary Root Forceps

Function To extract maxillary roots Characteristics Narrow, serrated beaks Straight handles

Mandibular Root Forceps

Function To extract mandibular roots Characteristics Narrow, serrated beaks Straight handles

Implant System

Function To use for implant surgery Characteristics Components—Depth drills, thread formers, hand wrench, ratchet, ratchet adapter, hex driver Many types of implant systems available

Implant

Function To use for implant surgery Characteristics Endosteal implant—An implant surgically embedded into the bone Osseointegration—The attachment of healthy bone to a dental implant, also referred to as stably integrated Two other types of implants—Subperiosteal and transosteal Components: Implant fixture (titanium) embedded into bone; many styles of implants available Center screw Crown

Tray Setup Extraction of Maxillary Right First Molar Top Row (Left to Right) Mouth mirror, explorer, cotton forceps, periosteal elevator, straight elevator, surgical curette, tissue forceps, hemostat, tissue scissors, mouth prop, needle holder, suture scissors, tongue and cheek retractor (Minnesota), disposable high-volume surgical evacuation tip, and maxillary right forceps no. 88R Bottom Row Silk suture with needle in sterile package

Tray Setup Extraction of Impacted Mandibular Molar Top Row (Left to Right) Mouth mirror, explorer, cotton forceps (pliers), scalpel #12 with blade, periosteal elevator, straight elevator, right and left root-tip elevators, surgical curette, tissue forceps, rongeurs, bone file, surgical chisel, surgical mallet Bottom Row (Left to Right) Tissue scissors, hemostat, silk suture with needle in sterile package, needle holder, suture scissors, tongue and cheek retractor (Minnesota), surgical long-shank burs in bur holder, mouth prop, disposable high-volume surgical evacuation tip, universal mandibular forceps No. 16

Tray Setup Suture Removal Left to Right Mouth mirror, pigtail explorer, cotton forceps (pliers), suture scissors, saliva ejector, high-volume evacuator (HVE) tip, air/water syringe tip

Sterilization and Protective Equipment

Protective Gown

Function To protect clothing, surgical scrubs, and skin during patient care and sterilization process to prevent contamination from blood and body substances Characteristics Disposable (pictured) or cloth (Cloth gowns must be made of polyester and cotton in accordance with state and federal regulations.) Cuffed long sleeves Closure at neckline Moisture resistant (against contamination by liquids) Many styles available

Protective Mask

Functions To protect against chemicals, airborne pathogens, bacteria, and viruses during processing of instruments for sterilization To protect against airborne pathogens, bacteria, and viruses and against scrap filling material during all phases of patient treatment Characteristics Dome shaped or flat Different levels of filtration

Protective Glasses/Loupes

Functions To protect against chemicals, airborne pathogens, bacteria, and viruses during processing of instruments for sterilization To protect against airborne pathogens, bacteria, and viruses during patient care and against scrap- filling material during restorative and rinsing phases of patient treatment To enhance (Loupes) depth-of-focus and field-of-view during treatment Characteristics Extend to sides, top, and bottom of eyes for complete protection Protective Glasses—Variety of styles available; some styles are larger to fit over prescription glasses. Loupes—Have different levels of magnification; may have a light source attached to the glasses for regular patient treatment, as well as, availability to change the light source for sensitive material (such as composite restorations).

Examination Gloves

Functions To wear during patient care To wear as a protective barrier To wear during treatment room disinfection Characteristics Latex (pictured), nitrile, or vinyl — Nonsterile and sterile gloves are available. Nonsterile gloves worn for most dental procedures; sterile gloves may be worn for surgical procedures. Examination Gloves should be worn over cuff of protective gown. Various sizes available

Overgloves

Functions To wear over examination gloves when leaving the patient To wear as a protective barrier over examination gloves so as not to cross-contaminate Characteristics Lightweight clear gloves Not to be worn for dental procedures Various sizes available

Nitrile Utility Gloves

Functions To protect hands during processing of instruments for sterilization procedures To wear for preparation and handling of chemicals To disinfect operatory To transport cassettes of tray setups to sterilization area from treatment area Characteristics Chemical resistant Puncture resistant Ribbed for nonslip grip Range of sizes and colors Refer to state regulations on when utility gloves should be worn

Cassette

Functions To use for instruments as tray setup To use for instrument sterilization Characteristics Available in metal or resin Color coded Range of sizes

Color-Coding System for Instruments

Function To color code instruments for organization and identification of tray setups Characteristic Variety of colors—Color coding coordinates with color cassettes

Parts Box for Sterilization

Function To use for sterilization of small items Examples Burs, dental dam clamps Characteristic Range of sizes to accommodate sterilization needs

Cassette Wrap

Functions To use to wrap cassette during sterilization To store cassette in wrapping after sterilization To use for tray cover during dental procedure Characteristic Range of sizes—To accommodate cassettes

Sterilization Pouches

Function To be used for sterilization of instruments and cassettes Characteristic Pouches have range of sizes to accommodate all sizes of instruments and cassettes. Available with Self Seal Pouches Available with indicator strip on pouch Indicator strip changed color after sterilization Indicator strip color before sterilization Cassette with indicator tape on outside of pouch

Indicator Tape and Dispensing Unit

Functions To secure wrap on outside of cassette To use outside cassettes or sterilization pouches to indicate exposure of instruments to a certain temperature—Color will change on the tape. Characteristics Available in preprinted tray setup procedures-refer to page 602 and 603. Available with color coding Available blank for labeling tape with procedure and/or instrument content

Biological Monitors for Sterilizers

Function To confirm efficacy of sterilization, documentation of results is recorded in office sterilization log Characteristic Many systems available

Sterilization Spore Check—In Office

Function To monitor and confirm the effectiveness of steam sterilizers Characteristics Record book Self-contained biological indicator Dry block incubator

Sharps Container

Function To serve as storage receptacle for used needles, old burs, scalpel blades, orthodontic wires, endodontic files, and all other disposable sharp items used during dental procedures Characteristics Must be puncture resistant Must be labeled “Biohazard” Must have a reclosable top

Ultrasonic Cleaning Unit

Function To remove debris and bioburden from instruments Characteristic Reduces risk of exposure to pathogens during the cleaning stage of the sterilization process

Sterilizer—Autoclave (Saturated Steam)

Function To kill all microbes, viruses, bacteria, and fungi, thereby sterilizing instruments Characteristics Uses steam under pressure—15 pounds per square inch (psi) at 250°F for 20 minutes Shelves and racks are available for cassettes Various styles and manufacturers Range of sizes

Statim G4 Cassette Autoclave

Functions To kill all microbes, viruses, bacteria, and fungi To sterilize instruments and handpieces Characteristics Statim 2000 G4 cycle times: 6 minutes unwrapped, 14 minutes wrapped Statim 5000 G4 cycle times: 9 minutes unwrapped, 17.5 minutes wrapped Uses fresh steam-distilled water with every cycle Uses Dri-Tec drying system for fast dry loads Readout Screen available for each cycle

Sterilizer—Dry Heat (Static Air)

Function To kill all microbes, viruses, bacteria, and fungi, thereby sterilizing instruments Characteristics Oven-type sterilizer 320°F for 60 to 120 minutes Shelves available for cassettes Various styles and manufacturers Range of sizes

Sterilizer—Dry Heat (Rapid Heat Transfer)

Function To kill all microbes, viruses, bacteria, and fungi, thereby sterilizing instruments Characteristics Forced air–type sterilizer 375°F for 12 minutes (wrapped) 375°F for 6 minutes (unwrapped) Instruments placed in preheated chamber Various styles and manufacturers Range of sizes

Dental Materials Equipment

Flexible Rubber Bowl

Functions To mix material, usually a powder and a liquid To mix impression material and irreversible hydrocolloid for study models, opposing models, bleaching trays, night guards, mouth guards, orthodontic appliances, or custom trays for removable appliances To mix laboratory plaster, stone, and die stone for models Characteristic Bowl is flexible to manipulate material.

Flexible Alginate (Irreversible Hydrocolloid) Spatula

Functions To mix powder and a liquid in a flexible bowl To mix impression material such as irreversible hydrocolloid (alginate) To mix laboratory plaster, stone, and die stone for models Characteristic Spatula is flexible to manipulate material.

Disposable Plastic Perforated Full Arch Impression Trays

Function To use for taking impressions with many types of impression material Example Irreversible hydrocolloid (alginate), crown, and bridge impression material

Metal Perforated Full Arch Impression Trays

Function To use for taking impressions with many types of impression material. Example Irreversible hydrocolloid (alginate), crown, and bridge impression material Characteristics Maxillary Metal Perforated Tray Mandibular Metal Perforated Tray Perforated trays allow material to push through the tray, creating a mechanical lock that keeps the material in place. Range of sizes

Disposable Plastic Perforated Quadrant and Anterior

Impression Trays Functions To use for taking impressions with many types of impression material To use for taking a quadrant or anterior portion of the mouth Characteristics Section tray for anterior maxillary or mandibular perforated tray Maxillary left or mandibular right perforated tray Maxillary right or mandibular left perforated tray Perforated trays allow material to push through the tray, creating a mechanical lock that keeps the material in place. Range of sizes Metal quadrant and anterior trays also available. Refer to sterilization notes below.

Alginator

Function To mix alginate, irreversible hydrocolloid automatically Characteristics Flexible bowl attaches to alginator Low and high buttons allow bowl to rotate, mixing the alginate and water together. Spatula pressing the material against the bowl along with the rotation of the bowl results in the material being a smooth consistency

Triple Tray (Disposable)

Functions To use for taking final impressions for crown and bridge restorations, opposing teeth, and bite registration with one impression To use in the mouth, taking maxillary and mandibular simultaneously To use with many types of impression material Characteristics Trays have a ledge on the side to hold sufficient amount of material for the impression. Trays have mesh-type material in the middle of the tray to hold material in place. Trays available: • Quadrant used for maxillary right/left or mandibular right/left • Maxillary left or mandibular right perforated tray • Anterior maxillary or mandibular perforated tray

Mixing Gun for Dental Impression Material

Functions To mix polyvinylsiloxane, polysulfide, and polyether material for final impression To mix base and catalyst for impression tray To mix wash material for the syringe To mix material for bite registration and temporary crowns Characteristics Mixing gun Material used in gun Manufacturers have different-style guns to accommodate their material. A different technique for the tray material is to mix a putty material that is a base and a catalyst.

Automixer

Functions To automatically mix impression material To mix base and catalyst for polyvinylsiloxane and polyether material To place material after dispensing from automixer into impression trays for final impressions Characteristics Different styles of automixers available Must attach mixing tips

Bite Registration Tray

Functions To use for taking bite registration for crown and bridge procedures To use in the mouth, taking maxillary and mandibular simultaneously To use with many types of bite registration material Characteristics Trays have mesh-type material in the middle of the tray to hold material in place. Range of sizes Trays can be used in right or left quadrant. Anterior section bite registration tray is also available.

Reversible Hydrocolloid Unit

Function To boil reversible hydrocolloid, store, and temper material for final impressions Characteristics Hydrocolloid unit has three baths: Liquefying the semisolid material at 212°F (100°C) Storage bath that cools the material and keeps it ready for impressions at 150°F (65.5°C) Tempering bath holds the filled impression tray for 5 minutes before it is placed in the patient’s mouth at 110°F (44°C). Tubes of the material are for the impression tray. Small cylinders are for the wash material and are used in syringes for operator to place around tooth before impression is take

Reversible Hydrocolloid Water-Cooled Impression Trays and

Hose Function To take impression with reversible hydrocolloid Characteristics Mandibular water-cooled tray Maxillary water-cooled tray Attaches to tray Attaches to water source on dental unit Attaches to vacuum system of dental unit A hose attaches to the tray on one end; the other end attaches to a water source and a vacuum for the water. The water runs inside the tray, which cools and sets the material once in the patient’s mouth.

Laboratory Spatula

Functions To mix powder and a liquid in a flexible bowl To mix and shape laboratory plaster, stone, and die stone for models Characteristics Spatula straight to help manipulate material Range of sizes

Vibrator for Laboratory

Function To vibrate material in mixing bowl to remove air bubbles from mixing plaster, stone, or die stone Characteristics Use vibrator after mixing the plaster or stone. Use vibrator while adding plaster or stone to impression to eliminate air bubbles in impression.

Vacuum Mixing Unit

Functions To vacuum mix all types of gypsums, plasters, and investment materials To program digitally type of material being mixed To remove excessive air from material while mixing Characteristics Vacuum mixing unit uses blades to mix material and vacuums air bubbles Bowl with blades attaches to unit and mixes material automatically Vacuum system within the unit removes excess air for smoother material consistency

Laboratory Knife

Functions To use for separating impressions from model(s) To use for hand-trimming models To use on any type of appliance for hand trimming Characteristics Range of sizes Usually has green wooden handle—Referred to as Green Handle Lab Knife

Model Trimmer

Function To trim plaster, stone, or die stone models Characteristics Trimmer has an abrasive grinding wheel to grind excess plaster, stone, and die stone from the models. Water runs next to the grinding wheel to reduce heat, reduce the dust created by grinding, and keep the wheel clean.

Flexible Mixing Spatula

Function To mix dental materials Characteristics Flexible metal to allow proper manipulation Range of sizes

Paper Mixing Pads

Function To mix all types of dental materials Characteristics Each paper on the pad is coated so material will not seep through the paper. Many types and sizes availab

Dental Imaging and Diagnostic Equipment

Intraoral Dental Film

Function To capture the image of teeth in the radiographic process Characteristics Outside covering of film—Soft plastic or paper (both waterproof) Sheet of lead foil to stop the radiation from extending beyond the film Black paper to protect the film from light penetration Film—Single or double film Film speed indicated on each packet—Set by American National Standards Institute (ANSI) Film speed A through F—D, E, F used intraorally Faster speed of the film reduces the amount of radiation exposure; F speed is faster than D speed. Film speed determines amount of radiation needed to produce a quality radiograph—Settings are on x-ray unit.

Intraoral Dental Film—Various Sizes

Functions To project an image of the patient’s teeth through x-ray onto the film To use for intraoral and extraoral projections Characteristics Commonly taken radiographs—Front and back view Size #0—Taken on children under 3 (not pictured) Size #1—Used for Anterior periapical image (narrow view) Size #2—Used for Periapical and bite-wing image Size #3—Used for extended bitewing projections (not pictured) Size #4—Used for occlusal projections; taken to view maxillary and mandibular teeth: commonly taken on children

Package of Dental Film

Function To package intraoral dental film Characteristics Box labeled: • Type of film • Film speed • Number of films in individual film packet • Number of film packets in the box • Expiration date of film Film packets—Single or double film

Bite-Wing Tabs

Function To take a bite-wing radiograph projection Characteristics Stick-on tab Slip-on tab Tab or wing is placed on the occlusal, and patient bites on the tab to secure the film.

Film Holder—Periapical (EeZee-Grip)

Function To position and hold the film in patient’s mouth for periapical images Characteristics Double ended: • One end holds film for posterior teeth projection, as shown. • Opposite end holds film for anterior teeth projection.

Film Holders—Periapical

Functions To position and hold a film in patient’s mouth for periapical image To allow patient to bite on holder to keep film in place while positioning the position-indicating device (PID) and exposing the film Characteristics Holds film for anterior teeth projection—Plastic that can be sterilized Holds film for posterior teeth projection—Plastic that can be sterilized Holds film for anterior and posterior projection—Disposable Styrofoam (one time use) Slot holds film in place

Film Holders—XCP

Functions To position and hold a film in patient’s mouth for periapical and bite-wing images using parallel technique To allow patient to bite on holder to keep film in place while positioning the position-indicating device (PID) and exposing the film Characteristics Blue—Anterior teeth projection Red—Bite-wing projection Yellow—Posterior teeth projection Green—Projections for endodontic procedures Slot holds film in place.

Lead Aprons

Function To place on patient for protection against scattered x-rays during exposure of x-ray film Characteristics Lead apron Lead apron with collar to protect thyroid area Lead apron poncho for front and back protection

Radiation Monitoring Device

Functions To place on operator’s protective clothing while employee is working in a dental office or radiography lab To use as a Direct Ion Storage, DIS, dosimeter constructed with non-volatile analog memory cells surround by gas-filled ion chambers To measure the ionizing radiation exposure dose incident on the dosimeter by calculating the amount of proportional change in the voltage across the memory cells Characteristics Each badge includes employee’s name, wear and account number, and the radiation monitoring device (dosimeter). Radiography monitoring device should be worn for traditional and digital projections.

Dental X-Ray Unit

Function To expose film with radiation that is generated in the x-ray unit Characteristics Position-indicating device (PID) Tube head X-ray unit Round or rectangular PIDs available

Manual Developing Unit

Functions To manually develop exposed dental radiographic films taken on patients To develop, rinse, fix, and wash dental radiographic films To develop dental radiographic films in a darkroom with only a safelight Characteristics Tank insert for the developing and fixing solution Developer in left tank; fixer in right tank Water bath and rinsing tank with constant running water in tank Cover for unit

Film Rack

Functions To place undeveloped film on the rack in the darkroom with only the safelight before putting rack in the developer To place film on rack without touching each other Characteristic Panoramic rack Individual single film racks Various sizes of racks available

Safelight

Function To provide enough illumination in the darkroom to process films safely without exposing or damaging the film Characteristics Safelight Safelight filter Minimum distance (at least 4 feet) from safelight to undeveloped x-ray Working area Undeveloped and unwrapped film

Automatic Film Processor

Functions To automatically develop x-ray film in darkroom To develop x-ray film Characteristics Automatic processor Front loader—Hands go into a dark area to unwrap film. View area from top. Darkroom not needed. Various types of processors available

Parts of Automatic Film Processor

Functions To automatically develop x-ray film To place film in processor to develop, fix, wash, dry; film then ready to mount Characteristics Slot to feed film Roller transporter in developer tank Roller transporter in fixer tank Roller transporter in water tank Roller transporter in drying compartment Film releases from rollers onto recovery slot Pump to replenish developer and fixer Replenishing solution for developer and fixer

View Luminator

Function To view traditional radiographs for diagnosis Characteristics Various sizes and styles of view luminators Also referred to as view box

Film Duplicator

Function To duplicate dental radiographic film Characteristics Produces white light to expose film Various sizes and styles available

Intraoral Sensors for Digital Images

Functions To take digital intraoral images without film or without processing the film To project the image of the teeth by digitally projecting radiation onto an electronic sensor and to computerized imaging system before going to computer storage Characteristics Different styles and systems of sensors and digital radiography available Different size sensors available: sizes 1, 2, and 3 Some sensors have wire connecting to the computer. Some sensors do not have wire but are put into a specially designed computer after exposure. Picture shows barrier placed on sensor.

Holder for Digital Sensor (EeZee-Grip)

Function To position and hold a digital x-ray sensor in patient’s mouth for periapical images Characteristics Double ended: Holds film for anterior teeth projection — barrier placed on sensor Holds film for posterior teeth projection — barrier placed on sensor Designed for snug fit to prevent slippi

One Ring and Arm Positioning System

Functions To position and hold digital sensors or film in patient’s mouth for periapical and bite-wing images using parallel technique To allow patient to bite on holder to keep digital sensor or film in place while positioning the position-indicating device (PID) and exposing the sensor or film Reduces the number of components needed for positioning—one arm, one ring Characteristics Holds film for bite-wing projection—barrier placed on sensor Holds film for anterior and posterior teeth projections—barrier placed on sensor Holds film for posterior teeth projection—barrier placed on sensor Slots on ring are color coded—blue, anterior; yellow, posterior; red, bite-wing Allows sufficient amount of space for sensors with wires

Rinn XCP Holders for Digital Sensors

Functions To position and hold digital sensor in patient’s mouth for periapical and bite-wing images, using parallel technique To allow patient to bite on holder to keep sensor in place while positioning the position-indicating device (PID) and exposing the electronic sensor Characteristics Blue—Holds film for anterior teeth projection Red—Holds film for bite-wing projection Yellow—Holds film for posterior teeth projection Green—Holds film when taking projections for endodontic procedures Slots hold electronic sensor in place with barriers placed on sensor and wire.

Digital Intraoral X-Ray Unit

Functions To take digital intraoral images without film or without processing the film To project the image of the teeth by digitally projecting radiation onto an electronic sensor and then to computerized imaging system Characteristics Position-indicating device (PID) (round) Tube head X-ray unit with digital panel Rectangular PID Digital radiographs use less radiation than conventional radiographs. Networks to computers in all areas of the dental office Immediate imaging available

Portable X-Ray Unit

Functions To take intraoral images with a portable device To expose digital sensors or conventional dental radiographic film Characteristics Wide color LCD with easy to recognize preset exposure; preset exposure time can be adjusted with one button Unit has a 3.0-mA current Features internal shielding and a backscatter shield to ensure safety and minimize x-ray exposure to operator and patient Can be used in place of wall-mounted units

SCANX Digital Imaging System

Function To produce diagnostic intraoral digital images Characteristics Uses phosphor storage plates (PSPs)—Plastic plates coated with an x-ray sensitive phosphor material Plates reused multiple times using one time only plastic barrier for each patient that covers the plates Plates placed in machine to erase current image taken Different size plates available for images Compatible computer software needed for the SCANX digital images Images appear on computer screen Computer software compatibility of enhancing digital images to aid in diagnosis

Extraoral X-Rays—Cephalometric and Panoramic

Functions To use to project the patient’s teeth through x-ray onto the film To use for extraoral projections Characteristics Film is placed in a cassette outside the mouth. Cephalometric radiograph—Shows bony and soft-tissue areas of the facial profile Panoramic radiograph—Shows a panoramic view of maxillary and mandibular teeth on one film

Digital Panoramic/Cephalometric Imaging Unit

Functions To take digital panoramic and cephalometric images without film or without processing the film To project the image of maxillary and mandibular teeth by digitally projecting radiation onto an electronic sensor and then to computerized imaging system Characteristics Unit pictured is a 3 in 1 unit that takes both panoramic and cephalometic images. (It also takes 3D CBCT scans.) Digital radiographs use less radiation than conventional radiographs. Networks to computers in all areas of the dental office Immediate imaging available

Cone-Beam Three-Dimensional (3D) Imaging System

Function To produce diagnostic 3D images of the head and neck as related to dentistry Characteristics High-resolution scans produce images at 0.2-mm voxel size to provide diagnosis for difficult areas to view with conventional radiographs. Typical scan time of 8.9 seconds Less radiation and more comfortable for the patient

Enhanced Oral Assessment System—VELscope Vx

Function To aid in the assessment of oral mucosal abnormalities in early visualization of potential oral cancer, precancerous lesions or tissue, infections, and trauma that are not apparent to the naked eye alone To use as an aid in determining surgical boundaries of oral lesions for excision To use in conjunction with the traditional intraoral and extraoral examination. Referred to as the comprehensive oral exam (COE) Characteristics Technology is based on an imaging modality that is sensitive to tissue changes that illuminates oral cavity to visualize potential abnormalities. Handheld device emits a harmless, ultraviolet (UV) light used to inspect the oral cavity. Device is sensitive to abnormal tissue changes. Distinctive blue-spectrum light causes the soft tissue (oral mucosa) of the mouth to naturally fluoresce. Imaging adapter with iPod touch attaches to VELscope Vx eyepiece for clinical photographic documentation

Vital Signs and Beyond

Stethoscope

Functions To listen to pulse To listen to heartbeat To listen to systolic and diastolic pressure when taking blood pressure Characteristics Ear pieces to hear pulse, and/or blood pressure Device to place on an artery to hear the sounds from the pulse, systolic and diastolic pressure Usually, blood pressure is taken at the brachial artery in the arm.

Aneroid Blood Pressure Cuff—Sphygmomanometer

Functions To place pressure on the arteries to hear the systolic and diastolic pressure of the arteries To place around the part of the arm above the bend in the elbow Characteristics Blood pressure cuff for the arm Meter—Aneroid dial system (without liquid); the readout for systolic and diastolic blood pressure Rubber bulb—Attached to cuff with rubber tubing Blood pressure cuff available in regular size, small size, and larger size cuffs to fit various arm sizes Cuff size should fit properly to obtain accurate blood pressure readings. Cuff is placed above the bend in the elbow above the brachial artery

Automatic Blood Pressure Monitor

Functions To measure blood pressure automatically To display the blood pressure readout on the screen To measure pulse rate automatically To display the pulse readout on the screen Characteristics Blood pressure cuff Readout screen for blood pressure and pulse rate Blood pressure cuff available in regular size, small size, and larger size cuffs to fit various arms Correct cuff size important for accurate blood pressure readings Data from past blood pressure information available on some monitors

Electrocardiogram (EKG) Machine

Function To measure the electrical activity of the heartbeat Characteristics EKG chest leads; self-adhesive pads with wires attached with electrodes for conductivity and placed in specific locations on the patient which are connected to the EKG machine A read-out is displayed on the screen.

Pulse Oximeter

Functions To measure the concentration of oxygen in the blood To detect the pulse rate Characteristics Monitor to display oxygen concentration in the blood and pulse rate Finger device that measures the oxygen concentration and pulse rate that sends information to the monitor

Capnograph

Functions To measure carbon dioxide (CO2) in exhaled breath To monitor patient’s ventilation Characteristics Capnograph monitors patient ventilation, providing a breath by breath trend of respirations and an early warning system of impending respiratory crisis. Monitor displays patient carbon dioxide in exhaled breath. Capnography provides an immediate picture of patient condition. Example Holding your breath. Capnograph will show immediate apnea. Pulse oximetry is delayed for several minutes, and the pulse oximeter will show high saturation of oxygen for several minutes with holding your breath. When a person hyperventilates, their CO2 decreases.

Automated External Defibrillator (AED)

Functions To use for emergency situations when a person is unresponsive To use when a person has no pulse and is not breathing