Instrumentation in conservative dentistry
The plan
Introduction
I. The examination tray
1- The plateau itself
2- The mirror:
3- Tweezers:
4- The mouth spatula:
5- The probe
II. Instrumentation specific to anesthesia
1-Syringes
2- The needles
3- The carpules
III. Specific instrumentation for isolation of the operating field (Dam)
1- The dam frame:
2- The crampons (clamps)
3- The pliers:
a- the punch pliers:
b- the clamp holders or clamp holders:
4- The dam leaves:
5- The wedjet:
6- Isolite
IV. Specific instrumentation for cavity preparation
1-rotating instruments
a-Turbine
2- active instruments
a- the excavator
b- contra angle
C- Strawberries
V. Specific instrumentation for cavity filling
1- Amalgam restoration
a- for the formwork
– The matrix ribbon
– The die holder
– Interdental corners
b- For the obturation
– The amalgam carrier
– The crusher
c- For pre-culture
-The mouth spatula
– The burnisher
d- For finishing
-Finishing tips and rubber cups
2- Composite restoration
a- For the formwork
– Smooth polyethylene strips
– Hawe’s cervical matrix
– Caulk Odus molds
b- for the obturation
-The mouth spatula
– The photopolymerizing lamp
-Finishing discs and tips
-Abrasive strips
Conclusion
Introduction :
Daily practice of dentistry requires varied instrumentation adapted to each stage of the operating protocol.
This instrumentation is essential and determines the success of the surgical procedure, as does the dexterity of the practitioner.
I. The examination tray
1- The board itself;
This is a tray that accommodates the following instruments:
2- The mirror:
It is composed of the mirror itself screwed onto a handle, it is used to:
– Spread the lips, tongue and cheeks
– Indirect vision
3- Tweezers:
– It is the extension of the fingers at the level of the oral cavity
– It is an instrument in the form of pliers with fine jaws.
It allows you to: Grab instruments, cotton, strawberries, etc.
4- The mouth spatula:
Allows the removal of the filling material and its insertion into the cavity.
5- The probe
Used for:
– Cavity detection thanks to its pointed end.
– Probing the bottom of caries cavities.
Available in various forms; the most common is the number 23 exploratory probe known as the shepherd’s hook.
No. 9 No. 17 No. 23 RHEIN probe
II. Instrumentation specific to anesthesia
1-Syringes:
There are 2 types:
– The single-use syringe
– The metal cartridge holder
2- The needles:
- Manufacturers offer practitioners needles in many lengths and different diameters.
3- The carpules:
-Currently, analgesic solutions with or without vasoconstrictor are presented only in cartridges.
-The volume of the cartridges is standardized at 1.8 ml
III. Specific instrumentation for isolation of the operating field (Dam)
1- The dam frame:
It is used to tighten the rubber around the clamped tooth and to keep the operating field fixed.
It can be made of plastic (Nygaard Ostby), or metal (Young).
2- The crampons (clamps):
These are devices equipped with small arms with ends having the shape of the collar of the different teeth, and are fixed to the latter by a spring movement.
3- The pliers:
a- the punch pliers:
Punch pliers are used to make round perforations of various diameters in latex.
b- the clamp holders or clamp holders:
They ensure the transfer and adaptation of the clamp around the tooth. Example: the Ivory clamp.
IVORY Pliers
4- The dam leaves:
Made of rubber or latex, they are available in square sheets or rolls to be cut.
Three thicknesses are available: fine, medium and heavy .
5- The wedjet:
– Rubber cord
– Facilitates the application and fixation of the dam between teeth.
Noticed:
The placement of the dam requires suction using a saliva pump, on which a single-use plastic cannula is mounted.
Alternatively, you can use rolls of renewable cotton.
Isolite
Isolite is a brand new dental arch isolation and suction system. This equipment consists of a retractor, lighting and integrated suction to control saliva contamination and humidity.
IV. Specific instrumentation for cavity preparation
1-rotating instruments:
a-Turbine:
It is a rotating instrument
– It allows the cavities to be cut in record time, with very little
vibration.
– It has a high speed: 400,000 rpm,
– this speed causes significant heating of the tissues
dental hence the need for the cooling system.
2- active instruments:
a- the excavator:
It is a double-angled hand instrument that can be considered a modified knife.
-The cutting edges are curved or rounded
-Used to rid the caries cavity of infected or softened dentin ( manual dentin curettage ).
b- contra angle:
– It is a rotating device that ends with a head forming a right angle with its body.
– It is mounted on a micromotor which operates on compressed air.
– Unlike the turbine, the direction of rotation is adjustable.
– It has a rotation speed between 500 and 120,000 rpm.
– The speed it generates being lower than that of the turbine, it does not cause any heating.
– Its disadvantage remains the vibrations.
– ROLE : mechanical dentin curettage
There are several types of contra-angle:
-A green ring: its rotation speed is 500 to 1000 rpm
-A blue ring: its rotation speed is from 1000 to 2500 rpm
At these speeds, the use of irrigation remains a possible option.
– With red ring: its rotation speed is from 20000 to 80000 rpm
C- Strawberries
Burrs are small, active instruments.
They are mounted on rotating instruments (turbine and contra angle).
Their main indications are:
– dentin curettage
– the size of the cavities
– They are available in different shapes: ball, inverted cone, cylindrical, pear, olive, etc.
– They are divided into three groups:
1-stainless steel strawberries
2- diamond cutters
3- tungsten carbide cutters
Diamond burs
V. Specific instrumentation for cavity filling
1- Amalgam restoration: a- for the formwork:
– The matrix ribbon
It is a small metal strip that allows:
-Restoration of the contour of the missing proximal face in a class ІІ cavity.
-Restitution of the contact point with the neighboring tooth.
– The die holder:
It is a metal device made up of 2 jaws connected to 2 articulated rods intended for tightening.
– Available in two sizes, junior and senior.
– It keeps the matrix in place.
– Interdental corners:
– These are hard wooden devices with a triangular section that are placed between the teeth.
b- For the obturation:
– The amalgam holder:
It allows the amalgam to be placed at the bottom of the cavity.
– The crusher:
It ensures the condensation of the amalgam inside the cavity.
c- For pre-culture:
-The mouth spatula:
It is a double-ended instrument intended for:
– placing the filling material in the cavity.
– to the modeling and sculpting of restorations.
– The burnisher:
It is an instrument that allows the modeling of the amalgam.
d- For finishing:
-Finishing tips and rubber cups:
Used for polishing amalgam.
2- Composite restoration: a- For the formwork:
– Smooth polyethylene strips
It is a transparent tape used for restorations of class III and IV cavities.
– Hawe’s cervical matrix:
-Used for class V restorations, treatment of mylolysis, hypoplasia and erosions.
– Caulk Odus molds:
Transparent cellulose acetate mold, used for class IV restorations
b- for the obturation:
-The mouth spatula:
It is a double-ended flat instrument intended for:
– Placing the filling material in the cavity.
– To the modeling and sculpture of restorations.
– The photopolymerizing lamp:
– Lamps allowing the polymerization of composite resins.
-Finishing discs and tips :
– They are used for polishing fillings.
– They are mounted on a contra angle and used at low speed.
-Abrasive strips:
Used for polishing proximal surfaces.
Conclusion
In conservative dentistry, the instrumentation is multiple and above all specific to each stage of the surgical procedure .
Instrumentation in conservative dentistry
Deep cavities may require root canal treatment.
Dental veneers correct chipped or discolored teeth.
Misaligned teeth can cause uneven wear.
Dental implants preserve the bone structure of the jaw.
Fluoride mouthwashes help prevent cavities.
Decayed baby teeth can affect the position of permanent teeth.
An electric toothbrush cleans hard-to-reach areas more effectively.