Hand Instruments for

Operative Dentistry
Operative Dentistry Dent 335/343
Mohammad Atieh , BDS, MS
 Introduction

Before the invention of rotary instruments,

dentists used to cut cavities using sharp hand
instruments.
The first pedal driven hand piece was
invented in 1871.
However, hand instruments are still used today
for specific purposes.

https://i2.wp.com/www.millerdentalcare.com/wp-
content/uploads/2015/03/dental-drill-pedal-driven.jpg
By PeterEasthope - Own work, CC BY-SA 4.0, https://commons.wikimedia.org/w/index.php?curid=54397032
Nomenclature and Classification
 Nib Blade Working end
or

Shank

Handle

Double-ended
 Handles

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 Out of Balance VS
Balanced

Balanced = stable doesn't rotate.

Also contra-angled term is used when the

shank has 2 angles to align the working
end within 2-3 mms of the axis of the
handle.

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 Cutting Edges

Primary and Secondary

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Fundamentals of Operative Dentistry. iBooks.
Single Beveled Vs Bi-beveled (Double Beveled)

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 Nomenclature

Black named instruments based on:

Appearance / shape.
Function /use
Number of angles

For cutting instruments he also gave a 3 or 4-number formula (e.g.15-95-10-7)

 Based on the Appearance

Examples:
Hatchets
Hoes
Spoons
Chisels
Hatchets
Hoes

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Spoons

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Chisels

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 Based on the function

Examples:
Excavators
Gingival margin trimmers
Condensers
Carvers
Burnishers
 Based on the Number of Shank Angles

Straight
Monangle
Binangle
Triple-angle
Quadrangle

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 Classification

There are different classifications available. The easiest one is the one that classifies hand
instruments to cutting and noncutting.
Cutting Instruments
 Cutting instruments

They cut tooth structure or restorative material

Examples :
Spoon excavators
 Spoon Excavators

The blade has:

A circular (called regular) or disk shape ( called discoid)
Outer convexity and inner concavity.
Double-ended (left cutting and right cutting)
Usage:
Soft caries removal.
Evaluating the hardness of dentine (to evaluate the presence any remaining caries).
Spoons

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 Cutting instruments

They cut tooth structure or restorative material

Examples :
Spoon excavators
Hatchets
 Finishing cavity
margins and removing
unsupported enamel
 Hatchets
Binangle hatchet Monagnle hatchet

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 Hatchets
Double-Ended
Left-cutting end Right-cutting end
 Off-Angle Hatchet
A term used when the working end is not perpendicular to the blade.

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 Cutting instruments

They cut tooth structure or restorative material

Examples :
Spoon excavators
Hatchets
Chisels
 Chisels

Has a blade that is either aligned with handle

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 Chisels

Or slightly angled or curved form the long axis

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The chisel has a cutting edge at right angle
to the long axis of the handle
Chisels
 Cutting instruments

They cut tooth structure or restorative material

Examples :
Spoon excavators
Hatchets
Chisels
Hoes
 Hoes

Has a cutting edge at right angle to the handle like the chisel.
But the blade has a greater angle from the long axis of the handle
than the chisel ( more than 45-degree).
They are used mainly for removing unsupported enamel and sharping
walls of anterior cavity preparations.
 Cutting instruments

They cut tooth structure or restorative material

Examples :
Spoon excavators
Hatchets
Chisels
Hoes
Gingival margin trimmers
 Gingival Margin Trimmers

Like a hatchet, but the blade is curved.

The bevel of the blade is always at the outside part
of the curve and the face is inside part of the curve.

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 Gingival Margin Trimmers

Comes in pairs:
Double ended mesial margin trimmer (Left cutting and right
cutting ends).
Double ended distal margin trimmer (Left cutting and right
cutting).

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Distal Mesial

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Strokes
Vertical (Chopping) or horizontal (Lateral
scarping):
Like gingival margin trimmers and
hatchets.
 The lateral scarping is carried out from the
beveled to the the non-beveled side. This
way is more effective in removing all
unsupported enamel without missing the
corners.

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Strokes
Pulling or pushing stokes
Like hoes.

Sturdevants Art and Science of Operative Dentistry, 6th edition

Mesial bevel Distal bevel

Push stroke Pull stroke
 Cutting instruments

They cut tooth structure or restorative material

Examples :
Spoon excavators
Hatchets
Chisels
Hoes
Gingival margin trimmers
Carvers
 Carvers

To shape amalgam and other tooth-

colored restorative materials after
placement into the preparation.
 Hollenback
For occlusal and proximal anatomy

Amalgam Knife
-For proximal
anatomy and
embrasures of
posterior teeth.
-F/L anatomy of
posterior teeth.

Discoid Cleoid
-Mainly for occlusal anatomy
-Discoid part is useful for lingual Premier USA
concavities on anterior teeth
Premier USA
Numeric Formula
 Numeric Formulas

3-Number formula:
When primary cutting edge at right angle to
the long axis of the blade:
First number = width of the blade in 0.1 mm.
 Numeric Formulas

3-Number formula:
When primary cutting edge at right angle to
the long axis of the blade:
First number = width of the blade in 0.1 mm.
Second number = length of the blade in mm.
 Numeric Formulas

3-Number formula:
When primary cutting edge at right angle to
the long axis of the blade:
First number = width of the blade in 0.1 mm.
Second number = length of the blade in mm.
Third number = angle of the blade with the
long axis of the handle in centigrades.
 Centigrade Scale

Based on a circle divided into 100 units.

Right angle has 25 centrigrades.
 Numeric Formulas

3-Number formula:
When primary cutting edge at right angle to
14
the long axis of the blade:
First number = width of the blade in 0.1 mm.
Second number = length of the blade in mm.
Third number = angle of the blade with the
long axis of the handle in centigrades.
 Numeric Formulas

4-Number formula
When primary cutting edge is not at right
angle to the long axis of the blade:
 4- Number Formulas

This additional number is located in the second

place of the formula:
15-95-10-7
First number = Width of the blade in 0.1 mm.
Second number = Angle of the cutting edge
with the long axis of the handle.
Third number = Length of the blade in mm.
Fourth number = Angle of the blade with the
long axis of the handle in centigrades.
Non-Cutting Instruments
 Non-Cutting Instruments

They dont cut tooth structure or restorative material.

Examples :
Diagnostic instruments
Diagnostic Basic set

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 Non-Cutting

They dont cut tooth structure

Examples :
Diagnostic instruments
Instruments Used for Amalgam restorations :
Amalgam carriers
 Double-ended

Universal

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 Amalgam Carriers

Carry amalgam and pushes it out into the

preparation.

Amalgam well Dappen dish

 Non-Cutting

They dont cut tooth structure

Examples :
Diagnostic instruments
Instruments used for amalgam restorations :
carriers
Condensers
 Condensers

They condense (compress) amalgam into the

preparation.
They are also used to push other restorative
materials like composite and glass-ionomer
into the preparation ( Those materials dont
need high condensation force like amalgam).
 Condensers

Nibs come in different shapes and sizes:

Shapes:
Round ( as shown in the picture).
Triangular
Rectangular
Diamond shaped
 Back Action (Triple Angle Condenser)

A special type.
Helps in condensing amalgam into distal
surfaces of teeth by applying the force
towards the operator (back action).
 Non-Cutting

They dont cut tooth structure

Examples :
Diagnostic instruments
Instruments used or amalgam restorations :
carriers
Condensers
Burnishers
 Acorn burnisher

FOOTBALL-SHAPED
BALL-SHAPED END END

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 Burnishers

Burnish means to make shiny (polish) metal by

rubbing.
They are used to burnish freshly placed amalgam to
make the surface smoother.
Burnishing also involves pinching off material edges.
This is useful in closing the margin of freshly place
amalgam.
Burnishers are also used to sculpt occlusal anatomy in
posterior resin composite restorations prior to
polymerization.
 Non-Cutting

They dont cut tooth structure

Examples :
Diagnostic instruments
Instruments Used for amalgam restorations :
carriers
Condensers
Burnishers
Instruments for composite restorations:
Plastic filling instruments
 Plastic Filling Instruments

They are named as that because they were originally

design to place plastic non-metal restorative
materials like acrylic resins and silicates.
They are used now used to place tooth-colored
restorative materials like resin composites and glass-
ionomer restorations; and temporary restorative
materials.

Hu Friedy Restorative Catalogue

 Non-Cutting

They dont cut tooth structure

Examples :
Diagnostic instruments
Instruments Used for amalgam restorations :
carriers
Condensers
Burnishers
Instruments for composite restorations:
Plastic filling instruments
Placement instruments
Calcium hydroxide applicator
 Calcium Hydroxide Applicator

To apply calcium hydroxide, glass-ionomer and

other liners into the cavity preparation.

Hu Friedy Restorative Catalogue

 Non-Cutting

They dont cut tooth structure

Examples :
Diagnostic instruments
Instruments Used for amalgam restorations :
carriers
Condensers
Burnishers
Instruments for composite restorations:
Plastic filling instruments
Placement instruments
Calcium hydroxide applicator
Mixing Spatulas
Hu Friedy Restorative Catalogue
 Lecture References

Fundamentals of Operative Dentistry. iBooks.

Sturdevants Art and Science of Operative Dentistry, 6th edition.
 Study Reference

From the handouts.

 Weeded Quiz

There will be no quiz!. Enjoy!. But study this lecture and the lab material the I will post online to
prepare you for the next exercise.
 Useful YouTube video:
https://www.youtube.com/watch?v=7xdqaGfa1b8