BASIC GUIDE TO DENTAL INSTRUMENTS Carmen Scheller C.D.A., R.D.N., Dip. Ad. Ed., PG Cert ODE Dental Nurse Tutor Dublin Dental School and Hospital Republic of Ireland © 2006 by Blackwell Publishing Ltd Blackwell Munksgaard, a Blackwell Publishing Company Editorial Offices: Blackwell Publishing Ltd, 9600 Garsington Road, Oxford OX4 2DQ, UK Tel: +44 (0)1865 776868 Blackwell Publishing Professional, 2121 State Avenue, Ames, Iowa 50014-8300, USA Tel: +1 515 292 0140 Blackwell Publishing Asia, 550 Swanston Street, Carlton, Victoria 3053, Australia Tel: +61 (0)3 8359 1011 The right of the Author to be identified as the Author of this Work has been asserted in accordance with the Copyright, Designs and Patents Act 1988. All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted, in any form or by any means, electronic, mechanical, photocopying, recording or otherwise, except as permitted by the UK Copyright, Designs and Patents Act 1988, without the prior permission of the publisher. The author has no financial interests and no formal links with any of the companies whose products are referred to in this book. First published 2006 by Blackwell Munksgaard ISBN-10: 1-4051-3379-1 ISBN-13: 978-1-4051-3379-1 Library of Congress Cataloging-in-Publication Data Scheller, Carmen. Basic guide to dental instruments / Carmen Scheller. p. ; cm. Includes index. ISBN-13: 978-1-4051-3379-1 (pbk. : alk. paper) ISBN-10: 1-4051-3379-1 (pbk. : alk. paper) 1. Dental instruments and apparatus – Handbooks, manuals, etc. I. Title. [DNLM: 1. Dental Instruments – Handbooks. WU 49 S322b 2006] RK681.S33 2006 617.6′0028 – dc22 2005029604 A catalogue record for this title is available from the British Library Set in 9 on 11.5pt Sabon by SNP Best-set Typesetter Ltd., Hong Kong Printed and bound in Singapore by COS Printers Pte Ltd The publisher’s policy is to use permanent paper from mills that operate a sustainable forestry policy, and which has been manufactured from pulp processed using acid-free and elementary chlorine-free practices. Furthermore, the publisher ensures that the text paper and cover board used have met acceptable environmental accreditation standards. For further information on Blackwell Publishing, visit our website: www.blackwellmunksgaard.com CONTENTS Dedication iv Acknowledgements v How to Use This Book vi Section 1: Infection Control in the Dental Surgery 1 Section 2: Dental Radiography 15 Section 3: Basic Instruments 31 Section 4: Instruments and Sundries Used in Moisture Control 39 Section 5: Local Anaesthesia 47 Section 6: Instruments Used for Rubber Dam Placement 57 Section 7: Handpieces, Burs and Rotary Attachments 65 Section 8: Instruments Used in Basic Restorative Procedures 83 Section 9: Matrix Bands and Matrix Retainers 111 Section 10: Instruments Used in Endodontic Treatment 125 Section 11: Elevators 143 Section 12: Extraction Forceps 149 Section 13: Surgical Instruments 161 Section 14: Measuring Devices 189 Section 15: Impression Trays 195 Section 16: Orthodontic Instruments 201 Section 17: Instruments Used in Periodontal Procedures 235 Section 18: Instruments Used in Removable and Fixed Prosthodontics 251 Appendix 269 Index 271 To my family, Mom, Dad and Clayton, for giving me the strength to follow my dreams, and to Padraig for being a big part of that dream. ACKNOWLEDGEMENTS I would like to thank the many people who helped with the development of this instru- ment guide: Margaret Crosswaite, Tina Gorman, Helen Phipps, Joan Brennan, Joy Markey and Ann Bradley for the constant guidance, encouragement and advice; Dr. Michael O’Sullivan, Dr. Frank Quinn, Dr. Therese Garvey, Dr. Johanna Glennon and Dr. Maria Jennings for their advice, encouragement and editing of relevant chapters; Catherine Waldron and Anne O’Byrne for their assistance; Dr. Barry Harrington, who helped me at the early stages of this project; Professor David Coleman, who supplied the photography equipment needed to take some of the photos; the staff at the Central Sterile Services Department (Dublin Dental School and Hospital) who were always helpful in finding the ‘best’ instruments for photography purposes; and Dr. Frank Quinn who supplied some excellent clinical photographs. Thank you to the following companies and people who supplied photographs: American Eagle Instruments Inc. DENTSPLY Ash®Instruments Dynaflex Garrison Dental Solutions Henry Schein Ireland Hu-Friedy J. Morita Europe GMBH Kerr Kodak Laerdal Medical Ltd Learning and Teaching Scotland LM – Instruments Oy L&R Manufacturing Dr. Anthony Maganzini Miltex Ormco Europe Owandy Dental Imaging Premier Dental Products Company Dr. Frank Quinn Roydent Dental Products SDI Septodont Sirona Dental Systems Sybron Endo Total Care Ultrasonics W&H (UK) LTD Young Dental HOW TO USE THIS BOOK As the dental profession evolves, there is an increasing demand for supplementary mat- erial that can keep up with advancing trends. ‘Hands on’ practical experience is essen- tial for anyone in the dental profession, and this needs to be supplemented with written information to reinforce our practical experiences. This illustrated manual has been prepared for students working and studying in the dental profession. It may be used as a study aid or kept in the dental surgery as a ref- erence guide. This manual is intended to complement other methods of learning, i.e. textbooks, lecture notes etc., and is not meant to be a comprehensive resource. The 100 items used in the National Examining Board for Dental Nurses in the United Kingdom are included in this book, and the current (at time of publishing) ‘spotter’ items list is included in the Appendix. Because many dental instruments look similar, and can be confusing to a student, the ‘false friends’ sub-sections identify instruments that may resemble the particular instrument. This manual is not intended to be a complete representation of all dental instruments, but it does include examples from each dental discipline. As many dental instruments are multi-functional and are referred to by more than one name, where possible, these are given beside the name of the instrument. Complete set-ups have been included at the end of most sections for various procedures. The dental profes- sional may have to modify these lists, depending on operator preference. Each section is dedicated to a specific discipline or division of dentistry. Some ins- truments feature in many sections, and these have been included in the set-up sub- sections of the relevant sections. Infection control is a fundamental requirement in the dental surgery, and as such the first section is dedicated to this area. This section aims to introduce the principles of health and safety, which must always be at the fore- front of a dental professional’s mind. Contact the legislative bodies for appropriate regulations and legislation relevant to your workplace. The instruments in this guide are not to scale, and during photography some colours may have been altered. SECTION 1 INFECTION CONTROL IN THE DENTAL SURGERY It is the responsibility of the dental team to ensure that the appropriate and correct pro- cedures are carried out in relation to infection control to protect the patients, the public and themselves. 2 Basic Guide to Dental Instruments N IY L R OE G R TR NU OS CL A N T N O E TID C E EH F NT I (a) (c) (b) Figure 1.1 Infection Control in the Dental Surgery 3 PROTECTIVE WEAR N FIGURE 1.1 a, b, c IY L R OE G R TR Name NU (a) Mask (b) Safety glasses (c) Face shields OS CL A Function, precautions and directions for use N T N • To protect the dental team from micro-organisms, debris, splatter and chemicals OE • A mask is worn to protect the mucous membranes of the nose and mouth. It filters TID C out small particles EHE (cid:1) F Should always be changed between each patient or before if it is visibly soiled NT (cid:1) Should be worn during patient care, sterilisation, disinfection, cleaning procedures I and during laboratory work • Safety glasses and/or face shields are worn to protect the mucous membranes of the eyes (cid:1) Should be disinfected between patients (cid:1) A face shield can be used instead of safety glasses, but a mask must still be worn (cid:1) Should be large enough to cover the eye area completely and provide protection from the top and side. With some safety glasses additional top and side shields have to be added to be used for this purpose (cid:1) Safety glasses are available to fit over prescription eye wear (cid:1) Must be shatterproof Varieties Different types of masks and glasses available 4 Basic Guide to Dental Instruments N IY L R OE G R TR NU OS CL A N T N O E TID C E EH F NT I Figure 1.2 (a) (b) Figure 1.3