Restorative dental instruments

Written by madeleine hall
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Restorative dental instruments
Without a dentist, dental instruments are nothing; without instruments, a dentist is nothing. (Thinkstock Images/Comstock/Getty Images)

Dental instruments are the tricks of a dentist's trade. There are instruments for everything and several for most procedures. A drill is an indispensable item, but it is not the drill that does the fine tuning of a restoration. It is the hand instruments that make each filling look fabulous and give patients the confidence to smile. Instruments rank right up there with the dentist, because they work together.

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Basic Examination Instruments

Every dentist must start somewhere with his patient. To find something to restore, he must start with a thorough examination of the patient's teeth. For this, he will likely have a mouth mirror and a double-ended instrument called a pigtail explorer. The mirror is to look at areas behind the teeth and under the tongue. The explorer assists in diagnosing decay because the sharp little edge of the explorer will sink into decay and be hard to remove.

Amalgam Filling Instrumentation

For a silver or amalgam filling, a syringe with anesthetic is necessary. A mouth mirror and explorer are on every tray set-up. They are standard armaments. A high-speed drill will access the decay. A spoon excavator scoops it out. A Dycal instrument will place Dycal, or calcium hydroxide, to help build secondary dentine. Tweezers and a cotton pellet will deliver Copalite, a dentinal tubule sealer, to the filling preparation. A Tofflemier retainer with a matrix band is used if decay extends between the teeth. An amalgamator mixes amalgam; an amalgam carrier carries it to the tooth, where pluggers compact the amalgam. An instrument called a discoid cleoid carves anatomy into the amalgam. Finally, a ball burnisher will make the silver shine.

Tooth Colored Composite Filling Instrumentation

A mouth mirror and explorer, along with a syringe with anesthetic for patient comfort are the first instruments used. A high-speed hand piece with diamond burs prepares the composite filling, with a spoon excavator used to scoop out decay. A Dycal application with a Dycal instrument protects the nerve with a deep cavity. A dappen dish with acid etch and a small paint brush etches the tooth to prepare it for bonding. Another dappen dish holds the bonding agent that bonds the composite to the tooth. A celluloid strip slides between the teeth should the filling extend that far. Celluloid strips are clear, allowing the UV light source to reach the composite when necessary. A composite gun distributes composite; an instrument with an angled flat edge, like a hockey stick, spreads the composite into the filling. A hand-held UV light source hardens the composite, with diamond finishing burs used to contour and remove excess composite from the filling.

Crown Preparation Instrumentation

A mouth mirror and explorer, as always, are used as is a syringe with anesthetic to make sure the patient is comfortable. A high-speed drill with different sizes and grits of diamond burs reduce the tooth to accommodate the thickness of the crown. With the crown prep completed, scissors cut a piece of retraction cord. Retraction cord treated with epinephrine relaxes the gums from the tooth temporarily. The retraction cord placement is under the gums with a thin, round-end instrument. Once the retraction cord has done it is job, usually five minutes, it gets removed and impressions taken with the dentist's preferred impression material, hydrocolloid or polyvinyl siloxane. Temporary crown fabrication protects the tooth. A metal temporary will need curved scissors and bell contouring pliers to shape it. Acrylic will add strength and a tight fit. Temporary cement mixed with a spatula cements the temporary on the prepared tooth

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