Rubber Dam Clamps
*Only clamps available in clinic are listed, see the chart on the wall by sterilization for selection
*Always tie floss to avoid aspiration
- 9 (butterfly) – anteriors
- 2A – bicuspids or primary molars (if no 6yr molar present to clamp) - 12A – UL and LR molars
- 13A – UR and LL molars - 14 – Maxillary molars
- Ash – Pediatric permanent molars (6 yr molars), most permanent molars Burs
- Operative Burs:
Types (by material)
Carbide – a rotary blade instrument composed of microscopic tungsten carbide particles held in a matrix of cobalt or nickel. Common shapes include 330 (pear), 245 (long pear), 556 (straight), and round (various sizes ¼, ½, 2, 4, etc.) Generally used for cavity preparations and to cut metal. These are generally single use and come as a set in clinic as ―amalgam burs,‖ which includes a #2 round, a #4 round, a 330, a 245 and a 556. Use this set for direct intracoronal restoration preps. As a basic guide, the 330 and 245 are use to make prep form covergent, a 556 for flattening floors, and the round burs on a slow speed handpiece for caries removal.
When you are done, these burs are disposed of in sharps.
Diamond – a rotary abrasive instrument composed of diamond particles embedded in a softer material. The size of the diamonds used impacts how aggressively the instrument removes tooth structure. They are categorized as coarse (green),
medium(blue), fine(red), and very fine(yellow). Common shapes include chamfer, modified shoulder, shoulder, round, football, needle, and wheel. These also vary in thickness, with a #14 being thicker than a #12. These instruments are generally used for crown preparations, cutting porcelain, and finishing and adjusting occlusion of composites. An assortment of these burs may be found in finishing blocks, so ask sterilization for a finishing bur block if you are doing one of the above procedures.
There is also a set of ―crown and bridge burs,‖ which includes a #12 chamfer, a #12 shoulder, a round bur, and a needle bur for breaking contacts. As a basic guide, the chamfer is used for metal crown margins, the modified shoulder or shoulder for porcelain or butt joint margins, and the football or round bur for adjusting occlusion.
When you are done, dispose of any heavily used burs and place the rest in the finishing block for sterilization and re-use.
Cutting instrument formulas
Example: 10-85-8-14. The first number indicates the width of the blade in tenths of millimeters. The second number is the clockwise angle of the primary cutting edge in centigrades. The third number is the blade length in millimeters. The fourth number indicates the blade angle in centigrades
- Periodontal burs:
End-cutting – A bur that only cuts at the tip, not the sides. Used to lower bone height around teeth during periodontal procedures like crown lengthening
- Endodontic burs:
48
Safe end bur – A bur that cuts only on the sides, not the tip. Used to remove ledges around the floor of the pulp chamber during access preparation.
Gates-Glidden – A bur with a slender shank and football shaped cutting tip. Used to flare the orifices of canals during endodontic cleaning and shaping. Make sure to irrigate well if using this bur to avoid forming a debris blockage in your canal.
Instruments to Know:
Spoon excavator
Chisels Hatchet Hoe Gingival Margin Trimmer
Hollenback Discoid Cleoid
Plastic Instrument
Acorn burnisher
Amalgam carrier Dycal applicator
Amalgam Condenser
49
Hand Instruments
- Explorer: caries detection, calculus detection, general tactile instrument - Handcutting instruments: remove caries and refine preparation form
- Spoon excavator: removing caries, soft dentin and debris
- Straight chisel: cut enamel margin of the tooth to form clean cavo-surface margin - Hatchet: cutting enamel, smoothing walls and floor of preparation
- Hoe: plane walls and floor of preparation
- Gingival margin trimmer: bevel enamel for composite restoration, remove interproximal overhang - Restorative Instruments:
- Amalgam carrier: holds and transports amalgam - Condenser: compress amalgam or composite into cavity
- Ball Burnisher: shape matrix bands, remove excess Hg from amalgam and smooth - Discoid/cleoid: remove excess amalgam, carve anatomy
- Acorn Burnisher: remove excess amalgam, carve anatomy - Composite instruments
- Plastic instrument: like a mini-spatula to carry and condense composite - Crown and Bridge instruments
- Cord packer: packs cord in gingival sulcus
- Dycal Applicator: mini-ball for placing dycal on pulpal floor Periodontal Instruments
- 13/14 Gracey: root planning distal surfaces of posterior teeth - 11/12 Gracey: root planning mesial surfaces of posterior teeth - 7/8 Gracey: root planning buccal/lingual surfaces of posterior teeth
- Younger Good 7/8 (Universal): Standard supragingival scaler (rounded toe) - Sickle scaler: Interproximal surfaces of anterior teeth (sharp toe)
- Periodontal probe: measuring sulci, depth gauge
- 11/12 explorer: detecting calculus/ verifying calculus removal - Naber's probe: measuring furcation classification
- Cavitron: Debridement of bulk calculus, staining and debris. Also used in endodontics to remove debris from pulp chamber.
Endodontic Instruments
- DG-16(Endodontic explorer): detecting orifices - Endodontic spoon: removing pulp chamber tissue - Apex locator: detecting working length.
- Hand files: K-file, K-flex: cleaning and shaping canals in clinic
- Rotary files: Protaper, Profile, and RaCe: adjunct to hand files for cleaning and shaping canals, not available in clinic - Pluggers: condensing gutta percha
- Spreaders: making space for accessory cones during lateral condensation technique (recommended technique in clinic) - Master cones: primary gutta percha cone, should be same size as master apical file
- Accessory cones: thinner cones used for lateral condensation, available in medium fine and fine sizes in clinic - Touch and Heat: removing gutta percha for post placement, severing gutta percha cones at orifice
50