Dental Instrument Setups

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Restorative Instruments

After completing this lesson, you should be able to:

• Define the  following terms:

Restorative.

Permanent restoration.

Interim.

Inlay.

Crown.

Fixed partial denture.

Pulp cap.

Cement base.

Rubber dam.

• Name the classes of cavity preparations.
• Identify the instruments used for examinations and diagnosis.
• Identify the four identifying characteristics of burs and the uses of them in cavity preparation.
• Name the uses of a rubber dam.
• List the various types of stainless steel burs.
• Cite the size and description of each of the following hand instruments.

Spoon excavators.

Enamel chisel.

Enamel hatchets.

Gingival Margin Trimmers.

• Describe the uses of matrix retainers and bands.
• Describe the uses of the following:

Spatula.

Cement pluggers.

Amalgamator.

Amalgam pluggers.

Carvers.

Hand finishing instruments.

Motor driven finishing instruments.

• State the ways the dental assistant can assist the dentist during cavity preparation.
• Describe the procedures for placing a rubber dam.
• Describe the procedure for cavity preparation.
• Describe the procedures for restorations with cement-based amalgams.
• Identify the procedures for placing a metal matrix band.
• Identify the procedures for restorations with composite resin.
• Identify the procedures for gold alloy inlays (crowns).

2-2. DEFINITIONS

a. Restorations. Restorations are artificial replacements for missing portions of teeth. They are retained in place within the confines of tooth structures prepared to receive them. The ideal restoration is one which restores the function and normal contours of the tooth, restores normal contact with adjacent teeth, protects the pulp, remaining tooth structure, and any adjacent periodontal tissues, withstands forces tending to fracture, wear, erode, or dislodge it, and presents an esthetic appearance.

b. Permanent Restoration. A permanent restoration is one that is intended to last for a prolonged period. It is made of a type of restorative material having properties that make it relatively durable and resistant to mechanical forces and chemical activity found in the mouth. Commonly used permanent restorative materials are silver amalgam, gold alloys (for inlays and crowns), and composite resin.

c. Interim (Temporary) Restoration. An interim, or temporary, restoration is one which is intended to protect a tooth between dental appointments or until more definitive and lasting treatment can be performed. Materials that may be used for interim restorations include various dental cements and soft metallic or celluloid preformed crowns temporarily cemented into place. Common interim restorative materials are zinc oxide and eugenol, and intermediate restorative material (IRM).

d. Inlay. An inlay is a restoration, usually made of gold alloy, which is cemented into place in a prepared area in a tooth. Steps in the fabrication of an inlay begin with the making of a wax pattern of the prepared area. The wax pattern is used to form a mold into which melted gold alloy is cast. The wax pattern is thus duplicated in gold, to fit the prepared area.

e. Crown. An artificial crown is a replacement for enamel and other layers of the natural crown of a tooth. Crowns are commonly made of metal alloys, acrylic resin, or porcelain. They are classified according to the type of material used in their construction and the number of tooth surfaces which they cover. For example, a three-quarter crown gold alloy is a crown made of gold alloy replacing three of the axial surfaces of the natural tooth crown. A full porcelain crown (or porcelain jacket) is one made of porcelain replacing all the surfaces of the crown of a tooth. A veneer crown is a full metallic crown with a porcelain or acrylic resin veneer on the facial surface. Steps in the fabrication of the various crowns are generally the same as those for the inlay.

f. Fixed Partial Denture. A fixed partial denture, often called a bridge or a fixed bridge, is a prosthodontic restoration which is fabricated to replace a missing tooth or teeth and is held in place by crowns or inlays cemented to one or more adjacent natural teeth.

g. Pulp Cap. Pulp capping is a treatment procedure in which a material is placed over an exposed or near-exposed portion of a dental pulp to protect it and facilitate its recovery from the effects of chemical, mechanical, or bacterial irritation. Calcium hydroxide is the preferred base material in pulp capping.

h. Cement Base. A cement base is a foundation, made of either zinc phosphate cement or zinc oxide and eugenol cement. The cement base is placed in the deep portions of cavities to protect the pulp from chemical, thermal, or electrical trauma.

i. Rubber Dam. A rubber dam is thin, rubber sheet material used to isolate the teeth and keep them dry during the performance of certain restorative and endodontic procedures.

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