From Big Medical Encyclopedia

DENTAL TOOLS (the outdated name — dental surgery tools) — the special tools intended for clinical inspection and treatment of diseases of an oral cavity and teeth, used in therapeutic, surgical and orthopedic stomatology and also for dental works. Page and. it is shared with the dental equipment (see. Bormashina , Dental equipment , Dental installation , Dental chair ). Tools were used to denture treatment in an extreme antiquity (see Dentures). The Greek-Roman doctors in 4 century BC applied special nippers to an exodontia, in 11 century AD the Arab doctor Abul-Kasim had already a set of nippers for an exodontia. In 16 century the fr. surgeon A. Paré for an exodontia and fangs used a set of nippers, an elevator, hooks and levers, applied various scrapers to cleaning of carious cavities in teeth and other tools. In 1820 De-labarr (M. of Delabarre) offered the hand drill and drills (borons) for preparation of cavities in teeth under seals. The English doctor to J. Tomes in 1840 designed nippers for an exodontia taking into account anatomic shapes of teeth. Implementation in practice of electric drills promoted development of dental tools in his modern understanding.

In our country quantity production of S. and. began after Great October socialist revolution and now completely provides the need of health care for dental tools.

To S. and. general-purpose instruments, for surgical stomatology, for therapeutic stomatology and for dental works belong.

Tools of general purpose turn on tools for a wedge, inspections of an oral cavity and teeth — stomatol. a mirror with the separated handle, curved No. 1, bayonet shaped No. 2 and crescent No. 3 stomatol. probes, bent stomatol. tweezers (see. Tweezers ). They are widely applied at inspection of patients, at therapeutic, surgical and orthopedic manipulations on teeth, cellular shoots, a hard and soft palate, language etc.

The industry of the USSR St. 300 standard sizes of borons for preparation of solid tissues of teeth at treatment of caries and denture treatment, and also others rod stomatol are issued. tools. Borons happen three main types: steel, counted on drilling with a speed up to 10 000 rpm.; hard-alloy (karbidvolframovy) and diamond — to 30 000 about! min.; borons for turbine drills — to 300 000 rpm. Steel borons are intended for processing of dentine of tooth and drilling of its solid fabrics struck with carious process; hard-alloy — for processing of dentine of tooth, metal and alloys; diamond borons, and also diamond stomatol. heads — for processing of enamel of tooth, turning of porcelain and ceramics.

Fig. 1. Rod dental tools: 1 — 13 — borons (1 — spherical, 2 — figured direct cylindrical with double cutting, 3 — conical a straight line with unary cutting, 4 — conical truncated with double cutting, 5 — obratnokonusny with unary cutting, 6 — kolesovidny, 7 and 8 — finira cylindrical, 9 — finir conical, 10 — finir spherical corrugated, 11 — finir plamevidny corrugated, 12 — polir spherical, 13 — polir plamevidny); 14 — 17 — mills (14 — oval, 15 — conic with double cutting, 16 — cylindrical with double cutting, 17 — conic with unary cutting); 18 — 21 — tools for turning of teeth (18 — kolesovidny, 19 — return and cone-shaped, 20 — cylindrical, 21 — discal).

Borons consist of a core for its fixing in a tip of a drill and a head with cutting. On length distinguish long-shanked burs — length of 44 mm, for an angular tip — length 17, 22, 27 mm and for a turbine tip — length of 20 mm. As a working part (a form of a head) distinguish (fig. 1) round, cylindrical, conical and obratnokonusny, kolesovidny, disk and plamevidny burs; on diameter of a working part they are divided according to numbers — from small No. 1 (1 mm) to No. 11 (2,5 mm). On character of a trimming blade borons happen figured — to unary or double cutting, finira — to a continuous trimming blade, polira — without cutting, corrugated and step borons — to a trimming blade at an end face. Usually borons for angular tips are completed in sets on 175 pieces, and for straight lines — on 125 pieces. During the dentoprosthetic works are generally applied stomatol. mills (see fig. 1) with large longitudinal sides on heads of various form (cylindrical, conic, oval with unary or double cutting). For turning of teeth the rotating karborundovy tools are used (see fig. 1): kolesovidny, return and cone-shaped, cylindrical and discal. In orthopedic stomatology (processing of steel, plastic and porcelain teeth and crowns) apply shaped diamond heads of various form (disk, kolesovidny, conic truncated and with a curve, obratnokonusny, plamevidny, cylindrical, spherical, etc.), and also flat and tarelchaty circles stomatol. about one - and a bilateral diamond covering, to dia. 12, 16, 18, 20 mm.

For transfer of rotary motion to borons, heads, circles, mills and other rod tools from a drill, the pneumatic micromotor or other source of rotation are intended stomatol. with the animator, to-ry the speed of rotation of boron, etc. tools allows to increase tips, cords, cable and rigid arms, including cable arms twice, providing at the same time longer operability of elements of rotation of a sleeve.

Stomatol. tips are available two types: direct and angular.

Fig. 2. Dental tips: 1 — direct NL-10; 2 — direct NP-30A, 3 — angular NU-10; 4 — angular NU-30.

Straight nozzles of NPB-10, NP-10A and angular NUB-10, NU-10 without bearings are counted on rotation with a speed no more than 6000 — 10 000 rpm; high-speed tips of direct NP-30A and angular NU-30 on bearings — for rotation to 30 000 rpm (fig. 2).

Also turbine tips of NST-300-2, NT-100, tips for sleeveless drills on 40 000 rpm, for micro motors with various transfer relation, dental, etc. are made.

Fig. 3. Tool kit for an endodontiya: and — a habit view small (at the left) and big (on the right) sets; — a working part of tools (1 — a depth gage, 2 — the pulp extractor, 3 — a drill root, 4 — a rasp root, 5 — a drill, 6 — development, 7 — a kanalonapolnitel, 8 — a plugger; in a circle — it is increased by 10 times).

Tools for therapeutic stomatology

Tools for therapeutic stomatology include the big, small and medium tool kits for an endodontiya intended for cleaning, expansion, medicamentous processing and sealing of a cavity and channels of tooth (fig. 3). Depth gages, pulp extractors, root burava, root rasps, drills, development, kanalonapolnitel, pluggers, the handle grip (allows to regulate length of the tool on depth of the channel of tooth and provides processing and sealing of the channel without damage of an apical periodontium), and also the holder, a key, etc. enter sets the different size. To expansion and passing of the channel at curved fangs apply the endodontichesky tip of NE-3-02 working from a drill, making smooth turn, it is bent on 90 ° to the right and to the left that allows the tool to pass on curvature of the channel of tooth, without perforating a wall of a root.

The tool kit for sealing of teeth consists of various form of excavators with acute spoons for removal from a carious cavity of a softened dentine, the remains of food, sealing material and removal of tooth deposits; bellied and capitate pluggers for introduction of amalgam and various form a gladilok for introduction and consolidation of pharmaceuticals and sealing material in the processed carious cavity; the metal pallet for preparation for use of pharmaceuticals and weight from sealing materials, and also the plastic pallet, to-ry it is used when pharmaceuticals can react with metal or when from contact with metals sealing materials can change coloring. Apply to grinding of seals finira and polira (see fig. 1). Other accessory instruments also are intended for sealing of teeth: matrixes, matritsederzhatel, separators, silver and polymeric pins for sealing of channels, etc. (see. Sealing of teeth ).

The tool kit for removal of tooth deposits consists of various hooks and curettes, to-rye are applied to a scraping of the affected bone tissue and granulations from patol. dentogingival pockets at periodontosis (see) and from holes after an odontectomy. A working part of tools for removal of subdingival tooth deposits is manufactured of hard alloys.

In therapeutic stomatology also manual and machine drills for direct and angular tips (everyone five types), root needles and other tools are used.

Tools for surgical stomatology

Tools for surgical stomatology are presented by nippers for an exodontia, elevators and other tools, and also surgical instruments of general purpose.

Fig. 4. Nippers tooth: 1 — for removal of upper left big molars; 2 — for removal of the lower big molars; 3 — for removal of the lower canines and small molars; 4 — bayonet shaped for removal of roots of upper teeth; 5 — for removal of upper big molars; 6 — bayonet shaped (bayonet) for removal of upper teeth of wisdom; 7 — for removal of upper cutters and canines.

Nippers for an exodontia consist of a working part (cheeks), handles (branches) and the lock. Nippers for an exodontia at adults and at children differ by the size. At nippers for teeth of an upper jaw of an axis of cheeks and handles match or are parallel (fig. 4); nippers for teeth of a mandible of a coronoid form, with a bend on an edge and on the plane at an angle from 90 to 110 ° depending on what teeth need to be extracted (front or side). The form of cheeks of nippers is defined by an anatomic structure of crowns of teeth, to-rykh they are intended for removal: cheeks of nippers for an exodontia do not contact to the unimpaired crown among themselves and have a concave surface for a reliable grasp of a crown of tooth; cheeks of nippers for an exodontia with strongly destroyed crown, roots and cutters meet. S-shaped nippers are intended for removal of upper big molars; they are produced for the right and left side and differ in the fact that on an outside cheek they have a thorn for capture of deepening between buccal roots. The doctor uses nippers as the lever, making at the same time considerable efforts therefore they are done massive, of strong steel; on an outer surface of handles there are notches that nippers did not slide in a hand of the stomatologist.

Fig. 5. Elevators dental: 1 — T-shaped; 2 — a straight line; 3 — right; 4 — left.

Elevators for an exodontia and roots are used the same as levers if application of great efforts is demanded. They consist of a working part (its sizes can be different), a connecting neck and the handle. Their total length is from 141 to 159 mm (fig. 5). Handles are hollow, faceted, a pear-shaped form for reliable fixing in hands. Direct elevators apply to removal of upper teeth and roots, bent at an obtuse angle — to removal of the lower teeth and roots; they are also done two types — with a working surface for the left or right side. The T-shaped elevator with the massive handle and a bayonet shaped working part sometimes is used for removal of the third big molars, but at the same time it is required to observe big care.

Tools for surgical stomatology usually complete in sets, napr, a set of tooth nippers and elevators of 14 objects, the tool kit for an exodontia at children from 27 objects containing tooth nippers, nippers tweezers, raspatories, looped spoons. Also tool kits for nek-ry types of plastic surgeries are issued.

All-surgical scalpels and scissors are applied depending on anatomic area where operation, and the nature of surgery is performed. Ophthalmologic scalpels and scissors are often used (see. Knives surgical ). Apply bone dental nippers which thin extended cheeks of a working part come to an end with acute sides to a skusyvaniye of keen edges of cellular shoots, interroot partitions and jaws.

Tools for dental works

Tools for dental works (dental tools) are used by orthopedic surgeons and dental technicians. By preparation of teeth for prosthetics apply borons and karborundovy heads (see fig. 1), and at removal of molds, to production of dentures and at their fitting — stomatol. a mirror, anatomic, curved tooth and technical tweezers (see. Tweezers ), scissors for crowns and for metal (see. Scissors surgical ), pallets and other tools.

Metal crowns stamp in the special device (ustroysvt). It consists from steel ditches where fusible alloy, and supports is poured. Alloy melt in stomatol. to a spoon for warming up of fusible alloys. The crown of tooth is created in a ditch. During the stamping of crowns, a flattening of pieces of metal, Clasps, a wire and other works use stomatol. the hammer and a dental anvil with shoots in an anatomic shape of teeth. To production of crowns from stainless steel use steel or brass hammers, to production of crowns from gold alloys — horn or steel hammers with a rubber slip. For finishing of metal and polymeric prostheses there are round, semicircular and flat files with a large and small notch, and also the serrated nickelized oxidized long nose pliers, kruglogubets, nippers, technical clasp bending-pliers, nippers coronoid and planimetric for formation of rings and crowns, etc. At production of prostheses, for removal of molds of teeth and jaws use various sizes and a form of a spoon for a top and bottom jaw, deep — for removal of molds in the presence of teeth and small — for molds from toothless jaws. Spoons for production of molds from gypsum have a smooth surface, and for molds from alginate sle-pochny masses — a surface with perforation. For mixing of gypsum with water rubber cups serve. For separation of plaster model from a mold, trimming of excesses of gypsum before modeling of a prosthesis use a knife for gypsum (see. Plaster equipment ). Okklyudator and an articulator are intended for fixing of plaster models on a bite for the purpose of the subsequent modeling of basis from wax and statement of false teeth in the correct occlusion.

Grinding of false teeth, finishing and polish of dentures is made by means of karborundovy heads and circles, shchetinny, filar and kapron brushes, disk-shaped, kolesovidny and cone-shaped felt wheels from felt or felt, to-rye strengthen on an axis of the grinder. Zagipsovka of wax models of future removable prostheses for receiving their form is carried out in dental flasks. From them wax is melted and replaced with basic material, to-ry it is maintained under a press; then in one - two - a three-flask clasp carry out polymerization. The ready prosthesis is processed a fret saw, shaber, zhelobovidny and nozhevidny shtikhelyam also polished.

Fig. 6. Tool kit for production of dentures using porcelain masses.

During the modeling and production of dentures from porcelain and metal ceramics use special tool kit for production of dentures using the porcelain masses (fig. 6), in to-ry the mouse-tooth forceps, squirrel brushes, a support, scissors, modeling needles, pipettes, cups, a clip, a mouse-tooth ophthalmic forceps, a plugger, a knife excavator, a gladilka, tooth tweezers, pins, etc. enter.

For production of dentures are available as well other tools: a manual vice, a screw-cutting board, a drawplate, ditches for casting of teeth from metals and alloys, etc., and also devices and devices (see. Dental equipment ).

Sterilization stomatol. tools it is carried out by the standard rules, i.e. boiling or in an air sterilizer (see). The rotating rod tools (borons, mills, etc.) and tools for an endodontiya before sterilization carefully clear of the remains of necrotic masses and shaving of dentine, enamel, a bone. Stomatol. mirrors sort then the metal handle will be sterilized a usual order, and keep a mirror in disinfecting solution and before the use process alcohol (see. Sterilization ).

Bibliography: Bezak V. I. Medical tools and equipment, page 131, M. 1969; Kopeykin V. N., etc. Dentoprosthetic equipment, M., 1978; Krendal P. E. and To and and t about in Yu. F. Medical merchandizing, page 295, M., 1974; M and and d E. A. and M at x and N. A N. The atlas at a phantom course in therapeutic stomatology, M., 1981.

G. M. Ivashchenko.