Introduction : Man has become the tool of their tools.

Modern hand instruments, when properly used, produce beneficial results that are advantageous to both the operator and the patients. It should be noted that certain results can be satisfactorily achieved only with hand instruments. The standadization of the design of hand cutting instruments by the manufactures has been helpful to the practioner. All the instruments are identified by a nomenclature and number that describes the size, design and common clinical usage. The proficiency and quality of the clinical treatment depend on the proper selection end use of the cutting instruments; therefore the nomenclature and design of the operative instruments must be mastered and adequate number of sharp and sterile instruments should be available for each clinical procedure.

Metals used in the manufacture of hand instruments : Carbon steel : It is an alloy made by the addition of small percentage of carbon to iron. It is capable of being hardened, softened and tempered. Two varieties i! "oft ii! #ard. It is harder than stainless steel, but when unprotected, it will rust and corrode. It maintains the been edge under use, so is used for ma$ing blade and actual cutting edge of the instruments. "terilization by boiling water and steam under pressure autoclave! will cause discoloration. %ry heat can be used. Stainless metals : a) Stainless steel : It is composed of carbon & ' ()*; chromium (+* and iron +( ' +(.,*. It is e-tremely hard but requires very careful and precise heat treatment during manufacture. The resistance to staining of these alloy is attributed to the formation of a thin coating of transparent o-ide on their surface, therefore it must be $ept highly polished at all times to prevent corrosion. It looses a sharp edge on repeated usage easily as compared to carbon steel so is used for handle, shan$ and part of blade. b) Monel metal : A natural alloy of nic$el, copper and iron, Monel metal contains appro-imately nic$el &.*, copper /+* and iron 0*. It is mar$edly resistant to acids and super heated system. c) Nichrome : 1ichrome contains chiefly of nic$el &) ' +)*, chromium (/ ' /)* and iron )./&*. It can be sub2ected to high degree of temperature, doesnot o-idize easily, and does not maintain a sharp edge. d) Satellite : This product is available in severed grades and consists chiefly of cobalt &0 ' 3)*, chromium ().40* with small quantities of tungsten,

molybdenum, iron or nic$el. Its chief characteristics are hardness, strength, density, high melting point, maintainance of cutting edge and resistance to action of acids. e) Tarno : Is made of popular chromium alloy and is used for manipulation of the cements. DESIGN CHARACTERISTICS ! HAND C"TTING INSTR"MENTS : #arts : A hand instrument consist of the following essential parts. Handle or shaft : It is mostly straight and octagonal in cross5section and may be serrated to increase friction for hand gripping. They are available in various sizes and shapes. 6arge, heavy handles are not conducive to delicate manipulation; therefore most instrument handles small in diameter and light. Most hand instrument handles are a continuation of the shan$. If the hand and blade are separate from the handle and intended to be screamed into it, the instrument is $nown as a cone5soc$et instrument. The advantage with this cone5soc$et instrument is that, if the wor$ing end is bro$en, it may be easily replaced incurring less e-pense. The disadvantage is it tendency to loosen at the 2oint. Shan$ : It connects the shaft with the blade or wor$ing point. It is usually tapers from its connection with the point shaft to where the blade begins. Any angulation in the instruments can be placed at the 2unction of shaft and shan$. %lade & Nib : The wor$ing end of cutting instrument is called the blade whereas the wor$ing end of the non5cutting instruments such as condenser is called a nib. The wor$ing surface or end of the nib is called a face. It begins at the angle where the shaft is terminated. Cuttin' ed'e : It is the wor$ing part of the instrument. It is usually in the form of a bevel with different shapes.

%lade an'le : It is defined as the angle between the long a-is of the blade and long a-is of the shaft. Cuttin' ed'e an'le : It is defined as an angle between the margins of the cutting edge and long a-is of the shaft. INSTR"MENT N MENC(AT"RE : %r. 7.8. 9lac$ established a nomenclature for hand instruments, similar to the biological classification. (. :rder ; <urpose of instrument =g ; e-cavator or sealer. /. "uborder ; <osition or manner of use =g ; <ush, pull 4. >lass ; ?rom of wor$ing end, =g ; hatchet, chisel. ,. "ubclass ; "hape of shan$ =g ; Monoangle or binangle. 1aming usually moves rom , to (. INSTR"MENT ! RM"(A : %r. 7.8. 9lac$ gave an instrument formula that describes the dimension and angulation of the hand instruments. The basic formula consists of three units whose measurements are based upon the metric system. The (st figure represents ; the width of the blade in tenths of the millimeter. The /nd figure represents ; 6ength of the blade in millimeters. The 4rd figure represents ; Angle which the blade forms with the long a-is of the handle. This angle is e-pressed in ())th of a circle or centigrades. These three measurements are sufficient for describing a great percentage of instruments. #owever for instruments with their cutting edge at on angle. :ther than a right angle to the long a-is of the blade, a fourth

unit, cutting edge angle is added to the basic three unit formula. This additional number represents the angle formed between the cutting edge and the long a-is of the handle. It is placed in the second position of the formula, i.e., before the length of the blade for e-ample, a gingival marginal trimmer has a , unit formula. INSTR"MENT DESIGN : )* Direct Cuttin' Instrument : It is the instrument that force is applied in the same plane as that of blade and handle. It is called @single5planedA instrument. It may have / or more curveBangle in shan$ but all are in same plane to handle. It is used as direct and lateral cutting instrument. +* (ateral Cuttin' Instrument : Are those in which force is applied at a right angle to plane of blade and handle. They are called @%ouble5planedA instrument. They have curveBangle right angled to handle. It is used in only lateral cutting. ,* Contra an'lin' : To gain access shan$ ( or more bends to angle of blade relative to handle. Its e-tent depends on length of the blade. "o the wor$ing point is moved out of line with the a-is of handle. If this occur more than 4 mm from handle, the instrument is out of balance in lateral cutting motions and force required to control rotating of instrument. "o ( or more angels given in shan$ to $eep wor$ing point within 4 mm. <rinciple is called contra angling length of the blade determined by depth of cavity. 9lade angle determined by accessibility. "o greater angle for posterior teeth and incisal portion of the anterior teeth. -* Ri'ht and left instruments : Instruments are made rightBlight by placing bevel on one side of blade. If the cutting edge down pointing away from operator and bevel on right side, it is right instruments. If bevel on left side, it is left instrument.

"ingle planed instrument for direct cutting, the non5beveled side of blade should be in contact with wall being shaved. ?or lateral cutting acts, move instrument in scraping action from beveled side to non5bebelled side of the blade. in lateral cutting instrument, blade down, cutting edge away, the instrument have curve directed to right, is right instrument and if the instrument having curve directed to left is left instrument. .* Sin'le be/elled instrument : These are all single planed instrument. >utting edge right angle to long a-is of shaft. They are designed li$e carpenter chisel. If the bevel on the blade away from shaft ' distal. If the bevel on blade towards shaft. Mesial. Chen these type of instrument have no angle in shan$ or an angle of (/) or less, they are used in push direct cutting! or scraping motion bevelled to non5bevelled side!. If this e-ceed (/ ) instrument used in pull motion distal, beveled! and push motion mesially beveled!. 0* %ibe/elled instruments : #atchets and straight chisels ' bibevelled. 9lade equally beveled both sides and they are cut by pushing them in the direction of long a-is of blade. 1* Tri2le be/elled instrument : 9evelling blade laterally together with ends ' 4 edges. Mostly single planed instrument and small one are tripe beveled. This has additional cutting potential. 3* 5* Circumferentiall4 be/elled : :ccur in double planed instrument. 9lade bevelled at all peripheries. Sin'le ended and double ended instrument : %ouble ended ' Mesial, distal, right, left in same handle. "ingle ended ' only one specific function. %alance : 9alance allows for the concentration of force on to the blade without causing rotation of instrument in the grasps. 9alance accomplished by

designing angles of shan$ so that cutting edge lies within the pro2ected a-is of the handle and nearly coincide with pro2ected a-is of handle. ?or optimal antirotational design the blade edge must not be off a-is by more than ( ' / mm. Shar2ness : "harpness concentrates the force into a small area of the edge producing a high stress. )* Chisels : These are instruments designed after ordinary carpenterAs tools and are intended for planning and cleaning. These are characterized by a blade that terminates in a cutting edge formed by a one sided bevel. >utting edge of a chisel is at right angle to the shaft. There are following types of chisels available a* b* c* d* Strai'ht chisel : These have a straight blade in line with the handle and shan$. The cutting edge is on one side only. Mon an'le chisels : In these, the blade is placed at on angle to the shaft. It may be mesially standard! or distally Deverse! bevelled. %inan'le chisels : These have two angles between the shaft and the blade. It may be mesially or distally bevelled. Tri2le 6 an'le chisels : These have three angles in the shan$ and are usually used to flatten pulpal floor. It may also be mesially or distally bevelled. +* E7ca/ators : They are used for e-cavation and removal of caries and sharpening or refinement of the internal parts of the cavity preparation. T42es : a* Hatchet : A chisel ' bladed instrument with a cutting edge in the plane of the instrument is termed a hatchet. If the blade of a hatchet is at perpendicular angles to the shaft, the cutting edge would be parallel to

the shaft. These are poised i.e. D E 6, with an indented ring on the shan$ or shaft of the right instrument. >ertain hatchets are bibevelled also with the cutting edge in the centre. A22lication : These are used for delicate cutting within the preparation especially in incisors. b* Hoe e7ca/ators : A hoe is a descriptive term gives to a form of chisel in which the angle of the blade more nearly approaches a right angle i.e. /0 centigrade. It is a single planed instrument, which can be distally bevelled or mesially bevelled and used with pull motion. A22lication : These are used for cutting mesial and distal walls of premolars and molars. 9oth hatchets and hoes are used to remove harder varieties of caries as well as to give form to the internal parts of the cavity preparation. c* S2oon e7ca/ators : In these, the cutting angle is ground to a semi5 circular circumferential bevel and sharpened to a thin edge. These are available in pairs with the blade of one curved to the right, and the blade of the other curved to the left. The spoon e-cavators all double5planed instruments with right or left cutting movement only. A22lication : Fsed for removal of decayed dentin. d* Cleoid 8cla9 li$e) e7ca/ator : It is similar to the spoon e-cavator, e-cept that the blade resembles a claw, hence the name @cleoidA. It is used in carving amalgam and e-cavating decay from areas of difficult access. ,* a* S2ecial forms of chisels : These are designed to perform specific functions. Enamel hatchet : These are used for splitting or clearing undermined enamel in pro-imal cavities and on buccal and lingual walls where it is not possible to

use a chisel. The smaller sizes are primarily used in anterior teeth and larger sizes are mainly used in posterior teeth. b* Gin'i/al mar'inal trimmer 8G*M*T) : It is a used for forming sharp angles in internal parts of preparation! modified form of hatchet. Two distinct modifications of the basic hatchet design are noted as ; i! >utting edge of a hatchet is at a perpendicular angle to the a-is of blade while cutting edge of a gingival margin trimmer is at an angle other than a perpendicular angle to the a-is of the blade so a , unit formula!. ii! curved. iii! #atchet is a single plane instrument while 7.M.T with curved blade is a double plane instrument, so is primarily a lateral cutting instrument. It is paired with right and left sided bevels. 7.M.T. is used for creating a proper bevel at the gingival floor. It is also used for trimming the margins of various walls of cavity, preparation. c* An'le former : It is a modified form of chisel. In this instrument, the primary cutting edge is sharpened at a angle to the a-is of the blade. The angle of cutting edge to the blade a-is is usually +)5+0 ) , unit formula!. 9lade of the angle former is bevelled on the sides also, to form three cutting edges. The acute cutting angle being directed to the right or left ma$es the angle former a paired instrument. Dight of the pair is identified by an indented ring. It is a single planed instrument. It is used to accentual line and point angles in the internal outline form. It is frequently used in cavity preparation for cohesive gold to establish retention form. #atchet has a straight blade, the blade of a 7.M.T is

d*

:edelstaedt chisel : It is li$e a straight chisel, but with a slight vertical curvature in its shan$. It is bevelled on one side only which can be placed mesially or distally. It is used for cleaving undermined enamel and for shaping walls.

-* a* b*

Miscellaneous : Dental 2robes : 8arious types of probes are available, these can be straight, curved or graduated used in periodontology!. ;ni/es : 1ibs of these instruments carry $nife edges faces on one of their sides only the $nives $nown as finishing $nives, amalgam $nives are made in various sizes and shapes. They are used for trimming off e-cess filling material on the gingival,

facial or lingual margins of a pro-imal restoration or trimming and contouring the surface of a class 8 restorations. c* ;ni/es for s2ecific 2ur2oses : :ilson<s $nife : In this nib is in a plane at perpendicular angle to that of the shaft, so that it can be introduced interpro-imally for use. Stein<s $nife : It has a trapezoidal nib and is used mainly for direct gold restorations for continuous and margination. !iles : 1ib in files can be foot5shaped, hatchet shaped or parallelogram shaped with serrations of the serrations are directed away from the handle, it is a push file, and if the serrations are directed towards the handle, it is a pull file. These are used for smoothening of margins; if $nives and carvers are not sufficient to produce the requisite caw surface margins at the gingival and, files can be used to achieve above said requisite. INSTR"MENT GRAS#S :

It is more than 2ust a manner of holding the instrument and must be ta$en quite seriously otherwise bad habits may be acquired that result in loss of operating efficiency and accumulation of unnecessary strain on the operator. ?undamentally, there are four grasps used with hand instruments. )* #en 'ras2 : It is similar to the method of holding a pen, e-cept that the pulps of the thumbs, ( st and /nd fingers contact the instrument, while the tip of the 4rd and ,th fingers are placed on the ad2oining teeth as rests!. The position of /nd finger is important for good control and thrust to the instrument. This way, due to greater length of the / nd finger, the application point for the force will be near the wor$ing point of the instrument. +* In/erted 2en 'ras2 : This is similar to the pen grasp, but the hand is rotated so that the palm is facing upwards. It is usually used in upper teeth. 1ot used two frequently, but on certain occasions, depending on the area of operation, type of instrument used and position of the point and operator, modifications of the inverted pen grasps are used. ,* #alm and thumb 'ras2 : It is similar to the method of holding a $nife, when cutting a piece of wood. The handle is placed in the palm of the hand and grasped by the four fingers, while the thumb rests on an area other than that being operated on. A supporting rest provided by thumb is necessary because distal control is somewhat insufficient. This grasp is used when the thumb must rest at some point distant from the operating site. It may be used on ma-illary teeth particularly the right side, when wor$ing form the right rear chair position. Conclusion :

It has to be remembered that rotary instruments are for gross reduction, but refinement is brought about best by hand cutting instruments. Thus with this vision of hand cutting instruments letGs strive towards precision in operative dentistry.

C NTENTS
INTR D"CTI N META(S "SED IN THE MAN"!ACT"RE INSTR"MENTS DESIGN CHARACTERISTICS INSTR"MENTS INSTR"MENT N MENC(AT"RE INSTR"MENT ! RM"(A INSTR"MENT DESIGN INSTR"MENT GRAS#S C NC("SI N H# ! RMAT ! SEMINAR ! HAND C"TTING ! HAND

C ((EGE
DE#ARTMENT

! DENTA( SCIENCES

! C NSER=ATI=E DENTISTR> AND END D NTICS

SEMINAR

HAND C"TTING INSTR"MENTS

#RESENTED %> :
Dr* Siddhes9aran =*