Instruments in Fixed Prosthodontics

Introduction to Instruments in Fixed Prosthodontics

• Instruments in fixed prosthodontics are crucial for preparing, shaping, and finishing tooth structures.
• They are used for both indirect and direct procedures ensuring accurate fits and aesthetics.
• Proficiency with these instruments is essential for creating high-quality restorations.

Types of Instruments

• Preparation Instruments: Used to modify tooth structure to accommodate the restoration. Includes burs, hand instruments, and diamond stones for various shapes and sizes.
• Finishing and Polishing Instruments: Used to prepare the margins, surfaces, and aesthetics of the restoration, improving its fit and appearance. This often includes finishing burs, finishing and polishing points, and diamond burs.
• Impression and Die-Making Instruments: Used for preparing dies for the fabrication of crowns, bridges, and other restorations which include impression trays and spatulas, different types of impression materials, and die-separation material.
• Cementation Instruments: Used to cement restorations onto prepared tooth structures, requiring accuracy and precision; often entails a proper selection and use of cement, along with cement applicators and brushes.
• Diagnostic Instruments: Used to evaluate the oral cavity for pre-treatment assessment, identifying the need for treatment and also determining the most suitable material(s) for the preparation.

Hand Instruments

• Chisels: Used for creating precise cuts and bevels.
• Hacksaws: Used for sectioning teeth into proper lengths.
• Files: Used for shaping.
• Mallets: Used for driving instruments and activating the process.
• Elevators: Used to remove specific elements of teeth or sections of teeth.
• Dental Probes: Used for probing around the gingiva and assess the health of the surrounding tissues.

Rotary Instruments

• Burs: Used for intricate tooth preparation.
• Diamond Burs: Used for cutting tooth structure.
• Carborundum Burs: Used for roughing and shaping.
• Finishing Burs: Used for smooth surfaces.
• Polishing Points: Used to create smooth, glossy surfaces.

Materials for instruments

• Steel and high-speed alloys: used for fabricating instruments and maintain their sharpness and strength.
• Diamond, silicon carbide, and other abrasives: used for cutting and shaping in rotary instruments
• Impression materials: used for creating molds.
• Cements: used for fixing the restoration.

Importance and Selection of Instruments

• Appropriate instrument selection is critical to achieve the desired outcome.
• Instrument size and shape must match the procedure and specific area.
• Assessing the condition of teeth is critical to proper preparation.
• Consideration of material properties of the restoration is a part of the instrumental selection.
• Proper maintenance and sterilization of instruments are crucial to prevent cross-contamination.

Instrument Handling and Usage

• Operators must follow standardized procedures and use the necessary protective equipment, like gloves, for safety.
• Maintaining the sterilization protocol and instrument preservation methods is essential to prevent contamination and maintain optimal performance.
• Operators must utilize a correct, precise, and efficient technique to avoid damage to the structures.

Instrument Care and Maintenance

• Periodic sharpening and cleaning of instruments.
• Regular sterilization procedures to prevent cross-contamination are crucial.
• Proper storage to keep instruments in optimal condition.
• Inspect for any signs of damage or wear.