Rotary cutting
instruments
ROTARY CUTTING INSTRUMENTS
The term “rotary
instruments” in dentistry
refers to a group of
instruments that turn on an
axis to perform a work such
as cutting, abrading,
burnishing, finishing or
polishing tooth tissues or a
restoration.
Classification of rotary instruments
Rotating instruments can be classified in various
ways:
Dental burs
Abrading tools
Polishing Agents
Polishing agents
The third category, although not used as often, is a
non bonded abrasive or polishing agent.
Used In the form of SLURRY, such as pumice or a
polishing compound, these are carried to the working
area with:
a polishing brush,
an impregnated cloth wheel
or a rubber cup.
Classification according to speed range
LOW / CONVENTIONAL SPEED : BELOW 6000
RPM
It is used for excavating caries with round burs, refining
cavity preparations, using sand paper disks,
marginating gold restorations and polishing procedures.
HIGH / INTERMEDIATE SPEED : 6000-100,000 RPM
It can be used for cavity preparations but not as
effectively as ultra speeds. Many finishing procedures
such as the placement of retentive grooves and bevels
are best performed at high speeds.
ULTRA / SUPER SPEED : ABOVE 100,000
RPM
This speed range is desirable for such operations as
bulk reduction, obtaining outline form and removing
metal restorations.
Common features of rotary instruments
Certain design features in common are the
shank, neck and head. Shank : The shank is
that part of the rotary instrument that fits
into the handpiece, accepts the rotary
movement from the handpiece and controls
the alignment and concentricity of the
instrument. The three commonly seen
instrument shanks are:
Straight handpiece shank
Latch type handpiece shank
Friction grip handpiece shank
DENTAL BURS
Bur is defined as a rotary cutting instrument
with cutting heads of various shapes and two
or more sharp edged blades, used as a rotary
grinder. Machine made burs were introduced
in 1891, which were made of steel. Later on
the carbide burs replaced the steel burs.
Composition
Depending upon their composition, dental burs can
be classified into 2 types :
stainless steel burs and
tungsten carbide burs.
STEEL BURS
Are cut from blank steel stock by means of a
rotary cutter that cuts parallel to the long
axis of the bur. The bur is then hardened and
tempered until its VHN is approx. 800. They
perform well in cutting human dentin at low
seeds, but dull rapidly at higher speeds or
when cutting enamel. Steel burs now are
used mainly for finishing procedures.
Tungsten carbide burs
It is a product of powder metallurgy i.e. a process
of alloying in which complete fusion of the
constituents does not occur. The tungsten
carbide powder is mixed with powdered cobalt
under pressure and heated in a vacuum.
A partial alloying or sintering of the metals take
place. A blank is then formed and the bur is cut
from it with a diamond tool.
The Vicker’s hardness number is in the range of
1650-1700
Classification of BURS
[Link] to their mode of attachment to the handpiece –
latch type or friction grip type.
[Link] to their composition –
stainless steel burs, tungsten carbide burs or a
combination.
[Link] to their motion –
right or left bur. A right bur is one which cuts, when it
revolves clockwise find a left bur is one which cuts when
revolving anticlockwise.
[Link] to the length of their head –
long, short or regular.
[Link] to their use –
cutting burs or those used to finish and polish restorations.
[Link] to their shapes –
round, inverted cone, pear shaped, wheel shaped, tapering
fissure, straight fissure, end cutting etc.
Bur shapes
The term 'bur shape' refers to the contour or
silhoutte of the bur head. The basic head shapes are
the round, inverted cone, pear, straight fissure,
tapering fissure and end cutting.
(a) Round bur
(b) Inverted cone bur
(c) Pear shaped bur
(d) Straight fissure bur
(e) Tapering fissure bur
(f) End cutting bur
Modification in the bur design
Modification in the bur design were seen with the
introduction of high speed hand pieces. The three other
major changes included:
1. Reduced use of crosscuts
2. Extended heads on fissure burs
3. Roundening of the sharp tip angles
Design of a dental bur
BLADE
RAKE ANGLE
BLADE ANGLE
LAND
CLEARANCE ANGLE
DESIGN OF DENTAL BUR RADIAL LINE
CLEARENCE
ROTATION FACE
-Ve RAKE ANGLE
RAKE FACE
O
+Ve CLEARENCE ANGLE
TOOTH/BLADE ANGLE
TOOTH
LAND
FLUTE/CHIP
SPACE
BUR BLADE
PLANE SURFACE
FOLLOWING
CROSS-SECTION OF BUR CUTTING EDGE
Factors Influencing Cutting Effectiveness And
Efficiency Of A Bur
Rake angle clearance angle and blade angle
Neck diameter
Spiral angle and crosscuts
Concentricity and run-out
Heat treatment
Influence of speed
Influence of load
Number of teeth or blades
RAKE ANGLES
Rake Angle: Is The Angle That The Face Of The Bur Tooth Makes With The Radial Line From The Center Of The Bur To The Blade
Referring to the direction of rotation, the angle
can be.
[Link]:
If the face is beyond or leading the radial line.
[Link]:
If the radial line and the tooth face coincide with
each other i.e. radial rake angle.
[Link]:
If the radial line leads the face i.e. the rake angle
is inside the radial line.
LAND, Clearence Angle
Land:
The plane surface immediately following cutting edge.
Clearance angle:
The angle between the back of the tooth and the
work: If a land is present on the bur, the clearance
angle is divided into:
Primary clearance:
The angle the land will make with work.
Secondary clearance:
The angle between the back of the bur tooth and
work.
If the back surface of the tooth is curved, the
clearance is called radial clearance.
Tooth angle:
This is measured between the
face and back. If a land is
present, it is measured between
face and land.
Flute or chip space:
The space between successive teeth.
FACTORS INFLUENCING THE CUTTING EFFICIENCY OF BURS
RAKE ANGLE
A negative rake angle is ideal and long lasting
such that the cut chip moves directly away from
the blade edge and fractures into the small bits
or dust and hence clogging prevented and
efficiency increased.
CLEARANCE ANGLE
Any slight wear of cutting edge will increase the
dulling perceptibility, hence a large clearance
angle will help in less raid dulling of the bur.
NUMBER OF TOOTH OR BLADES AND THEIR DISTRIBUTION
The number of blades on a bur is always even
because even numbers are easier to produce in the
manufacturing process. The number of blades on
an excavating bur may vary from 6 to 8 to 10.
Fewer blades provide increased space between the
teeth reducing clogging tendency. Burs intended
mainly for finishing procedures usually have 12-40
blades
RUN OUT AND CONCENTRICITY
Concentricity is a direct measurement of the symmetry of
the bur head. It measures how closely a single circle can
be passed through the tips of all of the blades. It indicates
whether one blade is longer or shorter that the others and
is a static measurement.
Run out is a dynamic test measuring the accuracy with
which all blade tips pass through a single point when the
instrument rotates. The average value of clinically
acceptable run out is about 0.023mm. it is the factor that
determines the minimum diameter of the hold that can be
drilled by a given bur.
DESIGN OF FLUTE ENDS
Dental burs are formed with two different
styles of end flutes:
[Link] revelation cut, where the flutes came
together at two junctions near a diametrical
cutting edge.
[Link] star cut, where the end flutes come
together in a common junction at the axis of
the bur.
The revelation type shows superiority in
cutting efficiency during direct cutting but in
lateral cutting both are equal.
A Man & His Tools Are Worth A
Thousand Times More
Than The Man Himself
A bad workman blames his tools
CURRENT CONCEPTS OF ROTARY
CUTTING PROCEDURES IN
OPERATIVE DENTISTRY
With the rotational speeds now available, tooth tissue can
be removed with almost phenomenal efficiency.
A carbide bur at 300,000 to 500,000 rpm moves through
tooth tissue with only a lightly directed force of 2 to 4
ounces. The technique has been likened to that of using an
air brush.
The rapidity with which tooth tissue removal is
accomplished means that the operator must have a clear
definitive concept in his mind of internal and external
cavity outline form.
Tactile discrimination related to the extent or amount of
tissue removed during a given cutting sequence is absent.
Ultra-speed tissue removal should be carried out with
adequate finger rests. The use of two hands for guiding the
handpiece provides maximum control of the cutting
instrument.
The bur action should be moved with a planing or wiping
motion, conservatively reducing thin layer after thin layer.
As the desired outline form is defined, the operator must be
mindful of end-cutting as well as lateral-cutting per
formance of the bur. Burs of small dimension are chosen so
that better control can be exercised.
Good visibility of the operative field is equally important.
This includes retraction of cheek, tongue, and floor of the
mouth, and adequate illumination.
Visibility may be impaired by mirror splatter from the air-
water coolant.
The application of a wetting agent to the mirror surface,
the attention of a trained assistant with a warm air jet and
an evacuating tip, and proper positioning of the patient,
allowing for the use of direct vision when possible, may all
contribute to improved visual and instrument access.
The fiber optic attachment on the handpiece provides
another source of illumination to the operating area.
It remains to be seen how widely this concept is accepted.
Isolation of teeth under a rubber dam for ultra-speed
cutting procedures requires some diligence on the part of
the dental assistant to gain complete recovery of an
atomized water spray by the evacuating tip.
Care must be exercised during cavity preparation to
minimize the trauma that rotary instruments can elicit on
gingival tissues. A carbide bur at ultra speeds is a coarse
abrading instrument capable of severely lacerating the
supporting tissues.
Hemorrhage that might ordinarily be indicative of the bur
contacting gingival tissue is rapidly dissipated by the air-
water coolant and removed by a high-velocity evacuator.
Lacerations may, therefore, occur without the operator's
awareness unless precautions are taken. Preoperative tissue
packs, the mechanical displacement of soft tissue with
cotton, a wooden wedge, or use of rubber dam isolation
each can greatly reduce the potential soft-tissue damage.
The selection of fine-grit diamond points with safe ends
when operating close to the free gingival margin, and the
HAZARDS WITH CUTTING
INSTRUMENTS
Pulpal precautions
The use of cutting instruments can harm the pulp by
exposure to mechanical vibration, heat generation, des
iccation and loss of dentinal tubule fluid and /or transection
of odontoblastic processes.
Enamel and dentin are good thermal insulators and will
protect the pulp if the quantity of heat is not too great and
the remaining thickness of tissue is adequate.
The longer the time of cutting and the higher the local
temperature produced, the greater is the threat of thermal
trauma. The remaining tissue is effective in protecting the
pulp in proportion to the square of its thickness.
Steel burs produce more heat than carbide burs because of
inefficient cutting.
The most common instrument coolants are air, or air-water
spray.
During normal cutting procedures a layer of debris,
described as a smear layer, is created that covers the cut
surfaces of the enamel and dentin.
The smear layer on dentin is moderately protective because
it occludes dentinal tubules and inhibits the outward flow
of tubular fluid and the inward penetration of microleakage
contaminants.
However the smear layer is still porous. When air alone is
applied to dentin, local desiccation may produce fluid flow
and affect the physiologic status of the odontoblastic
processes in the underlying dentin.
Air is applied only to the extent of removing excess
moisture, leaving a glistening surface.
Soft tissue precautions
The lips, tongue, and cheeks of the patient are the most
frequent areas of soft tissue injury. The handpiece should
never be operated unless there is good access and vision to
the cutting site.
With air turbine handpieces the rotating instrument does
not stop immediately when the foot control is released. The
operator must either wait for the instrument to stop or be
extremely careful when removing the handpiece from the
mouth so as not to lacerate soft tissues.
The large disc is one of the most dangerous instruments
used in the mouth. Fortunately such discs are seldom
required. They should be used with light, intermittent
application and with extreme caution.
Eye precautions
The operator, assistant, and patient should wear glasses
with side shields to prevent eye damage from flying
particles during some operative procedures.
Sufficiently strong high-volume evacuation applied by the
dental assistant near the operating site helps to alleviate
this problem. However, protective glasses are always indi
cated.
In addition to routine air-borne debris, occasionally there
may be particles produced by matrix failure of molded
abrasive cutting instruments. Hard matrix wheels may
crack or shatter into relatively large pieces.
Furthermore, precautions must be taken for prevention of
eye injury from unusual light sources, such as visible light-
curing units and laser equipment.
Ear precautions
Various sounds are known to affect people in different
ways. Soft music or random sounds like rainfall usually
have a relaxing or sedative effect.
Loud noises are generally annoying and may contribute to
mental and physical distress. A noisy environment
decreases the ability to concentrate, increases accident
proneness, and reduces overall efficiency.
Extremely loud noises such as explosions, or continuous
exposure to high noise levels can cause permanent damage
to the hearing mechanism.
Inhalation precautions
Aerosols and vapors are created by cutting tooth structure
and restorative materials. Both aerosols and vapors are a
health hazard to all present.
The particles that may be inadvertently inhaled have the
potential to produce alveolar irritation and tissue reactions.
Vapor from cutting amalgams is predominantly mercury
and should be eliminated, as much as possible, by careful
evacuation near the tooth being operated on.
The vapors generated during cutting or polishing by
thermal decomposition of polymeric restorative materials
(sealants, acrylic resin, composites) are predominantly
monomers. They may be efficiently eliminated by careful
intraoral evacuation during the cutting or polishing
procedures.
