Introduction to Dental Equipment

Brief introduction to the equipment and devices that could be found at any dental clinic or center, with an introduction to basic of principles of the dental chair and the Class B autoclaves.
There are also some explanations about certain small devices such as endodontic rotary devices

1. Introduction to Dental Equipment Inventory Prepared by: Eng. Ibrahim Tayyan

2. Dental Clinic

3. Items Available at Every General Practice Office Dental Cabinets: for storage of consumables, disposables, instruments, burs, handpieces and other small materials Consumables: materials that are used during treatment procedures, whether they are consumable tips or endo files of certain small devices, or biomaterials that are orally intraorally placed. Disposables: items that must be disposed after single usage, and normally are items that are of daily usage by anyone (e.g. gloves, sterilization pouches, waste bags, cotton rolls, etc..) Instruments: general small tools that are used examine, manipulate, treat, restore and remove teeth and surrounding oral structures (e.g. mirror, forceps, excavators, etc..) Handpieces: drill attachments to dental units or small auxiliary devices that are used for cutting, polishing and finishing the teeth (Will explain in further details) Cabinet Consumables Disposables Instruments

4. Treatment Dental Chairs Treatment Chairs Dental Compressors Dental Surgical Suctions Dental Stools

5. Other Essential Dental Equipment Steam Sterilizers Intraoral X-ray Sealer Machine

6. Small Dental Devices Such devices are found only at specific clinics according to the specialty of the dentist or found built-in in the chair Endo Rotary Devices Light Cure Consoles Implant Motors Dental Laser Piezosurgery Ultrasonic Units Air polishers Amalgamators

7. Medium to More Advanced Dental Equipment Bleaching Device Dental Microscopes CAD/CAM Systems Sedation Machine Extraoral Imaging Systems Navigation Systems

8. Dental Treatment Centers Basics of treatment chairs and its components

9. Dental Treatment Units Operating Light Monitor Display Patient Chair Dentist Element Assistant Element Foot Control Chair Base Supporting Arms Cuspidor

10. Patient Chair Components: A B C A. Headrest: For Most models the adjustment of the headrest is done by hand. Very few models have the headrest motor driven or controlled due to being expensive. They come in different types: flat, single or double articulating and motor driven B. Backrest: is normally controlled by a dental linear chair actuator to recline from seating position to rest or emergency one C. Seat: is controlled by a chair seat lift actuator to move upwards and downwards Double Articulating Head: The most preferred headrest types D E E. Chair Elevation System: The place where the lift actuator is located D. Seat Recline System: The place where the backrest actuator is located Backrest Actuator Seat Actuator

11. Dentist Element It has 2 main functions: It is the part where main handpieces are located for treatment use The control panel is located there. Control Panel: From there you can control the movement of the chair You can also store your favorite position settings or presets You switch on and off the operating light and adjust illumination You switch on and off cup filler and spittoon sink and adjust the time period for cup filling and sink flow duration Water/ Airway Syringe High and low speed Handpieces Ultrasonic Scaler Intraoral Camera

12. Dentist Element You can use one handpiece at a time by removing it from its position or holder Most dental chairs can hold 5 different handpieces and such a chair is called a 5-position chair After you remove the required handpiece that is attached into a hose, you can initialize the rotation of the handpiece’s bur by pressing on the foot control The foot control can also be used to adjust the position of the patient chair, and by pressing on one of the buttons available, you may position the chair to the emergency position You can control the water flow for each hose from the knobs that are found below the element tray (box)

13. Dentist Element There are different styles for the way the hoses are set at the dentist element. The most common two configurations are whip and traditional dentist element Whip Type or Continental: The hoses are arranged at whip holders that are located above the element box Traditional Type (Hanging Hoses or OTP): Hoses are arranged below the element box

14. Dentist Element Inside the dentist element, there are different components that are there for controlling the activated handpiece The long rectangular electronic board for example detects the hose that has been removed from its holder and then send certain electronic signals to the solenoid valves or blocks to permit or stop the flow of water or air through the hose from inside depending on the press on the foot control switch A solenoid valve is an electrically activated valve, typically used to control the flow or direction of air or liquid in fluid power systems Solenoid valves are used in both pneumatic and hydraulic fluid power systems

15. Dentist Element There are three universal types of hoses in which the handpieces and/or handpieces couplings are attached into them: Borden, Midwest and Fiber Optic The Borden one is rarely used and it will no longer be available in the coming years as it is an obsolete technology The other two types are the most common used types, with the Midwest being somehow more available due to its price Difference between Midwest and 6-hole one is that we can attach an LED light to the latter for better visualization while using the handpiece Each hole is a different path for air compressor, exhaust air, coolant water and air

16. Handpieces on Dentist Element Dental   Handpiece  is a hand-held, mechanical instrument used to perform a variety of common dental procedures, including removing decay, polishing fillings, and altering prostheses The handpiece itself consists of internal mechanical components which initiate a rotational force and provide power to the cutting instrument, usually a dental burr High Speed (Turbine) Low Speed (Contra-angle) Low Speed (Straight)

17. Handpieces on Dentist Element Non Fiber Optic Turbine Head Fiber Optic Turbine Head Turbines are high-speed handpieces that run at 250,000 to 400,000 rpm The turbine holds the bur or cutting instrument while rotating from high pressure compressed air A turbine consists of five components: spindle; chuck; impeller; bearings; and two "0" rings Turbines could be classified by their head diameter size or by the availability of LED light in it. Turbine Coupling Most models of turbines are attached to the hose through a turbine coupling Turbine incorporates ceramic balls, usually silicone nitride, instead of steel. Ceramic balls are harder but lighter than steel, thereby providing a longer wear life with less stress on the bearing retainer

18. Handpieces on Dentist Element Low speed handpieces are handpieces that operate at speeds up to 40,000 rpm You attach a contra-angle into a low speed motor that is attached to the motor hose There are three different types of motors: Air motor (driven by air compressor), brushed and brushless DC motors The speed of electric driven motor is not variated as you press on the foot switch

19. Handpieces on Dentist Element Contra-angle handpieces are color coded according to their gear ratio Gear ratio: the gears will either increase or decrease the transmission speed Green color for example has a gear ratio of 6:1. If we used a motor with a speed of 42,000 and attached to it a 6:1 contra, the resultant speed will be 7,000 rpm However, the contra-angle also has a maximum allowed speed to run

20. Handpieces on Dentist Element You cannot choose to use only high speed or only low speed handpieces since each of them has different indications of usage A good handpiece is titanium coated with LED for aiding visualization with a good friction bearing and reasonable torque Torque: It is the ability of the handpiece to withstand lateral pressure on the revolving tool without decrease its speed or cutting efficiency. Dependent -bearing and the amount of energy supplied to the handpiece Handpieces will emit water through nozzles around the head of the handpiece to prevent heat between the bur and the tooth the dentist is working on Turbines and contra-angle handpieces must be cleaned and lubricated to increase the life time of the inner gears

21. Other Handpieces at Dentist Element Triple way syringe: It is a dental device that supplies a focused stream of compressed air, water, or combination of both, frequently used to clean a tooth surface during dental treatment Ultrasonic Scaler: It uses tips that vibrate to do dental cleaning at the gingiva and in the spaces between the teeth to remove plaque buildup Intraoral Camera: It is used to capture still images or record videos of the teeth

22. Assistant Element It is the part where the suction hoses and other auxiliary handpieces are located and they are used by the dental hygienist or by the assistant You may find here an additional 3-way syringe and an additional small control panel may be available A B A: HVE (High volume suction hose) B: Saliva Ejector C C: Built-in Light Cure: Curing light is used for the polymerization of light-cured resin-based materials. Almost all resin composites, dental adhesives and adhesive cements utilize light energy for complete polymerization

23. Cuspidor

24. Safety Switches In case someone has unintentionally moved or bumped into these locations while the chair is moving, the chair will give an alarm beep then halts movement of the chair

25. Water Unit: Inside this box you will find the suction pumps and drainage systems There are different types of built-in suction systems: Air venturi , standard wet suction, automatic separator and amalgam separator These pumps and separators allow the chair to be connected to a central or single suction system that is externally installed

26. Water Unit: Air Venturi Systems: A suction machine is not necessary for the operation of an air jet pump at the treatment center Standard Wet Suction: Ready to be connected to external wet suction machine Automatic with amalgam separator: Automatic Separator Provides waste water disposal / suction for a dry suction system. Amalgam Separator centrifuge to separate solids (amalgam) from the waste water

27. External Suction Systems: Suction units range from models which can be operated on 1 dental chair to systems that can be operated to 12 dental chair and even more There are two types of suction techniques: Wet or Dry Wet dental vacuum systems use water to create vacuum pressure Dry vacuum pumps create vacuum pressure by pumping air out of the vacuum chamber

28. Operating Lights: There are two types of operating lights available: Halogen Lamp and LED A halogen light operates much like a standard incandescent bulb found in most homes. An LED (light emitting diode) is comprised of a single physical element called a semiconductor. Halogen Lamp LED Lamp

29. Operating Lights:

30. Dental Stools (For Dentists and Assistants) The saddle stool combines the healthy posture of standing with the advantages of a stable and comfortable sitting

31. Chair Base The chair base is the place in which the following components are inside: Power switch and power supply The unit’s main PCB (electronic board) The water and air inlets Ethernet port (Connecting it to a PC for diagnosing errors or upgrading the firmware where necessary

32. Chair Base

33. Dental Compressors Dental Compressor compresses, cleans, dries and stores air, which powers handpieces and certain functions of dental treatment centers and hand-piece cleaners The Dental Air Compressor is distinct to dental surgeries as they lower the dew point of the compressed air, removing impurities via an inline filtration system and removing moisture from the air through a compressed air dryer to protect your handpiece, ensure dry air from the 3:1 and eliminate bacteria There are two types of compressors: oiled and oil-less Oil-less is much safer to the patients with lower risk of contaminating the air with lubricant

34. Dental Compressors Some compressors are capable of operating one dental chair at a time while others could operate upto 15 different chairs and even more This depends on: Air Tank Volume Number of cylinders and heads Flow rate Horse power

35. Hygiene Systems Basics of Sterilization and Hygiene

36. Sterilization At the end of each treatment, the instruments used must be 100% clear of germs (autoclaved) to prevent any infection transmission between patients There are different methods of sterilization used in medical institutions: Heat, Chemical and Radiation Each method comprises of different types ( e.g the heat method may include: flaming, dry heat, steam and others..) The steam sterilization is the most common method and it is used at nearly all of the dental clinics worldwide The autoclave (steam sterilizers), is a device that uses steam heat to kill any microbial life that may be present on a contaminated Load.

37. Steam Sterilization There are three classes of steam sterilization: Class N (naked solid products), Class S, and Class B (big small autoclaves) Sterilization using a steam sterilizer is recommended as the most efficient, cost effective and safe method of sterilizing dental instruments in primary care dental practices. The sterilization process must be validated to ensure that instruments are reliably and consistently sterilized using predetermined and reproducible conditions To kill microorganisms, the instruments need to be exposed to steam at a specified temperature for a specific holding time (Usually 134 C for 4 minutes) These cycles differ in the manner in which air is removed, the types of load they can sterilize, and whether or not items can be wrapped during sterilization In Class N, air is directly replaced by steam, while in Class B, air is removed and replaced by vacuum them the steam starts to gradually enter the chamber.

38. Class B Principle of Operation Starting Process: You put the wrapped instruments on the sterilization tray and insert the tray into the milling chamber and shut the door completely. Air Removal Process: Vacuum pump removes air from the chamber at different phases Heating: Once all the air is removed, the steam generator will inject small burst of steam into the chamber until the pressure and temperature reaches the appropriate parameters to start the sterilization time (holding time) Sterilization : Once the temperature and pressure is reached the system will maintain this temperature and pressure throughout the sterilization time. This is the stage where the sterilization takes place.

39. Class B Principle of Operation 5. Pressure Release : The exhaust valve/solenoid valve will open to release the pressure/steam inside the chamber until the pressure is equal to atmospheric pressure. 6. Drying: After all the air is exhausted after the sterilization cycle. The vacuum pump will again pump out all the moisture and steam from the load until the load is completely dry. The heating elements around the chamber will stay on to allow the water to evaporate into gas and be pumped out by the vacuum. 7. Completion: After the drying is done, the cycle is complete and you can open the door

40. Notes Regarding Using the Autoclave Use only distilled water for sterilization process, either by filling manually the feed tank above the machine or by connecting it to a water distiller or treatment machine that purifies tap water The machine will give an error message if the conductivity sensor reads more than 10 micro siemens or such reading (Conductivity sensor measures the purity of feed water) The machine should be slightly be tilted backwards upon installation to prevent undried instruments problems You should not exceed the weight limit of the instruments or else instruments will be undried after process is finished There are certain pre-programmed cycles to use: Universal, Quick, Prion and others

41. Full Hygiene Systems There are systems that are used for cleaning and lubricating the handpieces automatically instead of manually clean them by tap water and lubricate them using a lubricant oil There are also systems that may perform sterilization for handpieces in addition to cleaning You place number of handpieces (usually not more than 6) and hang them on a holder them close the chamber and start the process The autoclave class for such systems is Class S The whole process of cleaning, lubricating and autoclaving takes around 12 minutes only

42. Full Hygiene Systems

43. Root canal Treatment Devices Used for Root Canal Treament

44. What is RCT Root canal treatment  (also known as  endodontic therapy ,  endodontic treatment , or  root canal therapy ) is a treatment sequence for the infected pulp of a tooth which results in the elimination of infection and the protection of the decontaminated tooth from future microbial invasion

45. What is RCT

46. Devices Used for Root Canal Treatment Endo Motor Console: It is a device that uses endo rotary files to clean and shape the root canal It consists of a motor, low speed 6:1 contra-angle and control pad with display There are different types of endo files that you attached on the contra-angle as there are different systems used for root canal treatment. Each company has it owns system, and for every system the files are color coded depending on size and other parameters On the control pad, you choose the system you want to use, then you choose the designated file according to the color code and type You may also adjust speed and torque when necessary

47. Devices Used for Root Canal Treatment Apex Locator: it is used along with the motor device to detect whether the endodontic has reached the apex of the root or not Its principle is similar to the proximity sensor that is used our cars Obturation Device: It is used to inject gutta percha after the pulp is cleaned Gutta Percha Oven : For heating the gutta percha