Partial chapter 19

1. Instrument Transfer and Maintaining
the Operating Field
Chapter 19

2. Instrument Transfer
• Proper instrument transfer occurs when:
– Operator’s view remains on oral cavity
– Stress and fatigue are reduced
– Safety and comfort are maintained
– Production is increased with less motion

3. Instrument Transfer
• Transfer zone
– Area just below patient’s nose near chin
• Fulcrum
– Point of rest on which fingers are stabilized
and can pivot
• Tactile sensation
– Feeling sensed by touch

4. Instrument Transfer
• Transfer hand
– Assistant passes and receives instruments
with left hand while working with right-
handed dentist
– Assistant passes and receives instruments
with right hand while working with left-
handed dentist

5. Instrument Grasps
• Pen
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• Modified pen
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6. Instrument Grasps
• Palm
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• Palm-thumb
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7. Instrument Grasps
• Reverse palm-thumb
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8. Eight Basic Instrument
Transfer Methods
1. Primary working end should be placed away
from assistant on tray
2. With straight-shank instruments, primary
working end should be placed toward
assistant

9. Eight Basic Instrument
Transfer Methods
3. With hinged instruments, beaks are placed
toward assistant
4. Hold instrument between thumb and index
finger and middle finger

10. Eight Basic Instrument
Transfer Methods
5. With pen grasp instrument, pick up
instrument from tray near end closest to
assistant
6. Assistant’s hand is placed on instrument
opposite from end operator uses

11. Eight Basic Instrument
Transfer Methods
7. Rotate working end of instrument until it is
directed toward dental arch being treated
8. Hold instrument to be passed parallel to
instrument held by operator

12. Instrument Transfer Methods
• Instruments transferred by:
– One-handed transfer
– Two-handed transfer

13. • What grasp would you use when using a
Wedelstaedt?
– Palm-thumb grasp

14. Instrument Transfer
Modifications
• Mirror and explorer
transfer
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15. Instrument Transfer
Modifications
• Cotton pliers transfer
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16. Instrument Transfer
Modifications
• Scissors transfer
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17. Instrument Transfer
Modifications
• Dental handpieces
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18. Instrument Transfer
Modifications
• Air-water syringe transfer
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19. Maintaining Operating Field
• Lighting
– Positioning
– Illumination of
oral cavity
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20. Maintaining Operating Field
• Evacuation system
– Remove water, saliva, blood, and debris
– Hose, evacuation tip, and handle
– Grasps
– Placement

21. Placement for Evacuation
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22. Placement for Evacuation
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23. Placement for Evacuation
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24. Placement for Evacuation
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25. Maintaining Operating Field
• Saliva ejector
– Removal of saliva
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26. Maintaining Operating Field
• Air-water syringe
– Emits water, air, or
combination of both
– Rinse mouth
– Dry areas of mouth
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27. Maintaining Operating Field
• Retraction of tissues
to increase visual field
– Mouth mirror
– Mouth props
– Gauze
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28. Isolite System
• System to maintain clear, dry field for
operator
• Provides:
– Isolation
– Retraction
– Evacuation
– Light source

29. Techniques for Moisture
Control and Isolation
• Cotton rolls
– Come in various sizes and shapes
– Isolate area
– Rest evacuator
– Place materials
– Serve as something on which patient can
bite

30. Techniques for Moisture
Control and Isolation
• Dry angles
– Triangular, absorbent
pads
– Absorb flow of saliva
and provide surface
for cheek retraction
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31. Expanded Functions
• Taking x-rays
• Placing and removing
rubber dam
• Coronal polishing
• Taking study model
impressions
• Placing sealants
• Making provisionals
• Placing bases and
liners
• Taking photographs
• Performing orthodontic
procedures
• Removing sutures
• Placing periodontal
dressing