INSTRUMEN

-UPDATE-

Drg. Arlina Nurhapsari.,SpKG

DETEKSI
 Dyes deteksi karies email :
Dyes Penggunaan dyes untuk
mendiagnosa early enamel lesions
belum mapan karena kemungkinan
dyes juga akan memvisualisasikan
tahap permulaan dari perawatan
remineralisasi.
Dyes deteksi karies dentin :
Dyes tidak mewarnai bakteri tetapi
mewarnai matriks organik dentin
yang mineral nya sedikit.
Dyes Kelemahan :
Dyes karsinogenik / toksik
Dye staining and bacterial
penetration are independent
phenomena, this limits the
usefulness of these dyes.
Dyes do not discriminate between
healthy and diseased tooth
structures.
 Teknik ini menggunakan argon laser (488
Qualitative Laser nm) dengan filtered blue light source.
Fluorescence pada jaringan gigi dikarenakan
Fluorescence adanya chromophores dare enamel. Pada
karies enamel terdapat perbedaan
fluorosensi karena hilangnya
chromophores.
Pada teknik QLF : blue light digunakan
menyinari permukaan gigi sehingga gambar
fluorescent dapat di tangkap oleh
komputer. QLF menunjukkan:
Titik hitam merupakan lesi
demineralisasi dan insipien.
Warna merah merupakan karies dan
plaq yang menandakan adanya bakteri.
 Keuntungan
Qualitative Laser Helps in detecting incipient caries.
Fluorescence Detects early caries adjacent to orthodontic
brackets and restorations.
Can detect failing fissure sealants.
Can monitor enamel erosion.
Convenient and fast.

Kerugian
It provides moderate sensitivity and
specificity.
High cost (Expensive).
Not able to differentiate caries, calculus or
hypoplasia.

DIFOTI
(Digital imaging fiberoptic
transillumination)
Light from DIFOTI probe is positioned on the
tooth, tooth is illuminated and resultant
images are captured by a digital electronic
charged coupled device camera (CCD) and
displayed on computer
Keuntungan :
Noninvasive
Instant image projection
Shows surface changes
associated with early deminer-
alization
Can detect even incipient and
recurring caries.

Kerugian :
Not able to measure the depth
of the carious lesions
Cannot differentiate dental
caries and stained deep fissures
Laser Doppler
Flowmetry

A, Laser Doppler flowmeter unit.

B, Mold made of quick-set putty with two
laser Doppler probes embedded.
C, Slow-speed round burs used to make
holes in putty for placement of probes.
D and E, Laser Doppler probes for
assessment of blood flow in anterior
teeth (D) and posterior teeth (E). F, Quick-
set putty with dental probes in position in the
mouth.
Laser Doppler
Flowmetry

G,Blood flow analysis readout. H. Fourier analysis of blood flow data.

 Prinsip LDF : Lampu merah dipancarkan dari
sumber cahaya; Jika berkas cahaya tersebar dari
Laser Doppler jaringan atau sel yg tidak bergerak, maka tidak ada
pergeseran dalam spektrum cahaya. Bila, cahaya
Flowmetry menyentuh sel yang bergerak di dalam pembuluh
darah, maka ada pergeseran spektrum cahaya.
Keuntungan :
Accurate
Reliable
Reproducible
Nonpainful
Luxation injuries
 Kelemahan :
Laser Doppler Terlalu mahal
Flowmetry Sensor harus dijaga agar tidak bergerak
untuk mendapat pengukuran yang akurat
Pengukuran LDF harus dilakukan 4 minggu
setelah trauma dan diulangi secara regular
hingga 3 bulan
Pigmen darah pada gigi yang mengalami
perubahan warna dapat menginterfensi
transmisi dari sinar laser sehingga dapat
menghasilkan positif palsu
Restorative
DENTAL AIR ABRASION UNIT

Video
LASER
(Light Amplification by Stimulated
Emission of Radiation)
Prinsip umum dari laser
1. Monochromatic : berarti bahwa
cahaya yang dihasilkan oleh laser
tertentu akan memiliki panjang
gelombang karakteristik. Jika
cahaya yang dihasilkan berada
dalam spektrum yang terlihat (400-
750 nm), maka akan terlihat
sebagai seberkas warna intens.
Penting untuk memiliki properti ini
untuk mencapai kerapatan daya
spektral yang tinggi pada laser.
LASER
(Light Amplification by Stimulated
Emission of Radiation)
3. Collimation : Artinya sinar laser terang
2. Coherence : Berarti semua cahaya
sempurna dalam fase saat dilepaskan.
Itu berarti bahwa tidak seperti sumber
cahaya normal, kontribusi individual
mereka dijumlahkan dan saling
menguatkan. Dalam sumber cahaya
biasa, sebagian besar energi hilang
karena gelombang fase saling
membatalkan satu sama lain.
sejajar saat meninggalkan aperture
laser. Properti ini penting untuk
transmisi yang baik melalui sistem
pengiriman
LASER
(Light Amplification by Stimulated
Emission of Radiation)

Video
LASER Bahaya yang bisa terjadi
(Light Amplification by Stimulated
Emission of Radiation) penggunaan laser
Ocular injury
Tissue damage
Respiratory hazards
Fire and explosion
Electrical shock.
ENDODONTI
LASER
Cleaning & Disinfecting

A to C, Erbium, chromium:yttrium-scandium-gallium-garnet (Er,Cr:YSGG) laser tips to create endodontic

access openings (A) and to instrument canals in anterior teeth (B),and posterior
teeth (C). D to F, Erbium:yttrium-aluminum-garnet (Er:YAG) laser tip being fitted for a stopper for working
length minus 1 mm of endodontic canal (D), entering the canal (E), and reaching measurement
depth (F). G, RCLase Side Firing Spiral Tip. H, Prototype of RCLase Side Firing Spiral Tip is shown in root
canal of extracted maxillary canine in which side wall of root was removed to enable visualization of tip.
ULTRASONIC
 Kegunaan ultrasonic :
1. Access refinement, finding calcified canals, and
removal of attached pulp stone
ULTRASONIC 2. Removal of intracanal obstructions (separated
instruments, root canal posts, silver points, and
fractured metallic posts)
3. Increased action of irrigating solutions
4. Ultrasonic condensation of gutta-percha
5. Placement of mineral trioxide aggregate (MTA)
6. Surgical endodontics: Root-end cavity
preparation and refinement and placement of
root-end obturation material
7. Root canal preparation
 Passive irrigation
Gelombang ultrasonik yang menginduksi dua
fenomena fisik: aliran dan kavitasi larutan irrigant.
ULTRASONIC Aliran akustik dapat didefinisikan sebagai gerakan
cairan dalam bentuk lingkaran atau pusaran di sekitar
berkas getar. Kavitasi didefinisikan sebagai
pembuatan gelembung uap atau ekspansi, kontraksi
dan / atau distorsi gelembung yang sudah ada
sebelumnya dalam cairan.
 Components of electronic apex
Apex Locator locators
Lip clip
File clip
Electronic device
Cord which connects above three
parts.
 Keuntungan :
Apex Locator Provide objective information with
high degree of accuracy
Accurate in reading (9098%
accuracy)
Some apex locators are also
available in combination with pulp
tester, so can be used to test pulp
vitality.
 Kerugian :
Can provide inaccurate readings in following
Apex Locator cases:
Presence of pulp tissue in canal
Too wet or too dry canal
Use of narrow file
Blockage of canal
Incomplete circuit
Low battery
Chances of over estimation
May pose problem in teeth with immature apex
Incorrect readings in teeth with periapical
radiolucencies, and necrotic pulp associated
with root resorption, etc. because of lack of
viable periodontal ligament.
Apex Locator
Kegunaan
Provide objective information with
high degree of accuracy.
Useful in conditions where apical
portion of canal system is
obstructed by:
Impacted teeth
Zygomatic arch
Tori
Excessive bone density
Overlapping roots
Shallow palatal vault.
In such cases, they can provide
information which radiographs cannot.
Useful in patient who cannot
tolerate X-ray film placement
because of gag reflex.
In case of pregnant patients, to
reduce the radiation exposure,they
can be valuable tool.
Useful in children who may not
tolerate taking radiographs,
disabled patients and patients who
are heavily sedated
Apex Locator
Kegunaan
Valuable tool for:
Detecting site of root perforations (Fig. 17.14D)
Diagnosis of external and internal resorption which have penetrated root
surface
Detection of horizontal and vertical root fracture
Determination of perforations caused during post preparation
Testing pulp vitality
Helpful in root canal treatment of teeth with incomplete root
formation, requiring apexification and to determine working length in
primary teeth.
Apex Locator
Basic Conditions for Accuracy of EALs
Whatever is the generation of apex locator; there are some basic
conditions, which ensure accuracy of their usage.
Canal should be free from debris.
Canal should be relatively dry.
No cervical leakage.
Proper contact of file with canal walls and periapex.
No blockages or calcifications in canal
 The first generation apex locator
Frekuensi tunggal arus searah untuk
Apex Locator pengukuran tahanan listrik. Rasa sakit
dan ketidaknyamanan sering dirasakan
dengan menggunakan tipe apex locator
ini.
The second generation apex locator
Yang dikenal sebagai apex locator
impedansi yang mengukur berlawanan
dari arus atau impedansi(resistensi arus
bolak balik (AC)). Kerugian dari generasi
ini adalah bahwa material
elektrokonduktif dalam kanal
mempengaruhi keakuratannya.
 The third generation apex locator (frequency
dependent apex locators) Disuplai oleh dua
Apex Locator frekuensi untuk mengukur impedansi di kanal.
Kerugian dari generasi ini adalah sensitivitas
terhadap cairan kanal dan mesin membutuhkan
baterai yang terisi penuh.
The fourth generation apex locator
Mengukur karakteristik impedansi menggunakan
lebih dari dua frekuensi. Kerugiannya termasuk
perlu dilakukan di kanal yang relatif kering atau
di kering sebagian.
The fifth generation apex locator
Dikembangkan pada tahun 2003 yang mengukur
kapasitansi dan resistensi rangkaian secara
terpisah.
 Terdapat 2 tipe
ENDO MOTOR Rotary motor
Reciprocate + rotary motor

Terdapat 2 pengaturan :
Speed (kecepatan putar)
Torque (kekuatan putar) high torque
lebih efektif namun lebih mudah patah
The amount of torque is related to:
mass of the instrument
canal radius
apical force when worked in the canal.
Heat instrumen
Thermoplastic
obturation system
backfill

Video
Thermoplastic
obturation system
Thermalfill

Video