Instruments in Oral Surgery Jan 18, 2008

Hemostats vs. Needle Holders Used for placing and removing surgical blades Needle holders Have gold loops Used specifically for pushing needles and suturing

Hemostats vs. Needle Holders

Full Thickness Flaps Mucosa, Submucosa and Periosteum Submucosa contains nerves, arteries, veins and lymphatics We raise full thickness flaps in O.S. Less swelling Less bleeding Less pain

Chisels Monobevel- Remove bone Bibevel Split Teeth

Elevators 301-smallest 34 46S-Largest

301 Elevator Lever action Displacement Smaller root tips

34 Elevator Lever action Displacement Most teeth and larger root tips

46S Elevator Lever action Displacement Most teeth and larger root tips

Curved Cryers Max. Impacted 3rds Molars ONLY Like a spoon, roll them out

Cryer Elevator Wheel and axle Adjacent empty socket Mandibular first molars Needs sharp tip i.e. no purchase point

East/West Wheel and axle Adjacent empty socket Mandibular first molars Needs sharp tip i.e. no purchase point

Miller Elevator Wheel and axle Impacted maxillary thirds NOT erupted maxillary thirds Place at MB of third molar below HOC and roll to the distal

Potts Elevators Max. Impacted 3rds Molars ONLY Wheel and axle Miller elevator with “T” handle Can deliver more force

Bone File Used for superficial smoothing Only used with a pull-stroke Otherwise you burnish the bone

Rongeur #4A Side cutting and end-cutting rongeurs Used by general dentists Cut bone by means of pinching

Rongeur #5 Large-bladed, side cutting rongeurs “Bone forceps”- cuts bone rather than pinching bone Can easily pinch or cut lips and cheek tissue

Molt Curette 2/4 #2 end is smaller to enucleate a cavity, cyst, granulomas, etc.

Minnesota Retractor Retract mucoperiosteal flap Protect mucosa during cutting Rest on bone ONLY

Periosteal Elevator Start with the pointed edge Reflect the flap with the broad end

Clover Leaf Sweetheart retractor, “Weider”

Austin Retractor Place down on bone, retracts cheek and protects

Bone Thickness The thinnest bone is on the lingual of the third molar region Most common place to find bone spicules If bone spicule is attached to bone, reflect flap If bone spicule is separated, pull it out with tweezers, adson forceps

Forceps Designed to attached to the anatomical crown of teeth 150 max. universal 151 mand. universal 150S/151S- pedo max. and mand.

Forceps Maxillary forceps have a gradual S-shaped curve Mandibular forceps have 90 degree bend

150/151 Forceps

Anterior Forceps Maxillary- #1 or #99 Anterior Cuspid to Cuspid- specific! Mandibular- 74 (Ash) can also use on the premolars

#1, #99 Forceps

74N Forceps

Broken Crowns Due to IRM, Deep decay, Temp. crowns, RCT “brittle teeth” 88R, 88L- maxillary 1st and 2nd molars Need furcation to engage forceps 1 prong between buccal roots 2 prongs cradle the palatal root Expands the buccal plate, can break roots and crush tissue

88R and 88L