Chapter 11

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Oral and Maxillofacial Surgery Instruments Chapter 11

Transcript of Chapter 11

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PERIOSTEAL ELEVATOR—MOLT

FUNCTION: To detach the periosteum from bone following an incision or to detach the gingivaltissues from around the neck of the tooth prior to placement of extraction forceps

FEATURES: Double ended with one round, blunted end and one pointed end

TRAY SET-UP: Used for most surgical procedures: extractions, gingivoplasty, alveoplasty, cystremoval

CLINICAL APPLICATION: 7A wax spatula or a Woodson #1 plastic instrument is sometimes used if a smallerperiosteal elevator is desired

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STRAIGHT ELEVATORS

FUNCTION: To loosen tooth or root from bony socket prior to placement of the extraction forceps

FEATURES: Straight handle and working end

Single rounded working end in several sizes

Often referred to by number—common sizes: 1, 34, 301

TRAY SET-UP: Tooth and root extraction

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ANGULAR ELEVATORS—CRYER

FUNCTION: To loosen tooth or root from bony socket prior to placement of the extraction forceps

FEATURES: Handles may be either large and straight or T-bar/crossbar design

Pointed working end in several sizes

Paired, right and left

Also called a “flag” elevator

Other common designs: Potts and Crane

TRAY SET-UP: Tooth and root extraction, impaction

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ANGULAR ELEVATORS—POTTS

FUNCTION: To loosen tooth or root from bony socket prior to placement of the extraction forceps

FEATURES: Handles may be either large and straight or T-bar/crossbar design

Rounded working end in several sizes

Paired, right and left

Other common designs: Cryer and Crane

TRAY SET-UP: Tooth and root extraction, impaction

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ANGULAR ELEVATORS—CRANE

FUNCTION: To loosen tooth or root from bony socket prior to placement of the extraction forceps

FEATURES: Large straight handle

Nonpaired, universal

Other common designs: Cryer and Potts

TRAY SET-UP: Tooth and root extraction, impaction

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ROOT TIP PICKS—ANGLED

FUNCTION: To loosen small root fragments from bony socket

FEATURES: Small elevator with thin, pointed, angled working end

Single or double ended

TRAY SET-UP: Tooth and root extraction, impaction

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ROOT TIP PICKS—STRAIGHT

FUNCTION: To loosen small root fragments from bony socket

FEATURES: Small elevator with thin, pointed, straight working end

Single or double ended

TRAY SET-UP: Tooth and root extraction, impaction

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SURGICAL CURETTES—DOUBLE ENDED/ANGULAR

FUNCTION: To remove tissue or debris from bony sockets

FEATURES: Spoon-shaped scraping instrument

Usually double ended and angular in several sizes

TRAY SET-UP: Extraction, impaction, and cyst removal

CLINICAL APPLICATION: Used following tooth extraction to ensure removal of debris and diseased tissue

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SURGICAL CURETTES—MOLT

FUNCTION: To remove tissue or debris from bony sockets

FEATURES: Single rounded working end with larger diameter handle

TRAY SET-UP: Extraction, impaction, cyst removal

CLINICAL APPLICATION: Molt #1 (pictured) also used to retract tissue flaps following incision

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HEMOSTATS

FUNCTION: To securely hold small items, clamp blood vessels, and remove small pieces of toothor bone

FEATURES: Angled or straight with locking, scissor-like handles

Common names: Mosquito, Kelly

Available in 43⁄4�, 51⁄2�, 61⁄4�, and 71⁄2�

TRAY SET-UP: Almost all surgical set-ups

CLINICAL APLICATION: Ratchet-type handles require some practice to open and close smoothly

Very versatile instrument used in all areas of dentistry

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NEEDLE HOLDERS

FUNCTION: To hold suture needle

FEATURES: Similar to hemostat but with a concave area on inside of each beak to allow forcurve of suture needle

TRAY SET-UP: Any surgical procedure involving an incision will require placement of sutures

CLINICAL APPLICATION: To avoid needle breakage, place the needle holder on the needle just beyond thesuture attachment point and at right angles to the curve of the needle

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SUTURE

FUNCTION: To close incision site

“Stitches” hold tissues in place during healing

FEATURES: Suture material attached to sterile stainless steel needle

Different sizes and designs of needles

Suture may be absorbable—plain or chromic gut, polyglycolic acid (PGA, Vicryl)or nonabsorbable—silk, polyester, nylon, polypropylene

Sized by diameter of suture material: 3–0 (000), 4–0 (0000), 5–0 (00000) mostcommon sizes used in dentistry (smaller number � larger diameter)

CLINICAL APPLICATION: Nonabsorbable sutures usually removed at 7–10 days postsurgical visit

Placed with needle holder or hemostat

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SCALPEL

FUNCTION: To cut soft tissue—a surgical knife

FEATURES: Often referred to as “Bard-Parker” or “BP”

Individually sterile wrapped for single use

Common blade sizes: #11 (a), #12 (b), #15 (c)

Metal, sterilizable handle for replaceable blades (d)

Disposable scalpel consisting of a plastic handle with attached blade (e)

TRAY SET-UP: Most surgical set-ups: impaction, extraction, biopsy, frenectomy, gingivoplasty,alveoplasty, incision and drainage, and apicoectomy

CLINICAL APPLICATION: For safety, blades are placed and removed from the metal handle with a hemostator a specially designed scalpel blade remover

Used blades should be disposed of in a sharps container

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SCALPEL BLADE REMOVER

FUNCTION: To safely remove blade from scalpel handle

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RONGEURS—SIDE-CUTTING

FUNCTION: To cut and contour bone—removes sharp edges of alveolar crest after extractionsfor better contour of alveolar ridge; removes exostoses

FEATURES: Scissor-type handle, cutting edges on side and top of beaks

TRAY SET-UP: Multiple extractions, alveolectomy/alveoplasty

CLINICAL APPLICATION: During use, bone will accumulate around cutting edges. Assistant should wipeworking ends with 4 � 4 periodically to remove debris.

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RONGEURS—END-CUTTING

FUNCTION: To cut and contour bone—removes sharp edges of alveolar crest after extractionsfor better contour of alveolar ridge; removes exostoses

FEATURES: Scissor-type handle, cutting edges on top edge of beaks

TRAY SET-UP: Multiple extractions, alveolectomy/alveoplasty

CLINICAL APPLICATION: During use, bone will accumulate around cutting edges. Assistant should wipeworking ends with 4 � 4 periodically to remove debris.

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BONE CHISEL AND MALLET

FUNCTION: To remove bone for better contour of alveolar ridge; remove exostoses, i.e., tori

TRAY SET-UP: Tori removal, alveoplasty

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BONE FILE

FUNCTION: To smooth bone for better contour of alveolar ridge, often following use ofrongeurs

FEATURES: Straight or curved working ends

Crosscut or straight cutting ridges

Double ended

TRAY SET-UP: Multiple extractions and impactions that require bone removal, tori removal,alveoplasty

CLINICAL APPLICATION: During use, bone will accumulate around cutting edges. Assistant should wipeworking ends with 4 � 4 periodically to remove debris.

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TISSUE SCISSORS—DEAN

FUNCTION: To cut and remove excess or diseased soft tissue

Also used to cut sutures after knots are tied during suture placement

FEATURES: 61⁄2�

Other common varieties of tissue scissors: Kelly, Iris

TRAY SET-UP: Gingivectomy/Gingivoplasty, frenectomy, multiple extractions

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TISSUE SCISSORS—IRIS

FUNCTION: To cut and remove excess or diseased soft tissue

Also used to cut sutures after knots are tied during suture placement

FEATURES: Straight or curved, 4� and 41⁄2�

Other common varieties of tissue scissors: Dean, Kelly

TRAY SET-UP: Gingivectomy/gingivoplasty, frenectomy, multiple extractions

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TISSUE SCISSORS—KELLY

FUNCTION: To cut and remove excess or diseased soft tissue

Also used to cut sutures after knots are tied during suture placement

FEATURES: Straight or curved, 61⁄4� and 7�

Other common varieties of tissue scissors: Dean, Iris

TRAY SET-UP: Gingivectomy/gingivoplasty, frenectomy, multiple extractions

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SUTURE SCISSORS

FUNCTION: To cut sutures for removal

FEATURES: One curved, hook-like tip to slip under suture

Holds suture away from tissue while cutting

31⁄2�, 41⁄2�, 51⁄2�, and 6�

TRAY SET-UP: Suture removal

CLINICAL APPLICATION: Suture removal often performed by the dental assistant. Wipe area clean with moistened 2 � 2, place curved scissor beak under suture near the knot, then graspthe knot with cotton plier or hemostat, and pull the suture out.

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TOWEL CLAMPS

FUNCTION: To secure surgical drapes and to secure plastic and rubber tubing to drapes

FEATURES: Sharp prong tips

31⁄2� and 51⁄4�

Additional use: Remove metal temporary crowns

TRAY SET-UP: Any procedure when face and head are draped to isolate surgical area

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TISSUE RETRACTOR—AUSTIN

FUNCTION: To deflect and retract the periosteum from bone following an incision

FEATURES: L-shaped with one rounded end and one forked end

Other common designs: Seldin, Senn

TRAY SET-UP: All surgical procedures

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TISSUE RETRACTOR—SENN

FUNCTION: To deflect and retract the periosteum from bone following an incision

FEATURES: Double ended with one rounded and one forked end

Other common designs: Austin, Seldin

TRAY SET-UP: All surgical procedures

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TISSUE RETRACTOR/PERIOSTEAL ELEVATOR—SELDIN

FUNCTION: To deflect and retract a tissue flap from bone following an incision

FEATURES: Double ended with round, blunted ends

TRAY SET-UP: Used for most surgical procedures: extractions, gingivoplasty, alveoplasty, cyst removal

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TONGUE AND CHEEK RETRACTOR—MINNESOTA

FUNCTION: To hold tongue and cheek away from surgical site

Other common designs: Shuman, Weider

TRAY SET-UP: All surgical procedures

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TONGUE AND CHEEK RETRACTOR—SHUMAN

FUNCTION: To hold tongue and cheek away from surgical site

Other common designs: Minnesota, Weider

TRAY SET-UP: All surgical procedures

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TONGUE AND CHEEK RETRACTOR—WEIDER

FUNCTION: To hold tongue and cheek away from surgical site

Other common designs: Minnesota, Shuman

TRAY SET-UP: All surgical procedures

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MOUTH PROP—BITE-BLOCK

FUNCTION: To keep mouth open with extensive procedures, sedated or disabled patients

FEATURES: Sterilizable rubber block in four sizes for children and adults

Other common design: mouth gag

TRAY SET-UP: Any procedure when patient may have difficulty keeping mouth open

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MOUTH PROP—MOUTH GAG

FUNCTION: To keep mouth open with extensive procedures, sedated or disabled patients

FEATURES: Rachet design with rubber tips

Other common design: bite-block

TRAY SET-UP: Any procedure when patient may have difficulty keeping mouth open

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SURGICAL ASPIRATING TIP—BYRD SELF-CLEANING

FUNCTION: To maintain a clear working field by removing saliva, blood, and debris

FEATURES: Built-in stylet to clear tip of bone or tooth fragments

Available in several diameters

Other common designs: Frazier, Cogswell

TRAY SET-UP: All surgical procedures

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SURGICAL ASPIRATING TIP—COGSWELL

FUNCTION: To maintain a clear working field by removing saliva, blood, and debris

FEATURES: Vacuum relief hole controls suction by covering/uncovering the hole with fingertip

Other common designs: Byrd, Frazier

TRAY SET-UP: All surgical procedures

CLINICAL APPLICATION: Tips are cleaned with long, flexible cleaning brushes

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SURGICAL ASPIRATING TIP—FRAZIER

FUNCTION: To maintain a clear working field by removing saliva, blood, and debris

FEATURES: Removable stylet to clear tip of bone or tooth fragments

Vacuum relief hole controls suction by covering/uncovering the hole with fingertip

Available in several diameters

Other common designs: Byrd, Cogswell

TRAY SET-UP: All surgical procedures

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SURGICAL ASPIRATING TIP—YANKEUR TONSIL ASPIRATOR

FUNCTION: To suction throat when using general anesthesia

FEATURES: Angled with perforated ball-type end for suctioning throat

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TISSUE PLIERS—ADSON

FUNCTION: To grasp and stabilize soft tissue flaps during suturing and reconstructiveprocedures such as gingival grafting

FEATURES: Similar in overall appearance to cotton pliers

Various serrated tips for securely grasping tissue flaps

TRAY SET-UP: Any surgical procedure requiring an incision and suturing

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TISSUE FORCEPS—ALLISON

FUNCTION: To grasp and stabilize soft tissue flaps during suturing and reconstructiveprocedures such as gingival grafting

FEATURES: Hemostat-type handles, serrated tips

TRAY SET-UP: Any surgical procedure requiring an incision and suturing

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EXTRACTION FORCEPS—#99 MAXILLARY ANTERIORS AND PREMOLARS

FUNCTION: To remove teeth from bony socket

FEATURES: Straight handle and beaks

Beaks designed to conform to facial and lingual root contour just apical to cervical line

Universal (both beaks same design-fit equally well on facial and lingual) for right and left quadrants

TRAY SET-UP: Extraction

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EXTRACTION FORCEPS—#150 (CRYER) MAXILLARY ANTERIORS AND PREMOLARS

FUNCTION: To remove teeth from bony socket

FEATURES: Beaks designed to conform to facial and lingual root contour just apical to cervical line

Universal (both beaks same design-fit equally well on facial and lingual) for rightand left quadrants

Maxillary counterpart to #151 Mandibular Cryer

TRAY SET-UP: Extraction

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EXTRACTION FORCEPS—#18R MAXILLARY RIGHT FIRST AND SECOND MOLARS

FUNCTION: To remove teeth from bony socket

FEATURES: Each beak has different design to adapt to the maxillary molar roots that differanatomically on the facial and lingual

Rounded beak contours to lingual root

Pointed beak contours to bifurcation of mesial–buccal and distal–buccal root #18Rand #53R are essentially the same instrument except that #18R has one curvedhandle while both handles are straight on #53R

TRAY SET-UP: Extraction

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EXTRACTION FORCEPS—#18 L MAXILLARY LEFT FIRST AND SECOND MOLARS

FUNCTION: To remove teeth from bony socket

FEATURES: Each beak has different design to adapt to the maxillary molar roots that differanatomically on the facial and lingual

Rounded beak contours to lingual root

Pointed beak contours to bifurcation of mesial–buccal and distal–buccal root #18Land #53L are essentially the same instrument except that #18L has one curvedhandle while both handles are straight on #53L

TRAY SET-UP: Extraction

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EXTRACTION FORCEPS—#53R MAXILLARY RIGHT FIRST AND SECOND MOLARS

FUNCTION: To remove teeth from bony socket

FEATURES: Bayonet design

Each beak has different design to adapt to the maxillary molar roots that differanatomically on the facial and lingual

Rounded beak contours to lingual root

Pointed beak contours to bifurcation of mesial–buccal and distal–buccal roots#53R and #18R are essentially the same instrument except that #18R has onecurved handle while both handles are straight on #53R

TRAY SET-UP: Extraction

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EXTRACTION FORCEPS—#53L MAXILLARY LEFT FIRST AND SECOND MOLARS

FUNCTION: To remove teeth from bony socket

FEATURES: Bayonet design

Each beak has different design to adapt to the maxillary molar roots that differanatomically on the facial and lingual

Rounded beak contours to lingual root

Pointed beak contours to bifurcation of mesial–buccal and distal–buccal roots#53L and #18L are essentially the same instrument except that #18L has onecurved handle while both handles are straight on #53L

TRAY SET-UP: Extraction

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EXTRACTION FORCEPS—#88R MAXILLARY RIGHT FIRST AND SECOND MOLARS

FUNCTION: To remove teeth from bony socket

FEATURES: Bayonet design

Each beak has different design to adapt to the maxillary molar roots that differanatomically on the facial and lingual

Beak with 1 projection contours to bifurcation of mesial–buccal and distal–buccalroots

Beak with two projections contours to lingual root

TRAY SET-UP: Extraction

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EXTRACTION FORCEPS—#88L MAXILLARY LEFT FIRST AND SECOND MOLARS

FUNCTION: To remove teeth from bony socket

FEATURES: Bayonet design

Each beak has different design to adapt to the maxillary molar roots that differanatomically on the facial and lingual

Beak with one projection contours to bifurcation of mesial–buccal and distal–buccal roots

Beak with two projections contours to lingual root

TRAY SET-UP: Extraction

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A B(A) Image courtesy of Hu-Friedy, www.hu-friedy.com. (B) Image courtesy of Miltex, www.miltex.com

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EXTRACTION FORCEPS—#210 MAXILLARY THIRD MOLARS

FUNCTION: To remove teeth from bony socket

FEATURES: Bayonet design

Beaks designed to conform to facial and lingual root contour just apical to cervical line

Universal (both beaks same design-fit equally well on facial and lingual) for rightand left quadrants

TRAY SET-UP: Extraction

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EXTRACTION FORCEPS—#65 MAXILLARY OVERLAPPING ANTERIORS AND ROOT TIPS

FUNCTION: To remove teeth, tooth fragments, and root tips from bony socket

FEATURES: Bayonet design

Universal (both beaks same design-fit equally well on facial and lingual) for rightand left quadrants

TRAY SET-UP: Extraction

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EXTRACTION FORCEPS—#69 MAXILLARY AND MANDIBULAR OVERLAPPING ANTERIORS AND ROOT TIPS

FUNCTION: To remove teeth, tooth fragments, and root tips from bony socket

FEATURES: Universal (both beaks same design-fit equally well on facial and lingual) for rightand left quadrants

TRAY SET-UP: Extraction

Oral

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EXTRACTION FORCEPS—#74 MANDIBULAR ROOT TIPS

FUNCTION: To remove tooth fragments and root tips from bony socket

FEATURES: Bird beak design

Universal (both beaks same design-fit equally well on facial and lingual) for rightand left quadrants

TRAY SET-UP: Extraction

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EXTRACTION FORCEPS—#101 ALL DECIDUOUS TEETH AND MANDIBULAR ANTERIORS

FUNCTION: To remove teeth from bony socket

FEATURES: Smaller overall

Beaks designed to conform to facial and lingual root contour just apical to cervicalline

Universal (both beaks same design-fit equally well on facial and lingual) for rightand left quadrants

TRAY SET-UP: Extraction

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EXTRACTION FORCEPS—#103 MANDIBULAR ANTERIORS AND PREMOLARS

FUNCTION: To remove teeth from bony socket

FEATURES: Straight handle and beaks

Beaks designed to conform to facial and lingual root contour just apical to cervicalline

Universal (both beaks same design-fit equally well on facial and lingual) for rightand left quadrants

TRAY SET-UP: Extraction

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EXTRACTION FORCEPS—#151 (CRYER) MANDIBULAR ANTERIORS AND PREMOLARS

FUNCTION: To remove teeth from bony socket

FEATURES: Beaks designed to conform to facial and lingual root contour just apical to cervical line

Universal (both beaks same design-fit equally well on facial and lingual) for right and left quadrants

Mandibular counterpart to #150 Maxillary Cryer

TRAY SET-UP: Extraction

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EXTRACTION FORCEPS—#15 MANDIBULAR FIRST AND SECOND MOLARS

FUNCTION: To remove teeth from bony socket

FEATURES: Beaks designed to conform to facial and lingual root contour just apical to cervical line

Universal (both beaks same design-fit equally well on facial and lingual) for rightand left quadrants

Pointed beaks contour to bifurcation area of mesial and distal root

#15 and #17 are essentially the same instrument except that #15 has one curvedhandle while both handles are straight on #17

TRAY SET-UP: Extraction

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EXTRACTION FORCEPS—#17 MANDIBULAR FIRST AND SECOND MOLARS

FUNCTION: To remove teeth from bony socket

FEATURES: Beaks designed to conform to facial and lingual root contour just apical to cervical line

Universal (both beaks same design-fit equally well on facial and lingual) for right and left quadrants

Pointed beaks contour to bifurcation area of mesial and distal root

#17 and #15 are essentially the same instrument except that #15 has one curvedhandle while both handles are straight on #17

TRAY SET-UP: Extraction

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EXTRACTION FORCEPS—#16 MANDIBULAR FIRST AND SECOND MOLARS

FUNCTION: To remove teeth from bony socket

FEATURES: “Cowhorn” forceps

Beaks designed to conform to facial and lingual root contour just apical to cervicalline

Universal (both beaks same design-fit equally well on facial and lingual) for rightand left quadrants

Pointed beaks contour to bifurcation area of mesial and distal root

#16 and #23 are essentially the same instrument except that #16 has one curvedhandle while both handles are straight on #23

TRAY SET-UP: Extraction

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EXTRACTION FORCEPS—#23 MANDIBULAR FIRST AND SECOND MOLARS

FUNCTION: To remove teeth from bony socket

FEATURES: “Cowhorn” forceps

Beaks designed to conform to facial and lingual root contour just apical to cervical line

Universal (both beaks same design-fit equally well on facial and lingual) for right and left quadrants

Pointed beaks contour to bifurcation area of mesial and distal root

#23 and #16 are essentially the same instrument except that #16 has one curvedhandle while both handles are straight on #23

TRAY SET-UP: Extraction

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EXTRACTION FORCEPS—#222 MANDIBULAR THIRD MOLARS

FUNCTION: To remove teeth from bony socket

FEATURES: Bayonet design

Beaks designed to conform to facial and lingual root contour just apical to cervicalline

Universal (both beaks same design-fit equally well on facial and lingual) for rightand left quadrants

TRAY SET-UP: Extraction

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SURGICAL HANDPIECE

FUNCTION: To place implants, remove bone, section teeth

FEATURES: Holds sterile water and equipped with pump for oral irrigation

Both straight and contra angle handpiece designs

Variable speed and torque

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LASER (LIGHT AMPLIFICATION BY SIMULATED EMISSION OF RADIATION)

FUNCTION: To remove soft tissue with minimal discomfort and bleeding

Laser also has bacteriocidal effects for enhanced wound healing

APPLICATIONS: Frenectomy, excision of lesions, gingivoplasty, crown lengthening, root canal therapy

CLINICAL APPLICATION: Laser beam is hazardous to eyes and skin. Patient, operator, and assistant mustwear special protective goggles and keep hands and body parts away from thebeam. Nonshiny instruments should be used to avoid reflection of laser energy.Smoke plume forms as tissue is vaporized; use high volume evacuation during procedure.

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ENDOSSEOUS IMPLANT FIXTURE

FUNCTION: To provide a root form for replacement of missing teeth

FEATURES: Cylindrical, screw-shaped device

Made of titanium alloy

Embedded within the alveolar bone

Provides support for a dental crown, bridge, or denture

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Photographs courtesy of Ed McGlumphy, D.D.S., M.S.,Associate Professor, Ohio State University, College of Dentistry.

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SURGICAL IMPLANT SITE PREPARATION KIT

FUNCTION: To remove and shape bone for placement ofan implant fixture

FEATURES: Multiple “drill” shapes and sizes

CLINICAL APPLICATION: An incision is made and a tissue flapdetached to expose the alveolar bone of theimplant site. Next, a surgical handpiece isused with the implant site preparation kit toshape a hole for the implant fixture. Theimplant fixture is placed and covered withthe soft tissue flap.

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Reprinted with permission from GladwinMA, Bagby M. Clinical aspects of dentalmaterials: theory, practice, and cases. 3rded. Baltimore, MD: Lippincott Williams &Wilkins, 2008.

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IMPLANT WRENCH/DRIVER

FUNCTION: To place implant screw or healing abutment on implant fixture

CLINICAL APPLICATION: The healing abutment extends above the oral mucosa. After the dental implant isstable and integrated with the bone, the top of the implant is exposed and the heal-ing abutment is placed. The gingiva heals and grows around the abutment creatingan esthetic gingival margin for the future implant crown.

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LifeART image copyright ©2010 Lippincott Williams &Wilkins. All rights reserved.

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BASIC EXTRACTION SET-UP

PURPOSE: To provide instrumentation for surgical removal of tooth/teeth.

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1. Local anesthesia syringe, needles, and cartridges

2. Sterile gauze

3. Surgical aspirating tip

4. Cotton pliers

5. Mouth mirror

6. Periosteal elevator

7. Straight elevators

8. Surgical curette

9. Hemostat

10. Extraction forceps (selected for specific tooth/teeth)

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74

8

910

1

2

53 6

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MULTIPLE EXTRACTION/ALVEOPLASTY/GINGIVOPLASTY SET-UP

PURPOSE: To provide instrumentation for surgically removing multiple teeth, reshaping boneand gingiva, and placing sutures.

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1. Local anesthesia set-up

2. Tissue retractor

3. Scalpel(s)

4. Mouth prop

5. Sterile gauze

6. Surgical aspirating tip

7. Cotton pliers

8. Mouth mirror

9. Periosteal elevator

10. Straight elevators

11. Tissue retractor

12. Surgical curette

13. Bone file

14. Extraction forceps (selected forspecific tooth/teeth)

15. Rongeur

16. Tissue scissor

17. Needle holder

18. Hemostat

19. Suture

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7

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8 9 1011 12 13

14

15

16

17

18

19

1

2

5

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IMPACTION SET-UP

PURPOSE: To provide instrumentation for surgically removing impacted tooth. Often involvesincision and bone removal.

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1. Anesthetic syringe, needles, and cartridges

2. Mouth prop

3. Tissue retractor

4. Austin tissue retractor

5. Surgical bur

6. Hemostat

7. Surgical aspirating tip

8. Mouth mirror

9. Cotton pliers

10. Periosteal elevator

11. Straight elevator

12. Crane pick

13. Angular elevators

14. Root tip picks

15. Surgical curette

16. Molt curette

17. Bone file

18. Tissue scissor

19. Extraction forceps

20. Needle holder

21. Scalpel(s)

22. Suture

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7

4

89

1011 12

1314

15

16

17

18

1920

21

22

12

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SUTURE REMOVAL SET-UP

1. Mouth mirror

2. Explorer

3. Suture removal scissors

4. Cotton pliers

5. Oral evacuator tip

6. Air/water syringe tip

7. 2 � 2 gauze

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