Instruments Used in Oral Surgery Oral Surgery

7/25/2019 Instruments Used in Oral Surgery Oral Surgery

1/41

INSTRUMENTS USED IN ORAL SURGERY


2/41

GENERAL SURGICAL INSTRUMENTChittle Forceps

Instruments used for lifting out sterile instruments from autoclae or instrument tra!"

It #as long #andles and long$ angulated and serrated %ea&s for %etter gri'"

(#en not in use %ea&s are 'laced di''ed in antise'tic solution"


3/41

Swab Holding Forceps

T#is is also an instrument )it# long #andles %ut straig#t %ea&s )#ic# are fenestrated

in t#e ends"

It is used for #olding t#e s)a% di''ed in an antise'tic solution for 're'aring t#e

surgical field"

Towel Clips

Instruments used to #old t#e 'atient*s dra'es in 'lace

Also used to cli' on t#e suction tu%es$ drills

on to t#e dra'es to #old t#em in 'lace"

It can also %e used to #old tongue and retract it for)ard in an unconscious 'atient"


4/41

Hemostat (artery forceps)

T#ese are t#e instruments used to clam' %leeding essels +arteries and eins,"

Also used to #old t#e essels for ligation"

T#e! #ae narro) ta'ering %ea&s )it# transerse serrations"

T#e #andle #as a latc# called rac#et"

T#e! can %e of different t!'es straig#t$ cured and come in different si-es"

A small arter! force's is also &no)n as mos.uito force's"


5/41


6/41

Scissors

Dissecting scissors can %e used for incising soft tissue fla's$ e/cising 'at#ological soft

tissue and can %e used for %lunt dissection into t#e dee'er la!ers"

Dean*s suture cutting scissors are used for cutting suture materials"

Dissecting scissors usuall! #ae narro)er %lades t#an a suture cutting scissors and

ma! %e straig#t or cured$ s#ar' ended or %lunt ended scissors"

Needle Holder

It is used to #old t#e suturing needle"

Dean*s suture cutting scissors #as %roader %lades and ma! %e straig#t or cure"


7/41

It #as s#ort %lades )#ic# #ae crisscross serrations and grooe in t#e centre"

It #as rac#et to #old t#e needle firml!"

T#e #andle of t#e instrument are #eld %et)een t#e ring finger )#ile t#e inde/ finger

su''ort t#e instrument"

Scalpel

T#is is an instrument used for incising tissues" T#ere are different t!'es of %lades

)#ic# can %e fit onto a 0ard 1ar&er #andle"

A num%er 22 %lade used for sta% incision for drainage of an a%scess"

A num%er 23 %lade used for 'lacing creicular incision for 'eriodontal 'rocedures"

A num%er 24 %lade used for s&in incisions"


8/41

TISSUE 5OLDING INSTRUMENTSAllis Tissue Holding Forceps

T#is is tissue #olding force's in )#ic# %ea&s are narro) %ut it %roadens out at ti'

)#ic# #as toot#ed edge"

T#is force's #as a rac#et and is used to #old on t#e soft tissue margins suc# as s&in$

'eriosteum$ muscles etc"$ to retract it a)a! from t#e surgical field to im'roe isi%ilit!

into dee'er la!ers"

Can also %e used to #old soft tissue under tension$ e"g"$ )#ile remoing a tumor %!

curettage$ after remoing it$ t#e 'at#ological tissue ma! %e #eld )it# an Allis and

'ulled a)a! from t#e attac#ed 'art so t#at t#e remaining attac#ments ma! %e curetted

out easil!"


9/41

Babcocks Tissue Holding Forceps

T#is is also tissue #olding force's %ut its %lades are non6toot#ed"

It ma! %e used to #old delicate soft tissues suc# as l!m'# nodes$ fascia etc"$ )#ic#

ma! %e torn if #eld )it# a toot#ed tissue #olding force's"

Tissue Holding Forceps T#is instrument is used to #old soft tissues )#ile suturing"

(#ile suturing fla' edged$ t#e margins of t#e fla' are #eld )it# t#is instrument so

t#at it is sta%ili-ed and t#e needle can %e 'ass t#roug# it easil!"

T#e! ma! %e toot#ed or non6toot#ed"


10/41

Delicate tissue suc# as fascia$ mucosa$ 'at#ological tissues ma! %e #eld )it# a non

toot#ed force's7 )#ereas 'eriosteum$ muscles$ a'oneurosis$ etc"$ ma! %e #eld )it# a

toot#ed tissue #olding force's"

Adson*s tissue #olding force's is a delicate toot#ed tissue #olding force's used for

cosmetic suturing on t#e face"

0ONE CUTTING INSTRUMENTS

Osteotome

T#is is an instrument used for s'litting %one"

It #as %i6%eelled edge and comes in arious si-es de'ending on t#e )idt# of cutting

edges and t#e lengt# of t#e instruments"

Used to 'erform osteotom! cuts and in certain cases ma! also %e used to s'lit

im'acted teet# to facilitate remoal"


11/41


12/41

Chise

Instruments used for cutting %one"

Used for transaleolar e/traction and for t#e remoal of im'acted teet#"

It #as single %eellel on its )or&ing edge"

(#ile cutting %one$ t#e %eellel is made to face to)ards %one )#ic# is to %e cut"

In mandi%le$ t#e grain 'attern is im'ortant )#ile using a c#isel$ It ma! %e necessar! to

'lace sto's cuts to 'reent unnecessar! %one remoal"


13/41

onguer

T#is is also called %one ni%%ler"

Used for remoal of s#ar' edges of t#e %one on t#e aleolar ridge as in case of

aleolo'last!"

It can %e used to remoe s#ar' margins of t#e %one around a surgical )ound after

e/traction or remoal of c!st or tumor"It ma! %e of end cutting or side cutting ariet!"

T#e %one is #eld firml! and crus#ed for remoal"


14/41

!one File

T#is is an instrument )#ic# #as s#ar' serrations on its )or&ing edge"

It is used for t#e smoot#ening of s#ar' edges of %one"

After cutting %one )it# a %urr or a rongeur$ t#e ends ma! need to smoot#ened or

rounded off 'rior to closure" T#is is done )it# a %one file"

"allet

An osteotome and c#isel are used )it# mallet"

It is usuall! made of steel and is used )it# a lig#t 8'ull6%ac&9 action )it# force comingfrom t#e )rist"


15/41

!urrs and Handpiece

T#is is a rotar! cutting instrument )#ic# is attac#ed to a micromotor"

T#e %urrs ma! %e round$ straig#t fissured or ta'ered de'ending on t#e need"

Used for cutting %one for transaleolar e/traction$ remoal of im'acted teet#"

Also used for remoal of %one enclosing a c!st or tumor"

Used for ma&ing osteotom!"

T#e %one is cut under co'ious saline irrigation to 'reent #eating of t#e %one and

%one necrosis"


16/41

INSTRUMENTS USED :OR MA;ILLO:ACIAL

TRAUMA

owe#s "a$illary %isimpaction ForcepsT#is is 'aired instrument )#ic# is used in ma/illofacial trauma"

It is used for disim'action of Le6:ort fractures of t#e ma/illa"

0! standing at t#e #ead6end of t#e 'atient t#e cured %lade is inserted onto t#e 'alate

)#ile t#e 'added %lade )it# lesser curature is inserted along t#e floor of t#e nose"

T#e ma/illa is t#us gras'ed %et)een t#e %lades of t#e instrument and mo%ili-ed"

T#is can %e used similarl! to mo%ili-ed t#e Le6:ort osteotom! segment"

& l h # F


17/41

&alsham#s Forceps

T#is is also 'aired instrument used for t#e reduction of nasal %one fractures"

One cured %lade is 'laced is 'laced e/ternall! along t#e %one )#ile t#e ot#er %lade

goes in to t#e nose to su''ort t#e nasal %one"

T#e fractured nasal %one t#us %e gras'ed and maintained in t#e 'osition"

Asche#s Septal Forceps

Also &no)n as nasal se'tel force's as it is used for reduction of a fractured nasal

se'tum" T#is is used along )it# (als#man*s force's in nasal fractures"

It is an un'aired intrument )#ose %lades are 'laced into t#e nose to gras' and realign

t#e nasal se'tum and omer"


18/41

'rich#s Arch !ar

T#is is an t#in$ flat stainless steel %ar )#ic# can %e easil! %ent and ada'ted along

u''er and lo)er arc#es"

T#e %ar consist of #oo&s and cleats )#ic# #el' in engaging t#e )ire for

ma/illomandi%ular fi/ation"

T#is is ada'ted to t#e arc# )it# t#e cleats facing t#e esti%ule and fi/ed in t#e 'osition

to t#e dentoaleolar as'ect )it# t#e #el' of dentoaleolar )iring"

U''er and lo)er arc# %ars ma! %e 'laced and )ired toget#er &ee'ing for teet# in

occlusion for MM:"

Arc# %ars can also %e used for t#e fi/ation of dentoaleolar fractures"

&ire Twister

T#is instrument is used for #olding )ire$ 'assing it interdentall! or t#roug# %one for

dentoaleolar )iring or transosseous )iring"

Usuall! 3< gauge )ires are used for ma/illofacial trauma"


19/41

T#is instrument is similar to needle #older e/ce't t#at t#e %lades are s#orter and

stouter" T#ere are no ertical grooe" It #as rac#et"

A #ea! )ire cutter is used for cutting t#e ends of t#e t)isted or stretc#ed )ire"


20/41

!one lating System

Consist of %one 'lates$ monocortical scre)$ scre) #older$ 'late %ending force's and

scre) drier"

Used for o'en reduction and fi/ation of fractures"

T#e %one 'lates come in different si-es de'ending u'on t#e t#ic&ness and si-e of t#e

#ole for t#e scre)" T#e! can %e 2"= mm$ 3mm" 3"= mm can %e used for fi/ation of

mandi%ular fractures"

T#e! come in ariet! of s#a'es suc# as 8L9$ 8;9$ 8Y9 and straig#t etc"

T#e scre) are of different lengt# and diameter de'ending u'on t#ic&ness of t#e

cortical %one into )#ic# t#e! are fi/ed"


21/41

RETRACTORSangenbac*#s etractor

8L9 s#a'ed retractor )it# long #andle"

Used for retraction of t#e edges of a fla' for im'roed isuali-ation of t#e dee'erla!ers and structures"It comes in different si-es de'ending u'on lengt# of t#e #andle and )idt# of t#e %lade"

Tongue %epressor

Also a 8L9 s#a'ed retractor )it#out #andle"

It #as %road$ flat rounded %lade"

Used for t#e retraction and de'ression of t#e tongue to im'roe isi%ilit! of t#e

'osterior '#ar!ngeal )all and t#e tonsillar region"

Also used for t#e rotation of t#e tongue for t#e remoal of t#roat 'ac&$ isuali-ing t#elin ual side of t#e mandi%le for t#e rocedures"

It can also %e used for c#ee& retractors


22/41

Austin#s etractor

Also an 8L9 s#a'ed retractor )it#out #andle"

Used %asicall! for t#e retraction of small intraoral fla's as in case of remoal of an

im'acted toot#"

MISCELLANEOUSSinus Forceps

T#is is used in t#e drainage of 'us from an a%cess"

It can also %e used for c#ee& retractors"

After an incision$ t#e sinus force's is inserted %! %lunt dissection into t#e a%cess cait!

and o'ened u'" T#e 'us drains along t#e %lades of t#e force's"

T#e %lades are narro)er and longer t#an a #emostat" It #as sterration onl! at t#e ti'"

eriosteal 'le+ators

T#ese can %e of different designs> 5o)art*s Dial*s 'eriosteal eleators$ Moon*s 'ro%e

etc"After a muco'eriosteal incision$ t#e s#ar' end of t#e 'eriosteal eleator is used to

reflect a muco'eriosteal fla'"


23/41

Dials periosteal elevator :T#is #as one rounded edge and one 'ointed end" T#e

'ointed edge is used todetect t#e 'a'illa )#ile t#e rounded edge to reflect t#e

muco'eriosteal fla' and small fla's"

Moons Probe :It is rig#t angled instrument )it# a narro) )or&ing edge" Used %asicall!

for muco'eriosteal eleation around t#e toot# %efore e/traction"

Curette

T#is is a s'oon6li&e instrument used for enucleation or curettage"

It is used to remoe soft tissue lesion )it#in t#e %one cait! suc# as c!st or tumor"

Can also %e used to remoe sinus tracts$ necrotic tissue from e/traction soc&et etc"

It is used %! scra'ing against t#e %on! )alls to se'arate t#e 'at#ological soft tissue

from t#e #ealt#! %one"


24/41

"outh ,ag

T#is is an instrument used to forcefull! o'en t#e mout# in case of trismus"

It #as %road serrated %lades )#ic# are made to rest on t#e occlusal as'ect of t#e

molars )#ile t#e instrument is o'ened )it# slo)$ gradual force"

It can also %e used to &ee' t#e mout# o'en for intraoral 'rocedures underanaest#esia"


25/41

INSTRUMENTS USED :OR E;TRACTION O: TEET5 AND

ROOT REMNANTSEleators

T#e dental eleators are used to lu/ate t#e teet# from soc&et 'rior to a''lication of t#e

force's" It addition eleators also e/'ands t#e %on! soc&et facilitating toot#e/traction"

T#e! are also used to remoe root remnants from t#e e/traction soc&et"

T# l t # t# t


26/41

2" T#e #andle$

3" T#e S#an& and

?" T#e %lade"

De'ending on t#e si-e and s#a'e of t#e %lades t#e eleators can %e classified as >

2" Straig#t or gouge t!'e

3" Triangular t!'e

?" 1ic& t!'e"

Commonl! Used Eleators

Straig#t Eleators +Cou'land$ London 1attern,

Straig#t eleators are most commonl! used for lu/ation of teet#" T#e %lades #aeconcae surface on one side$ t#at faces t#e toot# to %e eleated" Sometimes %lade

can %e at t#e angle of s#an&$ allo)ing t#e instrument to reac# t#e 'osterior areas of

t#e oral cait!" Common e/am'les of t#ese eleators are$ t#e Miller and t#e 1otts

eleator"

T#e eleator #as t#ree com'onents >


27/41

Cr!er*s Eleator

Cr!er*s eleator is a straig#t eleators )it# a triangular %lade"

T#e )or&ing ti' is angulated$ )it# one coe/ and anot#er flat surface"

T#e flat surface is t#e )or&ing side" It is %ased on leer and t#e )edge 'rinci'le"


28/41

Uses

2" :or e/traction of root stum's of mandi%ular molars )#en one root is remoed and t#e

ot#er left %e#ind"

3" :or e/traction of mandi%ular molar root stum's )#en %ot# t#e roots are 'resent %ut

one fractured at a lo)er leelt#an t#e ot#er or )#en t#e furcation is intact"

T)o se'arate eleators are aaila%le for t#e mesial and distal angles to t#e #andle"

(inter*s Eleator

It is a cross%ar eleator" T#e s#an& is at rig#t angles to t#e #andle" T#e )or&ing ti' ia

at an angle to t#e s#an&" T#e %lade #as flat and cone/ surface" T#e flat surface is

t#e )or&ing surface and is 'laced facing to %e eleated" It )or& on t#e )#eel and a/el

'rinci'le"

Uses > To lu/ate t#e mandi%ular molar teet#"


29/41

(inter C!rer*s Eleator

T#e eleator is cross %ar eleator )it# triangular %lade" It )or&s on )#eel$ a/el and

)edge 'rinci'le"

A'e/o EleatorsA'e/o Eleators are straig#t one and #ae a %iangulated and s#ar'$ straig#t )or&ing

ti'" T#e! are 'aired eleator for mesial and distal roots" T#e! can %e used to remoe

ma/illar! root stum's"

5oc&e! Stic& or London 5os'ital Eleator

It #as )or&ing %lade at an angulation to t#e s#an&$ %ut t#e %lade at an angulation to

t#e s#an&$ %ut t#e %lade is straig#t$ rat#er t#an triangular$ and #as cone/ and a flat

surface"

T#e flat surface is )or&ing surface and t#e transerse serration on it for %etter contact

)it# t#e root stum'"

(#en ie)ed t#e instrument loo& li&e a #oc&e! stic&"

E/traction :orce's

E/traction force's are designed to delier teet# from t#e soc&et"

Eac# force' #as an #andle$ a @oint and a %ea&"

All t#e force's #ae cross #atc#ing on t#e #andle to allo) a firm gri' and #ae


30/41

All t#e force's #ae cross #atc#ing on t#e #andle to allo) a firm gri' and #ae

serrations on t#e inner side of t#e %ea&s to allo) %etter gri' on t#e toot#"

T#e force's %ea&s are a''lied along t#e long a/is of t#e toot#$ %elo) Cemento6

enamel @unction of t#e toot#"

A firm gri' is esta%lis#ed 'rior to giing an! force' moement"

Ma/illar! E/traction force's

T#e #andle and t#e %ea&s are at 24 deg" To eac# ot#er$ i"e" in a straig#t line"

Ma/illar! Anterior :orce's

T#e! #ae identical %ea&s t#at are closed$ straig#t$ flat and %road"

T#e! are used to e/tract t#e ma/illar! incisors and canines"

Ma/illar! 1remolar :orce's

T#e! #ae identical %ea&s t#at are concae on t#e side of facing t#e o'rator"

T#e %ea&s are %road and o'en"

T#e! are used for e/traction of 'remolars"

T#e curature of t#e %lade is to access t#e 'remolars 'laced 'osteriorl! in t#e arc#"

Ma/illar! Molars +Rig#t and Left,

T#e %ea&s of t#ese force's are not identical" One %ea& is rounded and ot#er one is


31/41

1ointed


32/41

1ointed"

T#e 'ointed %ea& engages t#e grooe %et)een t#e %uccal roots and t#e rounded one

engages t#e 'alatal surface %elo) cemento6enamel @unction"

T#e %ea&s also #ae curature to t#e side facing o'erator"

(#en ie)ed$ if t#e 'ointed %ea&s to t#e left of t#e o'erator it is rig#t sided force' and

ice ersa"

Ma/illar! Co)#orn :orce's

T#ese force's #ae unidentical %ea&s$ one of )#ic# #as 'ointed ti' and ot#er one #as

%ifid 'ointed ti'"T#e single 'ointed ti' engages t#e furcation %et)een t#e t)o %uccal roots and t#e

ot#er %ifid 'ointed ti' engages t#e 'alatal root"

It is 'aired force's" T#e %ea&s are cures to)ards o'erator" (#ile ie)ing t#e

concae surface of t#e %ea&s$ t#e %ifid %ea&s )ill %e on t#e rig#t for t#e ma/illar! rig#t

side force's a%s ice ersa"T#e! are used for ma/illar! teet#$ )#ere t#ere is e/tensie destruction of t#e cro)n$

%ut roots are not se'rate"

Ma/illar! anterior root force's

T#e! #ae identical$ straig#t$ slender and closed %ea&s"

T#e! are used 'rimaril! for e/traction of stum's of t#e ma/illar! anterior teet#


33/41

T#e! are used 'rimaril! for e/traction of stum's of t#e ma/illar! anterior teet#"

Ma/illar! 'osterior root force's

T#e! are similar to t#e anterior root force's$ %ut li&e t#e 'remolar force's$ t#e! #ae

curature to)ards t#e o'erator for access 'osteriorl!"

T#e! are used for remoing of single molar root 'ieces and 'remolar root stum's"

0a!onet :orce's

T#e! #ae identical$ 'ointed$ angulated and closed %ea&s" T#e lengt# of t#e %ea&s

ar! from long to s#ort"

According to t#e t#ic&ness of t#e %ea& t#e! can %e classified into t#ic& %ea&s and t#in%ea& %a!onet force's" T#e t#ic& %ea& force's is used to remoe ma/illar! 'osterior

root stum's t#at are not se'arate$ )#ile t#e t#in %ea& force's are used to remoe

single roots"

Mandi%ular :orce's

Mandi%ular Anterior :orce's

T#e mandi%ular anterior force's #ae identical %road$ s#ort$ closed %ea&s" T#e @oints

is a riet @oint unli&e most force's #ae %o/ @oint"

T#e! are used for e/traction of mandi%ular anterior teet#"

Mandi%ular 1remolar :orce's


34/41

T#e mandi%ular 'remolar force's #ae identical %road o'en %ea&s t#at are longer


35/41

T#e mandi%ular 'remolar force's #ae identical %road o'en %ea&s t#at are longer

t#an t#e %ea&s of t#e anterior force's"

T#e! are used for e/traction of mandi%ular 'remolar teet#"

Mandi%ular Molar :orce's

T#e! #ae identical$ %road$ o'en %ea&s t#at are longer t#an t#e %ea&s of anterior

force's"

T#e! are used for e/tracting mandi%ular molar teet#"

Mandi%ular Co)#orn :orce's

It #as identical$ o'en$ %ea&s t#at resem%le t#e #orn of t#e co)" T#e %ea&s are roundand ta'er to t#e 'oint"

T#e force's gri's t#e toot# at t#e furcation %et)een t#e mesial and distal roots"

(#en 'ressure is a''lied and t#e %ea&s are closed$ t#e toot# is lu/ated or literall!

s.uee-ed out of t#e soc&et$ using %uccal and lingual 'lates as t#e fulcrum"

T#e! are used to remoe grossl! carious mandi%ular molars )it# e/tensie

destruction of t#e cro)n"

Mandi%ular root force's

T#ese force's #ae identical$ slender %ea&s t#at are closed" T#e %ea&s are longer

t#an t#at of t#e 'remolar force's to ena%le t#e force's to ta&e a dee' gri' on t#e root


36/41

stum's of all t#e mandi%ular teet#"

Suture Needles

T#e! #ae t#ree %asic com'onents>

2" T#e e!e$

3" T#e %od! and

?" T#e 'oint"

T#e E!e

T#e can %e closed or s)aged" T#e close e!e is similar to a #ouse needle" T#e s#a'e

of e!e ma! %e round$ o%long or s.uare"

T#e 0od!

T#e arious 0od! S#a'es are >

a" Straig#t$

%" 5alf Cure$

c" One6fourt# circle$

d" T#ree6eig#t circle$

e" 5alf circle$


37/41

f" :ie6eig#t circle

g" Com'ound cure

T#e 1oint

T#e 'oints id t#e e/treme ti' of t#e needle to t#e ma/imum cross section of t#e %od!"

T#e ti' can %e cutting$ round or %lunt"

Cutting needles #ae at least t)o o''osite cutting edge"

T#e S!ringe


38/41

T#e S!ringe

S!ringe T!'e aaila%le in dentistr! >

2" Nondis'osa%le s!ringe >

a" 0reec#6loading$ metallic$ cartridge6t!'e$ as'irating

%" 0reec#6loading$ 'lastic$ cartridge6t!'e$ as'irating

c" 0reec#6loading$ metallic$ cartridge6t!'e$ self6as'irating

d" 1ressure s!ringe for 'eriodontal ligament in@ection

e" Bet in@ection +8needleless9 s!ringe,3" Dis'osa%le s!ringe

?" 8Safet!9 s!ringe

" Com'uter controlled local anest#esia delier! s!stems

T#e Needle


39/41

Com'onents of local anest#etic needle >

2" 0eel$

3" S#aft$

?" 5u%$

" S!ringe ada'tor and

=" Cartridge 'enetration end

T#e Cartridge

T#e 'refilled 2"6ml dental cartridge consist of four 'arts >

2" C!lindrical glass tu%e

3" Sto''er +'lunger$ %lung,

?" Aluminum ca'" Dia'#argm


40/41


41/41

Reference

Te/t%oo& Of Oral Surger! 6 C#itra C#a&raart#!

Te/t%oo& Of Oral Ma/illofacial Surger! 0" S#riniasan

Instruments Used in Oral Surgery Oral Surgery

Documents

Transcript of Instruments Used in Oral Surgery Oral Surgery