Surgical Instruments

Armamentarium for basic

Oral surgeryDr . Sara Mahmoud

SURGICAL INSTRUMENTS

EXTRACTION FORCEPSES

ELEVATORS

SURGICAL INSRUMENTS

LOCAL ANESTHESIA INSTRUMENTATION

Upper forceps Straight forcepsOn straight line

lower forceps Angulated forceps

Extraction forcepsUpper Forcepses

Components

Anterior Premolar Molar Others

Forceps consist of : Handel Hinge = joint Beaks = blades

Upper anterior forceps

Upper anterior forceps used for: Extraction of upper anterior teeth

Beaks are symmetrical & are placed in the same line as the handles ( on straight line )beaks are concave and not pointed

Upper premolar forceps:

:Upper premolar forceps Used for extraction upeer premolars teethBeaks are symmetrical , concave, not pointedThe forcep have a slightly curved shape and look like an “S.”Holding the forceps in the hand, the concave part of the curved handle faces the palm , while the concave part of the beaks is turned upwards

sCurve due to

accessibility

FORCEPS FOR UPPER PREMOLARS

Upper molar forceps:

Maxillary molar forceps

Used to extraction upper molar teeth

There are two maxillary molar forceps: one

for the left and one for the right side R & L

Forceps have a slightly curved shapeThe have asymmetrical beaks : sharply

pointed buccal beak and rounded palatal beak

Beaks are broader than anterior forceps

Holding the forceps in the hand, the concave part of the curved handle faces the palm , while the concave part of the beaks is turned upwards

R L

FORCEPS FOR UPPER MOLARS

FORCEPS FOR UPPER REMANING ROOT

REED’S FORCEPSUse: Extraction of upper remaining roots in posterior teethAs upper premolar forceps but with closed blades

FORCEPS FOR UPPER REMANING ROOT•BAYONETUse: 1-Extraction of upper remaining roots2- Extraction of rudimentary upper wisdom tooth

FORCEPS FOR UPPER THIRD MOLAR

JOCKY FORCEPSUse: Extraction of upper third molars

Bayonet forceps jocky forceps

Upper canine forcepsUsed for extraction of upper canine As upper anterior forceps but their blades more wider

Lower Forceps

Anterior Premolar Molar Others

Extraction forceps

Lower anterior forceps

Lower anterior forcepsUse: Extraction of lower anterior teeth

• Lower anterior forceps have identical , short closed beaks

• Beaks are narrower than lower molar forceps, similar to upper root forceps

• Beaks are at right angles to the handles

• They can also be used as lower root forceps

LOWER ANTERIOR FORCEPS

2 -FORCEPS FOR LOWER PREMOLAR

• The mandibular premolar forceps have• identical long and broad open beaks

Mandibular premolar forcepsUse: Extraction of lower premolar teeth

3 -FORCEPS FOR LOWER MOLAR

Lower molar forceps

• Beaks are at right angles to the handles

• Beaks are symmetrically pointed & the sharp pointed tips engage the bifurcation at the buccal & lingual surfaces

• Beaks are more broader & stout

Use: Extraction of lower molar teeth

FORCEPS FOR LOWER MOLAR

4 -FORCEPS FOR LOWER REMAINING ROOTS

Use: Extraction of lower remaining roots

ELEVATORS component :

Classification of elevators (3 categories)According to shape

StraightCROSS BARCurved

Principles of dental elevators1. Lever Principle

three basic components:FulcrumEffortLoad

Wedge Principle

Wheel and AxlePrinciple

Elevators

USES:• 1 luxate a mesio-angular impacted lower third molar with distally

curved roots. fulcrum is interdental bone

•2 mult. ext. of neighboring teeth•3 luxation of last abutment •Mesial application of force.

Most commonly used Blade: concave surface

on one side-the tooth to be elevated

Principle:Wedging & lever& wheel & axel = rotational forces

STRAIGHT ELEVATOR

STRAIGHT APEXO

COUPLAND CHISEL

Use : luxation of R.R in accessible areas

CURVED APEXO

Use : luxation of R.R in inaccessible areas

Come in pair … one luxate mesial root in right side and distal

root in left side and the other luxate distal root in right side and mesial

root in left side … So its come in pair but

not used as R and L

Principal of actionwedging

CRYER

Use :removal of R.R in multi-rooted teeth

• EX. If extract 7 or 6 tooth .. useful when a broken root remains in the tooth socket and the adjacent socket is empty• concave surface on one side to root

to be elevated• Come in pairs • Curved elevator

MILLER

•Use : luxation of upper third molars

R L

CROSS BAR Socket applicator

Use :removal of R.R in mandibular multi-rooted teeth

Fracture of interseptal bone

CROSS BARBuccal applicator

Use :Luxation of vertically impacted lower third molar

CROSS BAR

SURGICAL INSTRUMENTS

BARD-BARKER BLADE HANDLE

Handle: The most commonly used handle in oral surgery is the Bard Parker blade handle no. 3. Its tip may receive different types of blades.

BARD BARKER BLADES

Blade no. 11 is used for small incisions, such as those used for incising abscesses (stap incision)

Blade no. 12 is indicated for incisions in inaccessible areas such as the maxillary tuberosity & retromolar areas.

Blade is no. 15 The most common type used for flaps and incisions on edentulous alveolar ridges.

No.10- similar to No.15oLarge skin incisions

Blade loaded

Blade removed

Scalpel

PERIOSTEAL ELEVATOR

Use: reflection of flap

RetractorsMinnesota retractors forretraction of the cheek and tongue and mucoperiosteal flap

MOUTH GAGUse: forceful mouth opening … open the mouth with uncooperative patients.

TONGUE DEPRESSOR

TONGUE HOLDER

Mouth props: Rubber bite blocks

used to hold the mouth open.

RETRACTOR

Use: retraction of flaps or cheek

Retractors

RETRACTOR

CHISELS• BEVELED CHISEL

▫ UNIBEVELED removal of bone inflanks

▫ BIBEVELED (OSTEOTOME):• tooth division• Condylotomy• Re-fracturing malunion bone

MALLET AND CHISELS• MALLET

MALLET AND CHISELS

CHISELS•GROVED CHISEL

Use: removal of soft bone or biopsy

BONE RONGEURS forceps

Use: bone cutting forceps

1. Side-cutting; suitable for trimming & cutting sharp edges of the alv. Plates.

2. End-cutting; suitable for cutting bone septum projecting in the socket of extracted teeth.

3. Side and end cutting.

SURGICAL BURS

Round burs are used to drill holes in the bones which are then connected by the Fissure bur

BONE FILEUse: smoothening of sharp bony edges

oRemoves bone: pull strokeBONE FILE

ARTERY FORCEPS

• CURVED • MOSQUITO HEMOSTAT

Use: ligation of blood Vessels and blunt dissection during I&D

ALLIS FORCEPS with ratchet lock Use: handling

pathological soft tissues

TISSUE FORCEPSUsed to hold normal soft tissue & stabilize it for suturing or dissection.

BONE CURRETTEUse: 1-bone curettage

2-cyst removal

SUTURING INSTRUMENTS

SUTURING INSTRUMENTS• NEEDLE HOLDER

Needle holder

SUTURING INSTRUMENTS• NEEDLE

Round suture needlesRound cross sectionMay be straight, curved or half circleSuturing of fragile and delicate tissues e.g. oral mucosa and

mucous membranesCutting (Atraumatic) suture needles

Triangular cross sectionMay be straight, curved or half circleSuturing of dense tissues e.g. oral mucoperiosteum

Types of needle

Suture materials

INTERRUPTED SUTURE

Simple Interrupted Sutures

• CONTINOUS SUTURES

SUTURING TECHNIQUES

Continuous Sutures

CONTINOUS LOCKED SUTURE BLANKET SUTURE

Continuous with Lock Sutures

SUTURING TECHNIQUES• MATTRESS

SUTURE HORIZONTAL

Horizontal Mattress Sutures

SUTURING TECHNIQUES• MATTRESS SUTURE VERTICAL

LOCAL ANESTHESIA INSTRUMENTATION

POSITIONS OF THE OPERATOR AND THE PATIENT• INFILTRATION

ANAESTHESIA

• NERVE BLOCK

INFILTRATION ANAESTHESIA

INFILTRATION ANAESTHESIAPALATAL INF. BUCCAL

INFILTRATION

INFERIOR ALVEOLAR NERVE BLOCK

RIGHT SIDE


• LEFT SIDE THR CROSS HAND TECHNIQUE


• LEFT SIDE THE BEHIND TECHNIQUE


•LEFT SIDE THE LEFT HAND TECHNIQUE

Mucoperiosteal Flaps

1 .Pyramidal flapsA. Triangular Flap (2 incision lines)

1.Pyramidal flaps

B. Trapezoidal Flap (3 incision lines)

2. Semilunar flaps

3. Gingival (Envelope) flaps

4 .Palatal flapsY-shaped Palatal Flap Double Y-shaped Palatal Flaps

5. Pedicle Flaps

Surgical Instruments

Education

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