Chapter
11
Oral and Maxillofacial Surgery Instruments
Sur Oral ger y
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266 PERIOSTEAL ELEVATORMOLT
FUNCTION:
To detach the periosteum from bone following an incision or to detach the gingival tissues from around the neck of the tooth prior to placement of extraction forceps Double ended with one round, blunted end and one pointed end Used for most surgical procedures: extractions, gingivoplasty, alveoplasty, cyst removal 7A wax spatula or a Woodson #1 plastic instrument is sometimes used if a smaller periosteal elevator is desired
FEATURES: TRAY SET-UP:
CLINICAL APPLICATION:
Image courtesy of Hu-Friedy, [Link]
267
Sur Oral ger y
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Sur Oral ger y
11
268 STRAIGHT ELEVATORS
FUNCTION:
To loosen tooth or root from bony socket prior to placement of the extraction forceps Straight handle and working end Single rounded working end in several sizes Often referred to by numbercommon sizes: 1, 34, 301
FEATURES:
TRAY SET-UP:
Tooth and root extraction
Images courtesy of Hu-Friedy, [Link]
269
Sur Oral ger y
11
Sur Oral ger y
11
270 ANGULAR ELEVATORSCRYER
FUNCTION:
To loosen tooth or root from bony socket prior to placement of the extraction forceps 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 ag elevator Other common designs: Potts and Crane
FEATURES:
TRAY SET-UP:
Tooth and root extraction, impaction
Images courtesy of Hu-Friedy, [Link]
271
Sur Oral ger y
11
Sur Oral ger y
11
272 ANGULAR ELEVATORSPOTTS
FUNCTION:
To loosen tooth or root from bony socket prior to placement of the extraction forceps 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
FEATURES:
TRAY SET-UP:
Tooth and root extraction, impaction
Images courtesy of Hu-Friedy, [Link]
273
Sur Oral ger y
11
Sur Oral ger y
11
274 ANGULAR ELEVATORSCRANE
FUNCTION:
To loosen tooth or root from bony socket prior to placement of the extraction forceps Large straight handle Nonpaired, universal Other common designs: Cryer and Potts
FEATURES:
TRAY SET-UP:
Tooth and root extraction, impaction
Image courtesy of Hu-Friedy, [Link]
275
Sur Oral ger y
11
Sur Oral ger y
11
276 ROOT TIP PICKSANGLED
FUNCTION: FEATURES:
To loosen small root fragments from bony socket Small elevator with thin, pointed, angled working end Single or double ended
TRAY SET-UP:
Tooth and root extraction, impaction
Images courtesy of Hu-Friedy, [Link]
277
Sur Oral ger y
11
Sur Oral ger y
11
278 ROOT TIP PICKSSTRAIGHT
FUNCTION: FEATURES:
To loosen small root fragments from bony socket Small elevator with thin, pointed, straight working end Single or double ended
TRAY SET-UP:
Tooth and root extraction, impaction
Image courtesy of Hu-Friedy, [Link]
279
Sur Oral ger y
11
Sur Oral ger y
11
280 SURGICAL CURETTESDOUBLE ENDED/ANGULAR
FUNCTION: FEATURES:
To remove tissue or debris from bony sockets Spoon-shaped scraping instrument Usually double ended and angular in several sizes
TRAY SET-UP: CLINICAL APPLICATION:
Extraction, impaction, and cyst removal Used following tooth extraction to ensure removal of debris and diseased tissue
Image courtesy of Premier Dental Products, [Link]
281
Sur Oral ger y
11
Sur Oral ger y
11
282 SURGICAL CURETTESMOLT
FUNCTION: FEATURES: TRAY SET-UP: CLINICAL APPLICATION:
To remove tissue or debris from bony sockets Single rounded working end with larger diameter handle Extraction, impaction, cyst removal Molt #1 (pictured) also used to retract tissue aps following incision
Image courtesy of Hu-Friedy, [Link]
283
Sur Oral ger y
11
Sur Oral ger y
11
284 HEMOSTATS
FUNCTION:
To securely hold small items, clamp blood vessels, and remove small pieces of tooth or bone Angled or straight with locking, scissor-like handles Common names: Mosquito, Kelly Available in 434 , 512 , 614 , and 712
FEATURES:
TRAY SET-UP: CLINICAL APLICATION:
Almost all surgical set-ups Ratchet-type handles require some practice to open and close smoothly Very versatile instrument used in all areas of dentistry
Images courtesy of Hu-Friedy, [Link]
285
Sur Oral ger y
11
Sur Oral ger y
11
286 NEEDLE HOLDERS
FUNCTION: FEATURES:
To hold suture needle Similar to hemostat but with a concave area on inside of each beak to allow for curve of suture needle Any surgical procedure involving an incision will require placement of sutures To avoid needle breakage, place the needle holder on the needle just beyond the suture attachment point and at right angles to the curve of the needle
TRAY SET-UP: CLINICAL APPLICATION:
Images courtesy of Miltex, [Link]
287
Sur Oral ger y
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Sur Oral ger y
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288 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 absorbableplain or chromic gut, polyglycolic acid (PGA, Vicryl) or nonabsorbablesilk, polyester, nylon, polypropylene Sized by diameter of suture material: 30 (000), 40 (0000), 50 (00000) most common sizes used in dentistry (smaller number larger diameter)
CLINICAL APPLICATION:
Nonabsorbable sutures usually removed at 710 days postsurgical visit Placed with needle holder or hemostat
Sur Oral ger y
11
289
Sur Oral ger y
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290 SCALPEL
FUNCTION: FEATURES:
To cut soft tissuea surgical knife 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 For safety, blades are placed and removed from the metal handle with a hemostat or a specially designed scalpel blade remover Used blades should be disposed of in a sharps container
CLINICAL APPLICATION:
E
(AD) Images courtesy of Hu-Friedy, [Link], and (E) courtesy of Miltex, [Link]
291
Sur Oral ger y
11
Sur Oral ger y
11
292 SCALPEL BLADE REMOVER
FUNCTION:
To safely remove blade from scalpel handle
Image courtesy of Hu-Friedy, [Link]
293
Sur Oral ger y
11
Sur Oral ger y
11
294 RONGEURSSIDE-CUTTING
FUNCTION:
To cut and contour boneremoves sharp edges of alveolar crest after extractions for better contour of alveolar ridge; removes exostoses Scissor-type handle, cutting edges on side and top of beaks Multiple extractions, alveolectomy/alveoplasty During use, bone will accumulate around cutting edges. Assistant should wipe working ends with 4 4 periodically to remove debris.
FEATURES: TRAY SET-UP: CLINICAL APPLICATION:
Images courtesy of Hu-Friedy, [Link]
295
Sur Oral ger y
11
Sur Oral ger y
11
296 RONGEURSEND-CUTTING
FUNCTION:
To cut and contour boneremoves sharp edges of alveolar crest after extractions for better contour of alveolar ridge; removes exostoses Scissor-type handle, cutting edges on top edge of beaks Multiple extractions, alveolectomy/alveoplasty During use, bone will accumulate around cutting edges. Assistant should wipe working ends with 4 4 periodically to remove debris.
FEATURES: TRAY SET-UP: CLINICAL APPLICATION:
Image courtesy of Hu-Friedy, [Link]
297
Sur Oral ger y
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Sur Oral ger y
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298 BONE CHISEL AND MALLET
FUNCTION: TRAY SET-UP:
To remove bone for better contour of alveolar ridge; remove exostoses, i.e., tori Tori removal, alveoplasty
Images courtesy of Hu-Friedy, [Link]
299
Sur Oral ger y
11
Sur Oral ger y
11
300 BONE FILE
FUNCTION:
To smooth bone for better contour of alveolar ridge, often following use of rongeurs Straight or curved working ends Crosscut or straight cutting ridges Double ended
FEATURES:
TRAY SET-UP:
Multiple extractions and impactions that require bone removal, tori removal, alveoplasty During use, bone will accumulate around cutting edges. Assistant should wipe working ends with 4 4 periodically to remove debris.
CLINICAL APPLICATION:
Images courtesy of Hu-Friedy, [Link]
301
Sur Oral ger y
11
Sur Oral ger y
11
302 TISSUE SCISSORSDEAN
FUNCTION:
To cut and remove excess or diseased soft tissue Also used to cut sutures after knots are tied during suture placement
FEATURES:
612 Other common varieties of tissue scissors: Kelly, Iris
TRAY SET-UP:
Gingivectomy/Gingivoplasty, frenectomy, multiple extractions
Image courtesy of Hu-Friedy, [Link]
303
Sur Oral ger y
11
Sur Oral ger y
11
304 TISSUE SCISSORSIRIS
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 412 Other common varieties of tissue scissors: Dean, Kelly
TRAY SET-UP:
Gingivectomy/gingivoplasty, frenectomy, multiple extractions
Images courtesy of Miltex, [Link]
305
Sur Oral ger y
11
Sur Oral ger y
11
306 TISSUE SCISSORSKELLY
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, 614 and 7 Other common varieties of tissue scissors: Dean, Iris
TRAY SET-UP:
Gingivectomy/gingivoplasty, frenectomy, multiple extractions
Images courtesy of Miltex, [Link]
307
Sur Oral ger y
11
Sur Oral ger y
11
308 SUTURE SCISSORS
FUNCTION: FEATURES:
To cut sutures for removal One curved, hook-like tip to slip under suture Holds suture away from tissue while cutting 312 , 412 , 512 , and 6
TRAY SET-UP: CLINICAL APPLICATION:
Suture removal 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 grasp the knot with cotton plier or hemostat, and pull the suture out.
Images courtesy of Hu-Friedy, [Link]
309
Sur Oral ger y
11
Sur Oral ger y
11
310 TOWEL CLAMPS
FUNCTION: FEATURES:
To secure surgical drapes and to secure plastic and rubber tubing to drapes Sharp prong tips 312 and 514 Additional use: Remove metal temporary crowns
TRAY SET-UP:
Any procedure when face and head are draped to isolate surgical area
Image courtesy of Hu-Friedy, [Link]
311
Sur Oral ger y
11
Sur Oral ger y
11
312 TISSUE RETRACTORAUSTIN
FUNCTION: FEATURES:
To deect and retract the periosteum from bone following an incision L-shaped with one rounded end and one forked end Other common designs: Seldin, Senn
TRAY SET-UP:
All surgical procedures
Image courtesy of Hu-Friedy, [Link]
313
Sur Oral ger y
11
Sur Oral ger y
11
314 TISSUE RETRACTORSENN
FUNCTION: FEATURES:
To deect and retract the periosteum from bone following an incision Double ended with one rounded and one forked end Other common designs: Austin, Seldin
TRAY SET-UP:
All surgical procedures
Image courtesy of Miltex, [Link]
315
Sur Oral ger y
11
Sur Oral ger y
11
316 TISSUE RETRACTOR/PERIOSTEAL ELEVATORSELDIN
FUNCTION: FEATURES: TRAY SET-UP:
To deect and retract a tissue ap from bone following an incision Double ended with round, blunted ends Used for most surgical procedures: extractions, gingivoplasty, alveoplasty, cyst removal
Image courtesy of Hu-Friedy, [Link]
317
Sur Oral ger y
11
Sur Oral ger y
11
318 TONGUE AND CHEEK RETRACTORMINNESOTA
FUNCTION:
To hold tongue and cheek away from surgical site Other common designs: Shuman, Weider
TRAY SET-UP:
All surgical procedures
Sur Oral ger y
11
319
Sur Oral ger y
11
320 TONGUE AND CHEEK RETRACTORSHUMAN
FUNCTION:
To hold tongue and cheek away from surgical site Other common designs: Minnesota, Weider
TRAY SET-UP:
All surgical procedures
Image courtesy of Hu-Friedy, [Link]
321
Sur Oral ger y
11
Sur Oral ger y
11
322 TONGUE AND CHEEK RETRACTORWEIDER
FUNCTION:
To hold tongue and cheek away from surgical site Other common designs: Minnesota, Shuman
TRAY SET-UP:
All surgical procedures
Image courtesy of Karl Schumacher Dental Instruments Company, Inc., [Link]
323
Sur Oral ger y
11
Sur Oral ger y
11
324 MOUTH PROPBITE-BLOCK
FUNCTION: FEATURES:
To keep mouth open with extensive procedures, sedated or disabled patients Sterilizable rubber block in four sizes for children and adults Other common design: mouth gag
TRAY SET-UP:
Any procedure when patient may have difculty keeping mouth open
Images courtesy of Hu-Friedy, [Link]
325
Sur Oral ger y
11
Sur Oral ger y
11
326 MOUTH PROPMOUTH GAG
FUNCTION: FEATURES:
To keep mouth open with extensive procedures, sedated or disabled patients Rachet design with rubber tips Other common design: bite-block
TRAY SET-UP:
Any procedure when patient may have difculty keeping mouth open
Image courtesy of Hu-Friedy, [Link]
327
Sur Oral ger y
11
Sur Oral ger y
11
328 SURGICAL ASPIRATING TIPBYRD SELF-CLEANING
FUNCTION: FEATURES:
To maintain a clear working eld by removing saliva, blood, and debris 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
Image courtesy of Hu-Friedy, [Link]
329
Sur Oral ger y
11
Sur Oral ger y
11
330 SURGICAL ASPIRATING TIPCOGSWELL
FUNCTION: FEATURES:
To maintain a clear working eld by removing saliva, blood, and debris Vacuum relief hole controls suction by covering/uncovering the hole with ngertip Other common designs: Byrd, Frazier
TRAY SET-UP: CLINICAL APPLICATION:
All surgical procedures Tips are cleaned with long, exible cleaning brushes
Image courtesy of Hu-Friedy, [Link]
331
Sur Oral ger y
11
Sur Oral ger y
11
332 SURGICAL ASPIRATING TIPFRAZIER
FUNCTION: FEATURES:
To maintain a clear working eld by removing saliva, blood, and debris Removable stylet to clear tip of bone or tooth fragments Vacuum relief hole controls suction by covering/uncovering the hole with ngertip Available in several diameters Other common designs: Byrd, Cogswell
TRAY SET-UP:
All surgical procedures
Image courtesy of Hu-Friedy, [Link]
333
Sur Oral ger y
11
Sur Oral ger y
11
334 SURGICAL ASPIRATING TIPYANKEUR TONSIL ASPIRATOR
FUNCTION: FEATURES:
To suction throat when using general anesthesia Angled with perforated ball-type end for suctioning throat
Sur Oral ger y
11
335
Sur Oral ger y
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336 TISSUE PLIERSADSON
FUNCTION:
To grasp and stabilize soft tissue aps during suturing and reconstructive procedures such as gingival grafting Similar in overall appearance to cotton pliers Various serrated tips for securely grasping tissue aps
FEATURES:
TRAY SET-UP:
Any surgical procedure requiring an incision and suturing
Image courtesy of Hu-Friedy, [Link]
337
Sur Oral ger y
11
Sur Oral ger y
11
338 TISSUE FORCEPSALLISON
FUNCTION:
To grasp and stabilize soft tissue aps during suturing and reconstructive procedures such as gingival grafting Hemostat-type handles, serrated tips Any surgical procedure requiring an incision and suturing
FEATURES: TRAY SET-UP:
Image courtesy of Hu-Friedy, [Link]
339
Sur Oral ger y
11
Sur Oral ger y
11
340 EXTRACTION FORCEPS#99 MAXILLARY ANTERIORS AND PREMOLARS
FUNCTION: FEATURES:
To remove teeth from bony socket Straight handle and beaks Beaks designed to conform to facial and lingual root contour just apical to cervical line Universal (both beaks same design-t equally well on facial and lingual) for right and left quadrants
TRAY SET-UP:
Extraction
Images courtesy of Hu-Friedy, [Link]
341
Sur Oral ger y
11
Sur Oral ger y
11
342 EXTRACTION FORCEPS#150 (CRYER) MAXILLARY ANTERIORS AND PREMOLARS
FUNCTION: FEATURES:
To remove teeth from bony socket Beaks designed to conform to facial and lingual root contour just apical to cervical line Universal (both beaks same design-t equally well on facial and lingual) for right and left quadrants Maxillary counterpart to #151 Mandibular Cryer
TRAY SET-UP:
Extraction
Images courtesy of Miltex, [Link]
343
Sur Oral ger y
11
Sur Oral ger y
11
344 EXTRACTION FORCEPS#18R MAXILLARY RIGHT FIRST AND SECOND MOLARS
FUNCTION: FEATURES:
To remove teeth from bony socket Each beak has different design to adapt to the maxillary molar roots that differ anatomically on the facial and lingual Rounded beak contours to lingual root Pointed beak contours to bifurcation of mesialbuccal and distalbuccal root #18R and #53R are essentially the same instrument except that #18R has one curved handle while both handles are straight on #53R
TRAY SET-UP:
Extraction
Images courtesy of Miltex, [Link]
345
Sur Oral ger y
11
Sur Oral ger y
11
346 EXTRACTION FORCEPS#18 L MAXILLARY LEFT FIRST AND SECOND MOLARS
FUNCTION: FEATURES:
To remove teeth from bony socket Each beak has different design to adapt to the maxillary molar roots that differ anatomically on the facial and lingual Rounded beak contours to lingual root Pointed beak contours to bifurcation of mesialbuccal and distalbuccal root #18L and #53L are essentially the same instrument except that #18L has one curved handle while both handles are straight on #53L
TRAY SET-UP:
Extraction
Images courtesy of Miltex, [Link]
347
Sur Oral ger y
11
Sur Oral ger y
11
348 EXTRACTION FORCEPS#53R MAXILLARY RIGHT FIRST AND SECOND MOLARS
FUNCTION: FEATURES:
To remove teeth from bony socket Bayonet design Each beak has different design to adapt to the maxillary molar roots that differ anatomically on the facial and lingual Rounded beak contours to lingual root Pointed beak contours to bifurcation of mesialbuccal and distalbuccal roots #53R and #18R are essentially the same instrument except that #18R has one curved handle while both handles are straight on #53R
TRAY SET-UP:
Extraction
Images courtesy of Miltex, [Link]
349
Sur Oral ger y
11
Sur Oral ger y
11
350 EXTRACTION FORCEPS#53L MAXILLARY LEFT FIRST AND SECOND MOLARS
FUNCTION: FEATURES:
To remove teeth from bony socket Bayonet design Each beak has different design to adapt to the maxillary molar roots that differ anatomically on the facial and lingual Rounded beak contours to lingual root Pointed beak contours to bifurcation of mesialbuccal and distalbuccal roots #53L and #18L are essentially the same instrument except that #18L has one curved handle while both handles are straight on #53L
TRAY SET-UP:
Extraction
Images courtesy of Miltex, [Link]
351
Sur Oral ger y
11
Sur Oral ger y
11
352 EXTRACTION FORCEPS#88R MAXILLARY RIGHT FIRST AND SECOND MOLARS
FUNCTION: FEATURES:
To remove teeth from bony socket Bayonet design Each beak has different design to adapt to the maxillary molar roots that differ anatomically on the facial and lingual Beak with 1 projection contours to bifurcation of mesialbuccal and distalbuccal roots Beak with two projections contours to lingual root
TRAY SET-UP:
Extraction
Images courtesy of Hu-Friedy, [Link]
353
Sur Oral ger y
11
Sur Oral ger y
11
354 EXTRACTION FORCEPS#88L MAXILLARY LEFT FIRST AND SECOND MOLARS
FUNCTION: FEATURES:
To remove teeth from bony socket Bayonet design Each beak has different design to adapt to the maxillary molar roots that differ anatomically on the facial and lingual Beak with one projection contours to bifurcation of mesialbuccal and distalbuccal roots Beak with two projections contours to lingual root
TRAY SET-UP:
Extraction
A
(A) Image courtesy of Hu-Friedy, [Link]. (B) Image courtesy of Miltex, [Link]
B
355
Sur Oral ger y
11
Sur Oral ger y
11
356 EXTRACTION FORCEPS#210 MAXILLARY THIRD MOLARS
FUNCTION: FEATURES:
To remove teeth from bony socket Bayonet design Beaks designed to conform to facial and lingual root contour just apical to cervical line Universal (both beaks same design-t equally well on facial and lingual) for right and left quadrants
TRAY SET-UP:
Extraction
Images courtesy of Miltex, [Link]
357
Sur Oral ger y
11
Sur Oral ger y
11
358 EXTRACTION FORCEPS#65 MAXILLARY OVERLAPPING ANTERIORS AND ROOT TIPS
FUNCTION: FEATURES:
To remove teeth, tooth fragments, and root tips from bony socket Bayonet design Universal (both beaks same design-t equally well on facial and lingual) for right and left quadrants
TRAY SET-UP:
Extraction
Images courtesy of Miltex, [Link]
359
Sur Oral ger y
11
Sur Oral ger y
11
360 EXTRACTION FORCEPS#69 MAXILLARY AND MANDIBULAR OVERLAPPING ANTERIORS AND ROOT TIPS
FUNCTION: FEATURES:
To remove teeth, tooth fragments, and root tips from bony socket Universal (both beaks same design-t equally well on facial and lingual) for right and left quadrants Extraction
TRAY SET-UP:
Images courtesy of Miltex, [Link]
361
Sur Oral ger y
11
Sur Oral ger y
11
362 EXTRACTION FORCEPS#74 MANDIBULAR ROOT TIPS
FUNCTION: FEATURES:
To remove tooth fragments and root tips from bony socket Bird beak design Universal (both beaks same design-t equally well on facial and lingual) for right and left quadrants
TRAY SET-UP:
Extraction
Images courtesy of Miltex, [Link]
363
Sur Oral ger y
11
Sur Oral ger y
11
364 EXTRACTION FORCEPS#101 ALL DECIDUOUS TEETH AND MANDIBULAR ANTERIORS
FUNCTION: FEATURES:
To remove teeth from bony socket Smaller overall Beaks designed to conform to facial and lingual root contour just apical to cervical line Universal (both beaks same design-t equally well on facial and lingual) for right and left quadrants
TRAY SET-UP:
Extraction
Images courtesy of Miltex, [Link]
365
Sur Oral ger y
11
Sur Oral ger y
11
366 EXTRACTION FORCEPS#103 MANDIBULAR ANTERIORS AND PREMOLARS
FUNCTION: FEATURES:
To remove teeth from bony socket Straight handle and beaks Beaks designed to conform to facial and lingual root contour just apical to cervical line Universal (both beaks same design-t equally well on facial and lingual) for right and left quadrants
TRAY SET-UP:
Extraction
Image courtesy of Miltex, [Link]
367
Sur Oral ger y
11
Sur Oral ger y
11
368 EXTRACTION FORCEPS#151 (CRYER) MANDIBULAR ANTERIORS AND PREMOLARS
FUNCTION: FEATURES:
To remove teeth from bony socket Beaks designed to conform to facial and lingual root contour just apical to cervical line Universal (both beaks same design-t equally well on facial and lingual) for right and left quadrants Mandibular counterpart to #150 Maxillary Cryer
TRAY SET-UP:
Extraction
Images courtesy of Miltex, [Link]
369
Sur Oral ger y
11
Sur Oral ger y
11
370 EXTRACTION FORCEPS#15 MANDIBULAR FIRST AND SECOND MOLARS
FUNCTION: FEATURES:
To remove teeth from bony socket Beaks designed to conform to facial and lingual root contour just apical to cervical line Universal (both beaks same design-t equally well on facial and lingual) for right and 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 curved handle while both handles are straight on #17
TRAY SET-UP:
Extraction
Images courtesy of Miltex, [Link]
371
Sur Oral ger y
11
Sur Oral ger y
11
372 EXTRACTION FORCEPS#17 MANDIBULAR FIRST AND SECOND MOLARS
FUNCTION: FEATURES:
To remove teeth from bony socket Beaks designed to conform to facial and lingual root contour just apical to cervical line Universal (both beaks same design-t 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 curved handle while both handles are straight on #17
TRAY SET-UP:
Extraction
Images courtesy of Miltex, [Link]
373
Sur Oral ger y
11
Sur Oral ger y
11
374 EXTRACTION FORCEPS#16 MANDIBULAR FIRST AND SECOND MOLARS
FUNCTION: FEATURES:
To remove teeth from bony socket Cowhorn forceps Beaks designed to conform to facial and lingual root contour just apical to cervical line Universal (both beaks same design-t equally well on facial and lingual) for right and 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 curved handle while both handles are straight on #23
TRAY SET-UP:
Extraction
Images courtesy of Miltex, [Link]
375
Sur Oral ger y
11
Sur Oral ger y
11
376 EXTRACTION FORCEPS#23 MANDIBULAR FIRST AND SECOND MOLARS
FUNCTION: FEATURES:
To remove teeth from bony socket Cowhorn forceps Beaks designed to conform to facial and lingual root contour just apical to cervical line Universal (both beaks same design-t 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 curved handle while both handles are straight on #23
TRAY SET-UP:
Extraction
Images courtesy of Hu-Friedy, [Link]
377
Sur Oral ger y
11
Sur Oral ger y
11
378 EXTRACTION FORCEPS#222 MANDIBULAR THIRD MOLARS
FUNCTION: FEATURES:
To remove teeth from bony socket Bayonet design Beaks designed to conform to facial and lingual root contour just apical to cervical line Universal (both beaks same design-t equally well on facial and lingual) for right and left quadrants
TRAY SET-UP:
Extraction
Images courtesy of Miltex, [Link]
379
Sur Oral ger y
11
Sur Oral ger y
11
380 SURGICAL HANDPIECE
FUNCTION: FEATURES:
To place implants, remove bone, section teeth Holds sterile water and equipped with pump for oral irrigation Both straight and contra angle handpiece designs Variable speed and torque
Image courtesy of Aseptico, [Link]
381
Sur Oral ger y
11
Sur Oral ger y
11
382 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 Laser beam is hazardous to eyes and skin. Patient, operator, and assistant must wear special protective goggles and keep hands and body parts away from the beam. Nonshiny instruments should be used to avoid reection of laser energy. Smoke plume forms as tissue is vaporized; use high volume evacuation during procedure.
CLINICAL APPLICATION:
Image courtesy of Sirona Dental Systems, [Link]
383
Sur Oral ger y
11
Sur Oral ger y
11
384 ENDOSSEOUS IMPLANT FIXTURE
FUNCTION: FEATURES:
To provide a root form for replacement of missing teeth Cylindrical, screw-shaped device Made of titanium alloy Embedded within the alveolar bone Provides support for a dental crown, bridge, or denture
Photographs courtesy of Ed McGlumphy, D.D.S., M.S., Associate Professor, Ohio State University, College of Dentistry.
385
Sur Oral ger y
11
Sur Oral ger y
11
386 SURGICAL IMPLANT SITE PREPARATION KIT
FUNCTION:
To remove and shape bone for placement of an implant xture Multiple drill shapes and sizes An incision is made and a tissue ap detached to expose the alveolar bone of the implant site. Next, a surgical handpiece is used with the implant site preparation kit to shape a hole for the implant xture. The implant xture is placed and covered with the soft tissue ap.
FEATURES: CLINICAL APPLICATION:
Reprinted with permission from Gladwin MA, Bagby M. Clinical aspects of dental materials: theory, practice, and cases. 3rd ed. Baltimore, MD: Lippincott Williams & Wilkins, 2008.
Sur Oral ger y
11
387
Sur Oral ger y
11
388 IMPLANT WRENCH/DRIVER
FUNCTION: CLINICAL APPLICATION:
To place implant screw or healing abutment on implant xture The healing abutment extends above the oral mucosa. After the dental implant is stable and integrated with the bone, the top of the implant is exposed and the healing abutment is placed. The gingiva heals and grows around the abutment creating an esthetic gingival margin for the future implant crown.
LifeART image copyright 2010 Lippincott Williams & Wilkins. All rights reserved.
389
Sur Oral ger y
11
Sur Oral ger y
11
390 BASIC EXTRACTION SET-UP
PURPOSE:
To provide instrumentation for surgical removal of tooth/teeth.
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 specic tooth/teeth)
2 1
9 7 3 4 5 6 8
10
391
Sur Oral ger y
11
Sur Oral ger y
11
392 MULTIPLE EXTRACTION/ALVEOPLASTY/GINGIVOPLASTY SET-UP
PURPOSE:
To provide instrumentation for surgically removing multiple teeth, reshaping bone and gingiva, and placing sutures.
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 le 14. Extraction forceps (selected for
specic tooth/teeth)
15. Rongeur 16. Tissue scissor 17. Needle holder 18. Hemostat 19. Suture
3 2
19 17 18 15 14 6 7 8 9 10 11 12 13 16
393
Sur Oral ger y
11
Sur Oral ger y
11
394 IMPACTION SET-UP
PURPOSE:
To provide instrumentation for surgically removing impacted tooth. Often involves incision and bone removal.
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 le 18. Tissue scissor 19. Extraction forceps 20. Needle holder 21. Scalpel(s) 22. Suture
1 2
3 4 5
21
7 8
9 10
11
12 13
16 14 15 17 18
19 20
22
395
Sur Oral ger y
11
Sur Oral ger y
11
396 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
6 1 2 3 5
397
Sur Oral ger y
11
End Chapter 11