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Instruments in Oral Surgery

Instruments in Oral Surgery. Jan 18, 2008. Hemostats vs. Needle Holders. Hemostats 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.

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Instruments in Oral Surgery

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  1. Instruments in Oral Surgery Jan 18, 2008

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

  3. Hemostats vs. Needle Holders

  4. 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

  5. Chisels • Monobevel- • Remove bone • Bibevel • Split Teeth

  6. Elevators • 301-smallest • 34 • 46S-Largest

  7. 301 Elevator • Lever action • Displacement • Smaller root tips

  8. 34 Elevator • Lever action • Displacement • Most teeth and larger root tips

  9. 46S Elevator • Lever action • Displacement • Most teeth and larger root tips

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

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

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

  13. 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

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

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

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

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

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

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

  20. Periosteal Elevator • Start with the pointed edge • Reflect the flap with the broad end

  21. Clover Leaf • Sweetheart retractor, “Weider”

  22. Austin Retractor • Place down on bone, retracts cheek and protects

  23. 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

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

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

  26. 150/151 Forceps

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

  28. #1, #99 Forceps

  29. 74N Forceps

  30. 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

  31. 88R and 88L

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