PONTILLAS, Kyla Mae D. [DMD 5y1-1] - Pull stroke, occasionally useful but tends to
shered or tear the periosteum unless done
CHAPTER 6 : Instrumentatin carefully.
fir Basic Oral Surgery RETRACTING SOFT TISSUE
Two most popular cheek retractors:
INCISING TISSUE
1. Right Angle Austin Retractor
Scalpel
2. The Broad Ofset Minnesota Retractor
- The primary instrument for making incisions
- Can be used to retract the cheek and the
- Resusable handle and a disposable, sterile,
mucoperiosteal fap simultaneously.
sharp blade
- Also available as a single-use scalpel with a - Seldin Retractor – the leading edge is not shap,
plastic handleand fixed blade but instead is smooth; should not be used to
- No. 3 handle = Most commonly used handle elevate the mucoperiosteum.
- No. 15 blade = Most commonly used scalpel - Mouth mirror – used to retract the tongue.
blade - Welder tongue retractor – a broad heart-
- No. 11 blade = for making stab incisions such as shaped retractor that is serrated on one side so
for incising into the abscess that it can more firmly engage the tongue.
- No. 12 blade = mucogingival procedures on the
posterior aspects of teeth or in the maxillary GRASPING SOFT TISSUE
tuberosity area. - Adson forceps – can be used to hold tissue
- Held by “Pen Grasp” gently, and thereby stabilize it
- Used to incise and not push away the mucosa - Stillies forceps – e-9 inches long, used when
working on posterior parts of the mouth.
- Coton forceps – pick up loose fragments of
ELEVATING THE MUCOPERIOSTEUM tooth, amalgam, or other foreign material.
- Allis tissue forceps – epulis fissurata, should
Periosteal elevator
never be used on tissue that is to be lef in the
- Used to refect periosteum from the underlying mouth.
cortical bone
CONTROLLING HEMORRHAGES
No 9 Molt periosteal elevator
- Curved hemostat – most commonly used in
- Has a sharp pointed end a a broader rounded surgery.
end. - Hemostat – has long delicate beaks and has a
- Pointed end is used in a twisting prying motion locking handle. Place a suture around the vessel
to elevate sof tissue, most commonly when or cauterize it. Remove granulation tissue from
elevating dental papilla from between teeth or the sockets and to pick up small root tips.
the atached gingiva around a tooth to be
REMOVING BONE
extracted
- Push stroke, where the pointed or the broad RONGEURS
end of the instrument is slid under the
periosteum, separating it from the underlying - Most commonly used for removing bone
refection of the periosteum - Has sharp blades that are squeezed together by
the handles
, - Have a rebound mechanism - Held 2 3 of the distance between the tip
- Make repeated bone trimming actions without and the base of the needle.
manually reopening the instrument
SUTURE MATERIAL
2 major designs of rongeurs:
- 3-0(000) – diameter used for suturing oral
1. Side cuttg forceps mucosa
- 6-0 – used for conspicuous places on the
2. Side atd etd cuttg forceps skin
- Can be inserted into the sockets - Non-resorbable – silk, nylon, vinyl, stainless
- Remove sharp edges of bone steel
- 3-0 Black Silk – most commonly used in the
BUR AND HANDPIECE oral cavity
- Gut – component of resorbable sutures
- High speed, high torque handpieces
- Catgut – made of sheep intestines that have
- No. 55e or No. e03 bur and No. 8 round bur
been treated by tanning solutions, resorbs
- Large bone bur – torus removal
3-5 days
MALLET AND CHISEL - Synthetic resorbable – made of long chains
of polymers braided sutures such as silk,
- Used when removing lingual tori polyglycolic acid and polylactic acid
BONE FILE SCISSORS
- Final smoothing of bone - Suture scissors – have short cutting edges
- A double ended instrument with a small - Dean scissors – slightly curved handles and
and larger end serrated blades
- Remove bone only on a pull stroke - Iris scissors and Metzenbaum scissors –
major types of tissue scissors
REMOVING SOFT TISSUE FROM BONY CAVITIES
- Metzenbaum – for undermining sof tissue
- Curete – angled, double-ended instrument, cutting
remove granulomas or small cysts from
HOLDING THE MOUTH OPEN
periapical lesions
- Bite block – sof, rubberlike block on which
SUTURING SOFT TISSUE
patient can rest his teeth
NEEDLE HOLDER - Side-action mouth prop or Molt mouth prop
– ratchet type action, opening the mouth
- Locking handle a short blunt beak wider as the handle is closed. Useful for
- 6 inches – for intraoral placement of patients who have mild forms of trismus
sutures
SUCTIONING
SUTURE NEEDLE
- Surgical suction – has smaller orifice
- Small half circle or three-eights circle. - Fraser suction – has a holeo n the handle
- Cutting portion – 1 3 length of entire portion that can be covered with finger tip
needle if needed.
- Tapered needles – more delicate tissues,
ocular or vascular surgery. IRRIGATING
- Sterile water or sterile saline
shered or tear the periosteum unless done
CHAPTER 6 : Instrumentatin carefully.
fir Basic Oral Surgery RETRACTING SOFT TISSUE
Two most popular cheek retractors:
INCISING TISSUE
1. Right Angle Austin Retractor
Scalpel
2. The Broad Ofset Minnesota Retractor
- The primary instrument for making incisions
- Can be used to retract the cheek and the
- Resusable handle and a disposable, sterile,
mucoperiosteal fap simultaneously.
sharp blade
- Also available as a single-use scalpel with a - Seldin Retractor – the leading edge is not shap,
plastic handleand fixed blade but instead is smooth; should not be used to
- No. 3 handle = Most commonly used handle elevate the mucoperiosteum.
- No. 15 blade = Most commonly used scalpel - Mouth mirror – used to retract the tongue.
blade - Welder tongue retractor – a broad heart-
- No. 11 blade = for making stab incisions such as shaped retractor that is serrated on one side so
for incising into the abscess that it can more firmly engage the tongue.
- No. 12 blade = mucogingival procedures on the
posterior aspects of teeth or in the maxillary GRASPING SOFT TISSUE
tuberosity area. - Adson forceps – can be used to hold tissue
- Held by “Pen Grasp” gently, and thereby stabilize it
- Used to incise and not push away the mucosa - Stillies forceps – e-9 inches long, used when
working on posterior parts of the mouth.
- Coton forceps – pick up loose fragments of
ELEVATING THE MUCOPERIOSTEUM tooth, amalgam, or other foreign material.
- Allis tissue forceps – epulis fissurata, should
Periosteal elevator
never be used on tissue that is to be lef in the
- Used to refect periosteum from the underlying mouth.
cortical bone
CONTROLLING HEMORRHAGES
No 9 Molt periosteal elevator
- Curved hemostat – most commonly used in
- Has a sharp pointed end a a broader rounded surgery.
end. - Hemostat – has long delicate beaks and has a
- Pointed end is used in a twisting prying motion locking handle. Place a suture around the vessel
to elevate sof tissue, most commonly when or cauterize it. Remove granulation tissue from
elevating dental papilla from between teeth or the sockets and to pick up small root tips.
the atached gingiva around a tooth to be
REMOVING BONE
extracted
- Push stroke, where the pointed or the broad RONGEURS
end of the instrument is slid under the
periosteum, separating it from the underlying - Most commonly used for removing bone
refection of the periosteum - Has sharp blades that are squeezed together by
the handles
, - Have a rebound mechanism - Held 2 3 of the distance between the tip
- Make repeated bone trimming actions without and the base of the needle.
manually reopening the instrument
SUTURE MATERIAL
2 major designs of rongeurs:
- 3-0(000) – diameter used for suturing oral
1. Side cuttg forceps mucosa
- 6-0 – used for conspicuous places on the
2. Side atd etd cuttg forceps skin
- Can be inserted into the sockets - Non-resorbable – silk, nylon, vinyl, stainless
- Remove sharp edges of bone steel
- 3-0 Black Silk – most commonly used in the
BUR AND HANDPIECE oral cavity
- Gut – component of resorbable sutures
- High speed, high torque handpieces
- Catgut – made of sheep intestines that have
- No. 55e or No. e03 bur and No. 8 round bur
been treated by tanning solutions, resorbs
- Large bone bur – torus removal
3-5 days
MALLET AND CHISEL - Synthetic resorbable – made of long chains
of polymers braided sutures such as silk,
- Used when removing lingual tori polyglycolic acid and polylactic acid
BONE FILE SCISSORS
- Final smoothing of bone - Suture scissors – have short cutting edges
- A double ended instrument with a small - Dean scissors – slightly curved handles and
and larger end serrated blades
- Remove bone only on a pull stroke - Iris scissors and Metzenbaum scissors –
major types of tissue scissors
REMOVING SOFT TISSUE FROM BONY CAVITIES
- Metzenbaum – for undermining sof tissue
- Curete – angled, double-ended instrument, cutting
remove granulomas or small cysts from
HOLDING THE MOUTH OPEN
periapical lesions
- Bite block – sof, rubberlike block on which
SUTURING SOFT TISSUE
patient can rest his teeth
NEEDLE HOLDER - Side-action mouth prop or Molt mouth prop
– ratchet type action, opening the mouth
- Locking handle a short blunt beak wider as the handle is closed. Useful for
- 6 inches – for intraoral placement of patients who have mild forms of trismus
sutures
SUCTIONING
SUTURE NEEDLE
- Surgical suction – has smaller orifice
- Small half circle or three-eights circle. - Fraser suction – has a holeo n the handle
- Cutting portion – 1 3 length of entire portion that can be covered with finger tip
needle if needed.
- Tapered needles – more delicate tissues,
ocular or vascular surgery. IRRIGATING
- Sterile water or sterile saline
