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GENERAL SURGICAL INSTRUMENT
Chittle Forceps
Instruments used for lifting out sterile instruments from autoclave or instrument tray.
It has long handles and long, angulated and serrated beaks for better grip.
When not in use beaks are placed dipped in antiseptic solution.
Swab Holding Forceps
This is also an instrument with long handles but straight beaks which are fenestrated
in the ends.
It is used for holding the swab dipped in an antiseptic solution for preparing the
surgical field.
Towel Clips
Instruments used to hold the patient’s drapes in place
Also used to clip on the suction tubes, drills
on to the drapes to hold them in place.
It can also be used to hold tongue and retract it forward in an unconscious patient.
Hemostat (artery forceps)
These are the instruments used to clamp bleeding vessels (arteries and veins).
Also used to hold the vessels for ligation.
They have narrow tapering beaks with transverse serrations.
The handle has a latch called rachet.
They can be of different types straight, curved and come in different sizes.
A small artery forceps is also known as mosquito forceps.
Scissors
Dissecting scissors can be used for incising soft tissue flaps, excising pathological soft
tissue and can be used for blunt dissection into the deeper layers.
Dean’s suture cutting scissors are used for cutting suture materials.
Dissecting scissors usually have narrower blades than a suture cutting scissors and
may be straight or curved, sharp ended or blunt ended scissors.
Dean’s suture cutting scissors has broader blades and may be straight or curve.
Needle Holder
It is used to hold the suturing needle.
It has short blades which have crisscross serrations and groove in the centre.
It has rachet to hold the needle firmly.
The handle of the instrument are held between the ring finger while the index finger
support the instrument.
Scalpel
This is an instrument used for incising tissues. There are different types of blades
which can be fit onto a Bard Parker handle.
A number 11 blade used for stab incision for drainage of an abscess.
A number 12 blade used for placing crevicular incision for periodontal procedures.
A number 10 blade used for skin incisions.
TISSUE HOLDING INSTRUMENTS
Allis Tissue Holding Forceps
This is tissue holding forceps in which beaks are narrow but it broadens out at tip
which has toothed edge.
This forceps has a rachet and is used to hold on the soft tissue margins such as skin,
periosteum, muscles etc., to retract it away from the surgical field to improve visibility
into deeper layers.
Can also be used to hold soft tissue under tension, e.g., while removing a tumor by
curettage, after removing it, the pathological tissue may be held with an Allis and
pulled away from the attached part so that the remaining attachments may be curetted
out easily.
Babcock’s Tissue Holding Forceps
This is also tissue holding forceps but its blades are non-toothed.
It may be used to hold delicate soft tissues such as lymph nodes, fascia etc., which
may be torn if held with a toothed tissue holding forceps.
Wire Twister
This instrument is used for holding wire, passing it interdentally or through bone for
dentoalveolar wiring or transosseous wiring.
Usually 26 gauge wires are used for maxillofacial trauma.
This instrument is similar to needle holder except that the blades are shorter and
stouter. There are no vertical groove. It has rachet.
A heavy wire cutter is used for cutting the ends of the twisted or stretched wire.
Bone Plating System
Consist of bone plates, monocortical screw, screw holder, plate bending forceps and
screw driver.
Used for open reduction and fixation of fractures.
The bone plates come in different sizes depending upon the thickness and size of the
hole for the screw. They can be 1.5 mm, 2mm. 2.5 mm can be used for fixation of
mandibular fractures.
They come in variety of shapes such as “L”, “X”, “Y” and straight etc.
The screw are of different length and diameter depending upon thickness of the
cortical bone into which they are fixed.
RETRACTORS
Langenback’s Retractor
“L” shaped retractor with long handle.
Used for retraction of the edges of a flap for improved visualization of the deeper
layers and structures.
It comes in different sizes depending upon length of the handle and width of the blade.
Tongue Depressor
Also a “L” shaped retractor without handle.
It has broad, flat rounded blade.
Used for the retraction and depression of the tongue to improve visibility of the
posterior pharyngeal wall and the tonsillar region.
Also used for the rotation of the tongue for the removal of throat pack, visualizing the
lingual side of the mandible for the procedures.
It can also be used for cheek retractors.
Austin’s Retractor
Also an “L” shaped retractor without handle.
Used basically for the retraction of small intraoral flaps as in case of removal of an
impacted tooth.
MISCELLANEOUS
Sinus Forceps
This is used in the drainage of pus from an abcess.
After an incision, the sinus forceps is inserted by blunt dissection into the abcess cavity
and opened up. The pus drains along the blades of the forceps.
The blades are narrower and longer than a hemostat. It has sterration only at the tip.
Periosteal Elevators
These can be of different designs: Howart’s Dial’s periosteal elevators, Moon’s probe
etc.
After a mucoperiosteal incision, the sharp end of the periosteal elevator is used to
reflect a mucoperiosteal flap.
Dial’s periosteal elevator : This has one rounded edge and one pointed end. The
pointed edge is used todetect the papilla while the rounded edge to reflect the
mucoperiosteal flap and small flaps.
Moon’s Probe : It is right angled instrument with a narrow working edge. Used basically
for mucoperiosteal elevation around the tooth before extraction.
Curette
This is a spoon-like instrument used for enucleation or curettage.
It is used to remove soft tissue lesion within the bone cavity such as cyst or tumor.
Can also be used to remove sinus tracts, necrotic tissue from extraction socket etc.
It is used by scraping against the bony walls to separate the pathological soft tissue
from the healthy bone.
Mouth Gag
This is an instrument used to forcefully open the mouth in case of trismus.
It has broad serrated blades which are made to rest on the occlusal aspect of the
molars while the instrument is opened with slow, gradual force.
It can also be used to keep the mouth open for intraoral procedures under
anaesthesia.
INSTRUMENTS USED FOR EXTRACTION OF TEETH AND
ROOT REMNANTS
Elevators
The dental elevators are used to luxate the teeth from socket prior to application of the
forceps. It addition elevators also expands the bony socket facilitating tooth
extraction.
They are also used to remove root remnants from the extraction socket.
The elevator has three components :
1. The handle,
2. The Shank and
3. The blade.
Depending on the size and shape of the blades the elevators can be classified as :
1. Straight or gouge type
2. Triangular type
3. Pick type.
Commonly Used Elevators
Straight Elevators (Coupland, London Pattern)
Straight elevators are most commonly used for luxation of teeth. The blades have
concave surface on one side, that faces the tooth to be elevated. Sometimes blade
can be at the angle of shank, allowing the instrument to reach the posterior areas of
the oral cavity. Common examples of these elevators are, the Miller and the Potts
elevator.
Cryer’s Elevator
The working tip is angulated, with one covex and another flat surface.
The flat surface is the working side. It is based on lever and the wedge principle.
Uses
1. For extraction of root stumps of mandibular molars when one root is removed and the
other left behind.
2. For extraction of mandibular molar root stumps when both the roots are present but
one fractured at a lower levelthan the other or when the furcation is intact.
Two separate elevators are available for the mesial and distal angles to the handle.
Winter’s Elevator
It is a crossbar elevator. The shank is at right angles to the handle. The working tip ia
at an angle to the shank. The blade has flat and convex surface. The flat surface is
the working surface and is placed facing to be elevated. It work on the wheel and
axel principle.