Instrumentation Flashcards
(elevating tissue)
• For interdental papillas, attached gingiva,
crestal periodontal fibers
- Fine/ precise mvmnts
WOODSON NO. 1
(elevating tissue)
• Pointed end for interdental papilla
• Broad end for free alveolar mucosa
elevation and flap retraction
MOLT NO. 9
(TECHNIQUE FOR ELEVATING MUCOPERIOSTEUM)
• Most common technique used, especially when combined with rolling/lifting component
• Push stroke
(TECHNIQUE FOR ELEVATING MUCOPERIOSTEUM)
• Good for interdental papilla
• Rolling/lifting
____ retractor
- Great for tongue retraction, and flap retraction
- Not used as a periosteal elevator (blunt ends)
• Seldin retractor
_____ retractor
- Cheek, flap retractor
- Workhorse of retractors in OMS
• Minnesota retractor
• Wieder retractor, a.k.a. “Sweetheart” retractor is used for _____ retraction
TOngue
• Any flap instrument for compressing bone around a nutrient ves
Burnisher
- Three teeth opposed
- Stabilize tissue while passing suture needle
- Not good for grasping needle
- Used on skin
ADSON FORCEPS
- Multiple serrated tips
- Grasping keratinized mucosal edges
- Good for grasping needle
- Not for skin or fine tissue
BROWN FORCEPS
• Grasping and manipulating large portions of tissue that are going to be removed from the
body
• I.E. epulis fissuratum, lesions, bone
• Not for grasping tissue that will remain
• Too much trauma from beaks
Allis tissue forceps
- Most commonly used for alveoloplasties
- Will crush/cut lips if not paying attention
- A relatively atraumatic means of removing bone
- Quick cut, does not create heat like a handpiece and bur
- Types:
- Side cutting
- End cutting
Rongeurs
- Used for final smoothing of small areas of sharpness
- Pull stroke is the action stroke
- Crosscut or parallel grooves
• Bone file
- MUST NOT EXHAUST AIR INTO OPERATIVE FIELD
- Electric vs Nitrogen powered
- Completely sterilizable
- High speed and torque
• Handpiece:
- Air-driven handpiece during surgical extraction
- Sudden edema
- Crepitus to area
- Possible for air embolus
- Air forced through venous system
- Possibly requires airway protection
- ABX to prevent secondary infection
- Resolves 3-7 days
Air emphysema
• Carbide • One time use, then throw away • #6 or #8 for bone removal or grooves • #702 or #703 for sectioning teeth/contouring alveolus/troughing • #703 has larger radius versus #702
Burs
- Surgical handpiece must be done under copious irrigation
- Will generate heat and kill superficial bone
- Thermal necrosis occurs at ____
47°C
• 6” or 15 cm
• Grasping surface on beak is crosshatched (prevent
needle spinning)
• As opposed to hemostats which are parallel
• Needle prone to spin
• Needle holder
• Tissue cutting only, do not use for suture cutting
• Iris scissors
- Tissue and suture cutting
* Serrated
• Dean angled scissors
- Passively placed to hold mouth open
* Decreases stress on TMJs
• Bite block
Holding mouth open
• Ratcheting system to remain open
• Can severely damage TMJs and teeth
• Molt mouth prop
- Uses:
- Luxate teeth, NOT to remove teeth
- Minimizes root fractures
- Requires a fulcrum point
- Types:
- Straight
- Flag/Cryer
- Pick
Dental elevators
Dental elevator
• Offset shank to aid in luxation force
• MAGIC STICK!! (E-92)
• Primary instrument for tooth delivery
• Forceps
______ Forceps
• Beaks parallel to handle
• Palm under handle
• Maxillary
______ forceps
• Beaks almost perpendicular to handle
• Palm on top of handle
• Mandibular
_____ forceps
• Beaks adapt to root structure
• Beak aligned parallel to long axis of tooth
• Acts as a wedge to expand alveolar bone
Extraction forceps
What motion is used with the ASH 13/Charlene forceps?
Twisting, turning motion
SHould the forceps contact the crown or the root?
Root only
What does ______ mean?
• Any strand of material that is utilized to ligate blood vessels or approximate tissues
‘suture’
- Sterile
- All-purpose
- composed of material that can be used in any surgical procedure
- Causes minimal tissue injury or tissue reaction
- ie, nonelectrolytic, noncapillary, nonallergenic, noncarcinogenic
- Easy to handle
- Holds securely when knotted
- ie, no fraying or cutting
- High tensile strength
- Favorable absorption profile
- Resistant to infection
Ideal Sutures
ESSENTIAL _____ CHARACTERISTICS
• Sterility
• Uniform diameter and size
• Pliability for ease of handling and knot security
• Uniform tensile strength by suture type and size
• Freedom from irritants or impurities that would elicit tissue reaction
SUTURE
_____ response to sutures (4-7 days)
• Invokes inflammatory response
• PMNL, mononeuclear cells, fibroblasts
• Initial response
• Suture made of single filament • Less inflammatory response • Less wicking • Requires more ties to assure an adequate knot
Monofilament
- Multifilament
- Greater inflammatory response
- Greater wicking
- Fewer ties for adequate knot
Braided
How are gut sutures absorbed?
proteolytic enzymatic digestive process
How are monocryl and vicryl sutures absorbed?
Hydrolysis
The more zeroes characterizing a suture size, the _____ the resultant strand diameter
smaller
• Straight line distance between the point of
the curved needle and swage
• Chord length
• Distance between point to end along needle
• Needle length
What type of needle point is used at UMKC?
Tapered
• Maintains strength and tissue position if
one portion fails
• Requires more time and suture material
• Has minimal holding power against stress
Simple interrupted sutures
- Tension suture
- Rapid
- Minimizes number of sutures needed
- Less suture material used
HORIZONTAL MATTRESS SUTURE
- Tension suture
- Brings tissue into good apposition
- Good to secure socket dressings
FIGURE OF EIGHT SUTURE
• Easy for linear long span wounds • I.e. alveoloplasty full thickness mucoperiosteal flap approximation • Involves one diagonal pass and one perpendicular pass • Uses less material vs multiple interrupted • Provides minimal tension-holding • Prone to failure if one portion fails
SIMPLE CONTINUOUS SUTURE
• Greater tissue stability vs simple running
• Uses more suture material vs simple
running
• More stable in the event of a partial failure
or breakage
LOCKING CONTINUOUS SUTURE
