Instruments - Surgical Dentistry Flashcards
How many towel clips are in the tray? What are they used for?
- 2 towel clips.
- Used for holding a piece of tubing to the patient’s sterile drape.
What is McKessons Mouth prop used for? When can it be used?
- Small rubber item used to PROP THE MOUTH OPEN.
- Can be used at any point during the procedure (ex. patient’s jaw tired of being open, patient finding pressure on the mandible challenging - gives mechanism for them to close together, stabilize things and facilitate tooth removal).
What is used to keep the mouth of patients open under GA? Why is this needed?
- Mouth is closed due to muscle relaxant.
- Use McKESSONS MOUTH PROP.
How is the McKessons Mouth Prop inserted?
- Inserted with the smaller end POSTERIORLY.
- The larger side/ side with writing sits facing the CHEEK.
- Serrated surface sits between the teeth and the flange.
- Chain comes up and out of the mouth and allows you to HOLD ON/ RETRIEVE them.
What are the 3 colors of the McKessons Mouth Prop ranked from smallest to biggest?
Yellow < Blue < Orange
What size scalpel handle is contained within the tray? What is the specific scalpel handle called?
- Size 3.
- Swann Morton Scalpel Handle.
3 instruments used to help elevate the flap?
- Molt No.9 Periosteal elevator.
- Mitchell’s Trimmer.
- Howarth’s Nasal Rasp/ Periosteal Elevator.
What does a Molt No.9 Periosteal Elevator?
- Gets under periosteum and sits against bone to help elevate the flap.
With what grip do we hold a Molt No.0 Periosteal elevator?
Pen grip.
Which part of the Molt No.9 Periosteal elevator and Mitchell’s Trimmer faces the bone? Which faces the mucosa?
- CONCAVE goes towards the BONE and under Periosterum.
- CONVEX used to push the mucosa out of the way.
What are the two ends of a Mitchell’s trimmer?
- Spoon end (used for raising elevating flap).
- Pointy end (used for stripping attachments from bone).
What is the pointy end of the Mitchell’s trimmer used for?
Used for STRIPPING ATTACHMENTS FROM BONE.
What are the 2 ends of the Howarth’s Periosteal Elevator used for?
- Soft end: introduced under periosteum and used to ELEVATE THE FLAP
- Curved/sharp end: Used for STRIPPING THINGS FROM BONE. (unwise to use these to retract flaps).
2 differences between Molt No.9 Periosteal Elevator and Mitchells Trimmer?
- Mitchells Trimmer SMALLER.
- Mitchells Trimmer has a sharp/ pointy end.
What was a historical use of the Howarth’s Nasal Rasp/ Periosteal Elevator?
FORMAL LINGUAL RETRACTION of a mandibualr 3rd molar.
- Was introduced between bone and soft tissues, aim to PROTECT THE LINGUAL NERVE FROM DAMAGE FROM A ROTATING BUR.
What does a Minnesota Retractor do?
Introduced under the periosteum and used to RETRACT TISSUES WHEN OPERATING.
What are the two ends of a Minnesota retractor?
- One end at a right angle.
- One end relatively straight.
How is the minnesota retractor placed within the mouth? In what area is it particularly useful for retraction?
- The slightly raised sides are towards the OPERATIVE SITE.
- Slight curvature to help overcome the CHEEKS.
- Good down the lateral aspect of the mandibular ramus for operating on MANDIBULAR 3RD MOLAR TEETH.
What retractor is good for operating on mandibular 3rd molar teeth?
Minnesota Retractor.
How is the Bowdler-Henry Rake retractor used?
- Spines/ teeth sit gently on the bone with the mucoperiosteal flap retracted behind it.
- Curve rests up and over the cheek going from intra to extra oral.
- Long handle which can be held at the very end to keep the non-dominant hand out of the operating site.
2 types of retractors?
- Minnesotta Retractor.
- Bowdler-Henry Rake Retractor.
How do we hold a Bowdler-Henry Rake Retractor?
Hold handle with FINGERTIPS and not fist as that can tend to make it DRAG.
How fast do surgical handpieces go?
Maximum 40,000 RPM which must be irrigated with SALINE.
What is a round bur in a straight surgical handpiece used for typically?
Used for removing bone around teeth. Although can also be used to section teeth.
What is a straight fissure bur in a straight surgical handpiece used for typically?
Used for sectioning teeth. Although can also be used to remove bone around teeth.
What must we be aware of when use a surgical handpiece?
Must be aware to not touch mucosa with spinning shank of the bur (when cutting with the tip) to ensure we do not BURN the tissues.
What must we be careful of regarding the saline used in surgical handpieces?
Must be only SODIUM CHLORIDE SALINE without any additives (ex. Potassium).
What are the 3 types of elevators present in the surgical tray?
- Couplands 1,2,3.
- Warwick James S, R and L.
- Cryers L and R.
What are spencer wells forceps useful for? What do they tend to look like? What are they also called?
- Good for crashing things (ex. an artery) and holding onto it while doing something else with it.
- Tend to look like NEEDLE HOLDERS - these will NOT hold a needle and needle will ROLL AROUND.
- Artery forcep.
How can you differentiate between needle holders and spencer wells?
- Less fine.
- More rough.
What is another term for Fickling forceps? What do they look like (2)?
- Rattooth forceps.
- One sharp blade pointing into a NOTCH.
- Have a small angle to them.
What are Fickling forceps used for (2)?
- Good for HOLDING and MANIPULATING soft tissue.
- Can occasionally be used to retrieve roots and teeth however they ARE NOT DESIGNED TO DO THIS and things can slip out.
Another term for Rongeurs? What is their function?
- Bone nibbler.
- Clips off little bits of bone.
How should Rongeurs be used? How should they be held?
- Should be held STATIC and should be used on THIN bits of PERIPHERAL bone.
- Must hold them with the PALM.
What does a bone file do? What is it also called?
- Files bone.
- Can draw it towards oyurself or push away - used to SMOOTH DOWN JAGGED BITS OF BONE.
- Also called a RASP.
How is a bone file held? What are its two ends?
- Held in a pen grip.
- Double ended, both rasps of slightly different sizes.
What can be used to smooth over bone (3)?
- Rongeurs.
- Bone file
OR - Straight handpiece and bur.
Why must we irrgate after surgical XLA? How?
- Bone, dust, debris, tooth fragments in the mucoperiosteal flap and socket, must be removed as POTENTIAL SOURCES OF INFECTION.
- Elevate the flap, retract the periosteum and irrigate underneath.
- Irrigate the extraction socket.
3 uses of a lacks retractor?
- Reflect a mucoperiosteal flap.
- Gently retract the tongue - COMMON.
- Airway protection during elevation (for maxillary and mandibular teeth).
What is an instrument that can be used to retract the cheek?
Kilners Cheek Retractor.
What are tooth tissue forceps used for? What grip is used?
- Hold and manipulate tissues during suturing.
- PEN grip.
What are the two types of scissors contained in the surgical tray?
- Mcindoe.
- Iris.
What are Mcindoe scissors used for?
- Long with gentle curvature to tips aka NO SHARP END.
- Curvatures allow to CUT SUTURES at the back of the mouth and the curved parts will not damage gingivae/ buccal mucosa.
- good for BACK OF MOUTH.
What are iris scissors used for?
- Have SHARP tips - can nip mucosa.
- SHORTER.
- Preserved for CLOSER TO THE FRONT OF THE MOUTH.
