Tools Flashcards
Straight Upper anterior forceps
only straight
easy access
3-3
single rooted
upper universal forceps
same single rooted tip as upper straight
but curved to allow slightly further back in oral cavity
upper molar forceps
2 roots buccal and 1 palatal
- engage furcation on buccal side
- beak to cheek
separate ones for each side
- smooth single root
- point engage furcation
what forceps are these
upper universal forceps and then straight upper anterior forceps
- Straight upper anterior forceps Vs upper universal forceps
- Similar tips
- Curvature allows access to premolars
lower forceps
have 90o bend to allow reach in lower arch
root and universal narrower at tip - single rooted
molar has pointy beaks on both sides to engage both furcations
cowhorn forceps
engage furcation in mesial and distal roots
- Only really on younger individual – lifts tooth
- Need divergent roots
- No grip, just squeeze
‘bayonet’ forceps
Z shaped
Uppers
- Narrow pointy one – root forceps
Upper 8s have variable morphology – common to have multiple roots fused – assume single root no furcation to grip
right handed operator stance for extractions
behind pt for lower right
all other in front of pt on their right
elevator functions
- Mobilise the tooth
- Widen PDL
- Before delivering tooth with forceps – more control, less chance of inhalation of loose tooth
Grab tooth higher up as forceps can go into the socket that has been widened
3 types of elevators
couplands
cryers
warwick james
coupland’s elevators
most frequently used
- Hug rounded surface of tooth trying to elevate
- single
- Bigger number = wider the tip (1, 2, 3)
cryer’s elevators
- Sets of 2 – pairs
- Tips facing, concave surface is facing up – right hand holds right (same for Warwick James) (smile to sky)
- Elevate roots down a socket
- E.g. fractured part remains in sockets
Warwick James elevators
Sets of 3
- Right
- Left
- Straight
Concave surface of right and left, but less sharp than cryers
- Uppers 8s wisdom
Straights – useful for lower 8s elevation as can fit more effectively into narrower space
luxators
Very sharp
- Like Coupland’s ended – but sharper
Narrow – easily broken, bend
Very effective but risky as can cause harm
Designed for luxating the tooth
- Tear ligament around tooth
(not elevators)
periotome
Mini blade
Work down PDL
Cut space
- Effectively cut most ligament around tooth to ease extraction
Atraumatic to adjacent bone – good for implant
- Save as much bone as possible
Timely – long procedure but more preservative for bone
Can get tips of US
wheel and axle motion
most common - Elevators (not luxators – bend tip)
- Buccal elevation
- Twisting on axle
- Elevate tooth upwards
lever
- More force
- Can be dangerous – large force on bone – can fracture
wedge
- Can be used for luxators if careful of fractured root fragments
- Push down ligaments to displace fractured root out
mechanical principles of elevators
- All three actions can be used in combination with each other
- Must avoid excessive force (e.g. with bodily movement of elevator rather than rotation)
There are various points of application for the elevators
couplands, cryers, Warwick James
start mesial
- concave surface mesial to surface to elevate
- twist wrist
upwards and backwards force on tooth to displace tooth out
lower 8 go lingual (only one) as buccal bone denser
combination of sequence of mesial then buccal – best
- don’t do in unison - need to have a hand supporting pts jaw
Ash periosteal elevators - used to separate the periosteum from underlying bone
Bone file – looks nail file – single or double ended
smooth bone
Hennry Rake retractor – fancy L shaped thing – flap deflection
Howarth’s periosteal elevators – used to separate the periosteum from underlying bone
mitchells osteo trimmer – remove sharp bony spicules
Victoria curette – remove granulation tissue from socket
double spoon
1 – Safety plus syringe – used deliver LA
2 – mirror – used for soft tissue retraction and indirect vision
3 – straight probe – used to test anaesthesisa
4 – college tweezers – used place CWR, remove small sequestra
5 – scalpel handle and blade – used to make incision for flap raising or biopsy
6 – S cheek retractor - to retract the cheek
7/8 – Howarth’s periosteal elevators – used to separate the periosteum from underlying bone
9 – Ash periosteal elevators - used to separate the periosteum from underlying bone
10 – Couplands No 1 – used to elevate the tooth and create space for forceps , smallest size
11 - Couplands No 2
12 - Couplands No3
13 – Warwick James Right
14 – Warwick James straight
15 – Warwick James Left
16 – Cryers Elevator Right
17 – Cryers Elevator Left
18 – curved moskito forcepts – picking up fractured/separated instruments or posts or artery clips
19 – bone nibblers –trim bone and remove bone spicules
20 – Rake retractor – fancy L shaped thing – flap deflection
21 – Bone file – looks nail file – single or double ended – looks like nail file
22 – Victoria curette – remove granulation tissue from socket
23 – mitchells osteo trimmer – remove sharp bony spicules
24 – straight spencer wells forcepts – picking up teeth and remove sharp bony spicules
25 – alice tissue forceps – used to soft tissue
26 – kilner need holders – used for suture needle holding
27 – fickling forceps
28 – gillies needle holders
29 – gillies toothed tissue forceps – used for holding soft tissue whilst suturing
30 – scissors – used to cut suture
31 – lack’s tongue depressor – to keep togue still
32 – 2x towel clips – clip things onto trolley
alice tissue forceps – used to hold soft tissue
bone nibblers –trim bone and remove bone spicules
curved moskito forcepts – picking up fractured/separated instruments or posts or artery clips
towel clips – clip things onto trolley
fickling forceps - type of needle holder
gillies needle holders
gillies toothed tissue forceps – used for holding soft tissue whilst suturing
kilner need holders – used for suture needle holding
lack’s tongue depressor – to keep togue still
straight spencer wells forceps – picking up teeth and remove sharp bony spicules, can clip arteries
