Surgery

2. SURGICAL INSTRUMENTS
EXTRACTION FORCEPSES
ELEVATORS
SURGICAL INSRUMENTS
LOCAL ANESTHESIA INSTRUMENTATION

3. Upper forceps
Straight forceps
On straight line
lower forceps
Angulated forceps

4. Upper Forcepses
Anterior Premolar Molar Others
Components

6. Forceps consist of :
Handel
Hinge = joint
Beaks = blades

7. Upper anterior forceps

8. Upper anterior forceps used for :
Extraction of upper anterior teeth
Beaks are symmetrical & are placed in
thesame line as the handles ( on
straight line )
beaks are concave and not pointed

10. Upper premolar forceps :

11. :Upper premolar forceps
Used for extraction upeer premolars teeth
Beaks are symmetrical , concave, not
pointed
The forcep have a slightly curved shape
and look like an “S.”
Holding the forceps in the hand, the
concave part of the curved handle
faces the palm , while the concave
part of the beaks is turned upwards
sCurve due
to
accessibility

12. FORCEPS FOR UPPER PREMOLARS

13. Upper molar forceps :

14. Maxillary molar forceps
Used to extraction upper molar
teeth
There are two maxillary molar forceps: one for the
left and one for the right side R & L
Forceps have a slightly curved shape
The have asymmetrical beaks : sharply pointed
buccal beak and rounded palatal beak
Beaks are broader than anterior forceps
Holding the forceps in the hand, the
concave part of the curved handle faces
the palm , while the concave part of the
beaks is turned upwards
R
L

15. FORCEPS FOR UPPER MOLARS

16. FORCEPS FOR UPPER REMANING ROOT
REED’S FORCEPS
Use: Extraction of upper remaining rootsin
posterior teeth

17. FORCEPS FOR UPPER
REMANING ROOT
• BAYONET
Use: 1-Extraction of upperremaining roots
2- Extraction of rudimentary upper wisdom
tooth

18. FORCEPS FOR UPPER THIRD MOLAR
JOCKYFORCEPS
Use: Extraction of upper third
molars

19. Bayonet forceps jocky forceps

20. Upper canine forceps
Used for extraction of upper canine
As upper anterior forceps but their blades more wider

21. Lower Forceps
Anterior Premolar Molar Others

22. Lower anterior forceps

23. Lower anterior forceps
• Lower anterior forceps have identical , short closed beaks
• Beaks are narrower than lower molar forceps, similar to upper root
forceps
• Beaks are at right angles to the handles
• They can also be used as lower root forceps

24. LOWER ANTERIOR FORCEPS

25. 2- FORCEPS FOR LOWER PREMOLAR

26. • The mandibular premolar forceps have
• identical long and broad open beaks
Mandibular premolar forceps

27. 3- FORCEPS FOR LOWER MOLAR

28. Lower molar forceps
• Beaks are at right angles to the handles
• Beaks are symmetrically pointed & the sharp pointed tips engage the
bifurcation at the buccal & lingual surfaces
• Beaks are more broader & stout

29. FORCEPS FOR LOWER MOLAR

30. FORCEPS FOR LOWER MOLAR

31. 4- FORCEPS FOR LOWER REMAINING ROOTS
Use: Extraction of lower remaining roots

32. ELEVATORS
Classification of
elevators (3 categories)
According to shape

33. 1. Lever Principle
three basic components:
Fulcrum
Effort
Load

34. Wedge Principle

35. Wheel and Axle
Principle

37. USES:
• 1 luxate a mesio-angular
impacted lower third molar with distally
curved roots. fulcrum is interdental bone
• 2 mult. ext. of neighboring teeth
• 3 luxation of last abutment
• Mesial application of force.
Most commonly used
Blade: concave surface
on one side-the tooth to be elevated
Principle:
Wedging & lever
& wheel & axel = rotational forces
STRAIGHT ELEVATOR

38. STRAIGHT APEXO
COUPLAND CHISEL

40. CURVED APEXO
Come in pair … one luxate
mesial root in right side
and distal root in left side
and the other luxate distal
root in right side and
mesial root in left side …
So its come in pair but not
used as R and L
Principal of action
wedging

41. CRYER
• EX. If extract 7 or
6 tooth .. useful when a
broken root remains in
the tooth socket and
the adjacent socket is
empty
• concave surface
on one side to root to
be elevated
• Come in pairs
• Curved elevator

42. MILLER
R L

43. CROSS BAR
Socket applicator

44. CROSS BAR
Buccal applicator

45. CROSS BAR

46. SURGICAL INSTRUMENTS

47. BARD-BARKER BLADE HANDLE
Handle: The most commonly used handle in
oral surgery is the Bard Parker blade handle
no. 3.
Its tip may receive different types of blades.

48. BARD BARKER BLADES
Blade no. 11 is used for small incisions
, such as those used for incising abscesses (stap incision)
Blade no. 12 is indicated for incisions in inaccessible
areas such as the maxillary tuberosity & retromolar areas.
Blade is no. 15 The most common type used for flaps
and incisions on edentulous alveolar ridges.
No.10- similar to No.15
oLarge skin incisions

49. Blade loaded
Blade removed

50. Scalpel

51. PERIOSTEAL ELEVATOR
Use: reflection of flap

52. Retractors
Minnesota retractors for
retraction of the cheek and tongue and
mucoperiosteal flap

53. MOUTH GAG
Use: forceful
mouth
opening …
open the
mouth with
uncooperative
patients.

54. TONGUE DEPRESSOR

55. TONGUE HOLDER

56. Mouth props:
Rubber bite blocks used
to hold the mouth open.

57. RETRACTOR
Use: retraction of flaps or
cheek

58. Retractors

59. RETRACTOR

60. RETRACTOR

61. CHISELS
• BEVELED CHISEL
▫ UNIBEVELED removal of bone in
flanks
▫ BIBEVELED (OSTEOTOME):
• tooth division
• Condylotomy
• Re-fracturing malunion bone

62. MALLET AND CHISELS
• MALLET

63. MALLET AND CHISELS

64. CHISELS
• GROVED CHISEL
Use: removal of soft bone
or biopsy

65. BONE RONGEURS forceps
Use: bone
cutting forceps

66. 1. Side-cutting; suitable for trimming
& cutting sharp edges of the alv.
Plates.
2. End-cutting; suitable for cutting
bone septum projecting in the socket
of extracted teeth.
3. Side and end cutting.

67. SURGICAL BURS
Round burs are used to drill holes in the
bones which are then connected by the
Fissure bur

68. BONE FILE
Use: smoothening of sharp
bony edges

69. oRemoves bone: pull stroke
BONE FILE

70. ARTERY FORCEPS
• CURVED • MOSQUITO HEMOSTAT
Use: ligation of blood
Vessels and blunt
dissection during I&D

71. ALLIS FORCEPS with ratchet lock
Use: handling pathological
soft tissues

72. TISSUE FORCEPS
Used to hold normal soft tissue & stabilize it
for suturing or dissection.

73. BONE CURRETTE
Use: 1-bone curettage
2-cyst removal

75. SUTURING INSTRUMENTS

76. SUTURING INSTRUMENTS
• NEEDLE HOLDER

77. Needle holder

78. SUTURING INSTRUMENTS
• NEEDLE

79. Round suture needles
Round cross section
May be straight, curved or half circle
Suturing of fragile and delicate tissues e.g. oral mucosa and
mucous membranes
Cutting (Atraumatic) suture needles
Triangular cross section
May be straight, curved or half circle
Suturing of dense tissues e.g. oral mucoperiosteum
Types ofneedle

80. Suture materials

82. INTERRUPTED SUTURE

83. Simple Interrupted Sutures

84. SimpleInterruptedSutures

86. • CONTINOUS SUTURES
SUTURING TECHNIQUES

87. Continuous Sutures

89. CONTINOUS LOCKED SUTURE
BLANKET SUTURE

90. Continuous with Lock Sutures

91. SUTURING TECHNIQUES
• MATTRESS SUTURE
HORIZONTAL

92. Horizontal Mattress Sutures

93. SUTURING TECHNIQUES
• MATTRESS SUTURE VERTICAL

95. POSITIONS OF THE OPERATOR
AND THE PATIENT
• INFILTRATION
ANAESTHESIA
• NERVE BLOCK

96. INFILTRATION ANAESTHESIA

97. INFILTRATION ANAESTHESIA
PALATAL INF. BUCCAL INFILTRATION

98. INFERIOR ALVEOLAR NERVE
BLOCK
RIGHT SIDE

99. INFERIOR ALVEOLAR NERVE
BLOCK
• LEFT SIDE THR CROSS HAND TECHNIQUE

100. INFERIOR ALVEOLAR NERVE
BLOCK
• LEFT SIDE THE BEHIND TECHNIQUE

101. INFERIOR ALVEOLAR NERVE
BLOCK
• LEFT SIDE THE LEFT HAND
TECHNIQUE

102. Mucoperiosteal Flaps

103. 1. Pyramidal flaps
A. Triangular Flap (2 incision lines)

104. 1. Pyramidal flaps
B. Trapezoidal Flap (3 incision lines)

105. 2. Semilunar flaps

106. 3. Gingival (Envelope) flaps

107. 4. Palatal flaps
Y-shaped Palatal Flap Double Y-shaped Palatal Flaps

108. 5. Pedicle Flaps