Lecture 5 - Instrumentation & Mechanical Principles of Exodontia

what is the most common scalpel used in oral surgery?

15 blade

how should a scalpel blade be placed?

using a hemostat, not your fingers

should a scalpel be used with short strokes or long cuts?

long cuts

what are examples of instruments used to elevate periosteum?

#9 mold and PP buser periosteum elevators

what is the function of a minnesota retractor?

retraction of the cheek, flap retraction

what is the function of a henahan/seldin retractor?

hold, retract, protect soft tissue

is a weider tongue retractor more commonly used when patient is awake or unconscious?

unconscious

what is the function of adson forceps?

grasp tissue without damaging it

what do debakey tissue forceps allow for compared to other tissue forceps?

more posterior access

when are halstead-mosquito hemostats used?

thin soft tissue only

when are kelly hemostats used?

flexible, easily moved tissue

what is the function of rongeurs?

breaks large pieces of bone down for removal

what type of bur should be used for root removal?

turbine/air handpiece with a 45 degree angle

why should a turbine/air handpiece not be used to open a flap or section bone?

air from handpiece can cause emphysema

what type of bur should be used for bone removal?

electric handpiece with self-irrigation

at what temperature does bone die?

42 degrees C

what is the function of a 702-L bur?

fissured end allows for effective bone and tooth removal

what does filing of bone allow for?

smoothing and rounding of sharp corners from exodontia, allowing for proper healing

is a cross-hatch or parallel bone file (miller-colburn) more effective?

cross-hatch

what is the function of an alveolar curette (lucas)?

granulation tissue removal, scraping of bone walls

are needle holders straight tipped or curved tipped?

straight tipped

can hemostatic clamps be used to suture?

no

what are luxators?

thin, wedged instruments that go parallel to the root to wedge PDL out of the way in order to inch closer to the apex and push the tooth loose

what is the function of a periotome luxator?

cuts PDL while compressing the alveolar bone, cutting the membrane and and easing the tooth from the socket while preserving bone integrity

how should an elevator be held in relation to a tooth?

45 to 90 degrees to the root

should force be applied to the crown or CEJ of a tooth with an elevator?

CEJ

how is the tip of a 301 elevator described?

straight

how is the tip of a cryer elevator described?

angled/triangular

how is the tip of a crane pick elevator described?

angled/tapered

when are forceps used during exodontia?

once a tooth is mobile

where are 150 universal forceps used?

maxillary anteriors/premolars

where are 1 forceps used?

maxillary anteriors

where are 53 R and L forceps used?

maxillary molars

if the tip of forceps is parallel to the handle, is it meant to be used for the maxilla or mandible?

maxilla

if the tip of forceps is at 90 degrees to the handle, is it meant to be used for the maxilla or mandible?

mandible

where are 88 R and L forceps used?

maxillary molars

where are 210 forceps used?

maxillary molars with conical roots

where are 65 forceps used?

maxillary root tips

where are 151 forceps used?

mandibular anteriors/premolars

where are english style forceps used?

mandibular anteriors/premolars

where are 17 forceps used?

mandibular molars

where are 87 forceps used?

mandibular "cow horn" molars (furcation)

what is the result of a wedging movement using a small, straight elevator?

can be used to expand, split and displace; displaces tooth root from its socket by driving the elevator apically in the PDL space

what is the result of using the beaks of forceps as wedges?

expands alveolar bone, displaces tooth in occlusal direction

what is the result of a lever movement using the tip of an elevator placed at the purchase point?

depresses the handle apically and elevates the tooth occlusally out of the socket with bucco-alveolar bone used as the fulcrum

what is the result of a wheel (tip) and axel (handle) movement using an elevator?

engagement and elevation of the tooth root from the socket

what is the result of apical pressure using forceps?

tooth socket is expanded by insertion of the beaks down into the PDL space, center of rotation is displaced apically

what is the result of buccal displacement using forceps?

expansion of the buccal plate mainly at the crest of the ridge

what can excessive force during buccal displacement with forceps cause?

fracture at the apical portion of the root

what is the result of lingual-palatal displacement using forceps?

lingual pressure expands linguocortical plate at crestal area and slightly expands buccal bone at apical area

what is the result of rotational pressure using forceps?

internal expansion of tooth sockets and tearing of PDL

what types of teeth are more likely to fracture under rotational pressure?

teeth with multiple roots or abnormally shaped roots with curves

what is the result of tractional forces using forceps?

pulls tooth from socket once adequate bony expansion has been achieved

what are the limitations of tractional forces?

should only be used in the final portion of the extraction process and should be gentle