Equipment for bone surgery
Compact electric dispenser machines are used to work with jaw bone. Their main feature is the ability to maintain high torque at low rotational speeds. This is critically important in clinical practice, as this mode minimizes the risk of thermal bone injury.
Each dispenser machine is equipped with a roller pump. Its purpose is to continuously supply cooling liquid either directly to the bone tissue surface or through the internal channel of the cutting instrument.
The standard equipment set of the office must include two types of surgical handpieces for the dental drill:
- Straight handpieces.
- Contra-angle handpieces.
Diagnostic Instruments
This group is intended for the examination of teeth and the oral cavity, as well as for the safe retraction of soft tissues (tongue, lips, cheeks). The main instruments include a spatula, Buyalsky spatula (used for tissue retraction), dental mirror, tweezers, and explorers.
A dental mirror consists of a handle, a screw-in stem, and a round reflective surface (about 2 cm in diameter) in a frame. Mirrors can be flat (providing a real image) or concave (magnifying the object). Their functions include:
- Examination of hard-to-reach areas.
- Additional illumination of the operating field.
- Fixation of soft tissues and their protection from accidental trauma.
To prevent the mirror from fogging up, it is wiped with ethanol or warmed to body temperature by pressing it against the buccal mucosa.
Dental explorers are divided into:
- Straight (with a bayonet working part) and contra-angle.
- Sharp-pointed: for detecting caries, assessing fissures, and root canal topography.
- Sickle-shaped: for exploring root furcations.
- Ball-ended periodontal probes (with markings): for measuring pocket depth and assessing gingival recession.
- Ball-ended probes: for investigating fistulas.
- Fine blunt-ended probes: for catheterization of salivary gland ducts.
Forceps are used for placing cotton pellets, holding small instruments, and assessing tooth mobility.
Surgical instruments
The arsenal for surgeries is extensive and classified by purpose:
- Cutting instruments (for dissection and excision of tissues). These include scalpels (one-piece, with a replaceable blade, sapphire, laser, radioscalpels), scissors (counter-cutting instruments for suture removal, cutting tissues and threads), and trephines (for biopsy and gingival punch during implantation).
- For bone surgery. This category includes chisels, osteotomes, mallets, surgical curettes, bone rongeurs, bone files, saws (disc and single-bladed), drills, trephines, burs of various shapes (steel, carbide, diamond), and cutters.
- For tooth extraction. Traditionally, these are forceps and elevators.
- For tissue retraction. Retractors (Langenbeck, Farabeuf, Deaver), spatulas, and Buyalsky spatula are used.
- For tissue grasping. Clamps and forceps.
- For tissue approximation. Surgical needles, needle holders, suture material.
- Specialized equipment. Mouth gags, dental splinting kits, and the mandatory tracheotomy kit (includes a cannula, a sharp single-prong hook for tracheal fixation, and a dilator).
Basics of Ergonomics
Work in the surgical dental office is subject to the rules of ergonomics — the science of creating optimal working conditions. The main goals of applying ergonomic principles in dentistry are:
- Reducing the physical and mental workload for both the dentist and the dental nurse.
- Prevention of occupational diseases.
A properly organized workspace and strategic equipment layout increase productivity and preserve staff health.
Briefly: answers to topical questions
What types of surgical retractors are used for tissue retraction?
- Langenbeck retractor — an instrument for retracting soft tissues.
- Farabeuf retractor — a plate-type instrument for retracting wound edges.
- Deaver retractor — an instrument for tissue retraction.
- Spatulas — auxiliary devices for retraction.
- Buyalsky spatula — a specific instrument for soft tissue retraction.
- Sharp metal rake retractor (Volkmann) — a jagged hook for retracting skin and subcutaneous adipose tissue.
- Blunt metal rake retractor (Volkmann) — an instrument for retracting deeper tissues.
- C-shaped plate retractor (Farabeuf) — an instrument for retracting wound edges.
- Sharp single-prong hook — an instrument for tissue fixation and traction.
What shapes of dental burs are used for bone work?
Burs of various shapes are used for working with bone and hard tissues, including round, cylindrical, tapered, and inverted cone burs.
What types of forceps are used for extracting maxillary teeth?
- Straight forceps — instruments with short beaks for extracting upper incisors and canines.
- S-shaped forceps without a projection — special instruments for extracting upper premolars.
- S-shaped forceps with a projection — instruments for extracting upper molars, where the projection is located on the buccal side.
- Bayonet forceps — universal instruments for extracting the roots of all maxillary teeth.
- Forceps with elongated and more curved beaks — a modification of bayonet forceps for extracting upper third molars.
- Forceps curved flatwise — special instruments for molar extraction.
What types of elevators are used for tooth extraction?
- Straight elevator — an instrument used for the extraction of single roots of maxillary teeth and separated roots of maxillary molars, as well as mandibular third molars.
- Angular elevator — an instrument with a working part bent along the edge, used for the extraction of mandibular tooth roots.
- Bayonet elevator (Lecluse elevator) — a modification of the straight elevator with a bayonet-shaped bend of the shaft, designed for the extraction of the mandibular third molar.
What types of suture materials are used for tissue approximation in the oral cavity?
- Catgut — a natural absorbable suture material.
- Chromic or silver catgut — a natural absorbable material impregnated with metals to prolong the absorption period.
- Silk — a natural non-absorbable suture material.
- Vicryl — a synthetic absorbable suture material.
- Dexon — a synthetic absorbable suture material.
- Capron — a synthetic non-absorbable suture material.
- Lavsan, dacron, nylon, fluorlon — synthetic non-absorbable suture materials.
What types of bone rongeurs are used in oral and maxillofacial surgery?
- Luer bone rongeurs — rongeurs with oval jaws designed for trimming sharp bone ends and edges.
- Liston bone rongeurs — rongeurs used for bone resection and cutting small bone fragments.
Class and exam questions
Why is low rotational speed important when working with bone tissue?
Low speed combined with high torque and mandatory cooling reduces the risk of thermal injury (burn) to the bone tissue.
What is the purpose of a graduated periodontal probe?
It features linear graduations and is used to measure periodontal pocket depth, determine the level of gingival recession, and assess the degree of tooth root exposure.
What is included in the tracheostomy kit in the oral surgeon's office?
The kit includes a tracheostomy cannula, a tracheal dilator, a sharp single-hook for tracheal fixation, and auxiliary instruments.
What else to study on this topic
- Types of burs for surgical bone procedures
- Structure and operating principle of the radiosurgical unit and electrosurgical knife
- Technique of using elevators in tooth extraction
- Instruments for periodontal surgery
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Other topics in "Chapter 2. Organization and Equipment of the Dental Surgery Office (M.M. Pozharitskaya)"
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