1. 3rd Year 2nd Semester Oral Surgery Propedeutics Instruments AMIT DATTANI 2012
University of Debrecen, Medical and Health Science Center – Faculty of Dentistry 1
Oral Surgery Propedeutics
Instruments
Amit Dattani
2012

2. 3rd Year 2nd Semester Oral Surgery Propedeutics Instruments AMIT DATTANI 2012
University of Debrecen, Medical and Health Science Center – Faculty of Dentistry 2
Contents
Extraction Forceps ..................................................................................................................................4
General Notes .....................................................................................................................................4
Maxillary Extraction Forceps...............................................................................................................4
Incisors & Canines...........................................................................................................................4
Premolars........................................................................................................................................5
Molars .............................................................................................................................................6
3rd
Molar/Wisdom...........................................................................................................................7
Upper Roots ........................................................................................................................................8
Incisors & Canines...........................................................................................................................8
Premolars and Molars.....................................................................................................................8
Mandibular Extraction Forceps.............................................................................................................10
Incisors, Canines, Premolars .............................................................................................................10
Molars ...........................................................................................................................................11
Lower Root Forceps ......................................................................................................................12
Instruments for Incision........................................................................................................................13
Instruments for Elevating Mucoperiosteum.........................................................................................14
Instruments for Retracting Soft Tissues................................................................................................16
Instruments for Retraction of the Tongue............................................................................................17
Instruments for Controlling Bleeding....................................................................................................18
Hemostats.........................................................................................................................................18
Instruments for Grasping Tissues .........................................................................................................19
Forceps..............................................................................................................................................19
Instruments for Removing Bone...........................................................................................................21
Instruments for Removing Soft Tissues from Bone Defects.................................................................23
Instruments for Suturing Mucosa.........................................................................................................24
Needle Holders .................................................................................................................................24
Surgical Needles................................................................................................................................24
Suture Materials ...............................................................................................................................24
Resorbable ....................................................................................................................................24
Non-resorbable.............................................................................................................................24
Monofilament ...............................................................................................................................24
Polyfilament..................................................................................................................................24

3. 3rd Year 2nd Semester Oral Surgery Propedeutics Instruments AMIT DATTANI 2012
University of Debrecen, Medical and Health Science Center – Faculty of Dentistry 3
Scissors..............................................................................................................................................25
Instruments for Holding the Mouth Open............................................................................................26
Instruments of Irrigation.......................................................................................................................26
Dental Elevators....................................................................................................................................27
Straight Elevators..............................................................................................................................27
Triangular Elevators ..........................................................................................................................28
How to identify between left and right Barry Elevator?...............................................................29
Cryer Elevator................................................................................................................................29
Pick Type Elevators ...............................................................................................................................30
Towel Clamps........................................................................................................................................31
Sponge and Dressing Clamps................................................................................................................31
Probes ...................................................................................................................................................32
Sinus Probe .......................................................................................................................................32
Other Instruments ................................................................................................................................32
--------------------------------------------------------------------------------
The content of this material has been obtained from the lectures at the University of
Debrecen, internet sources and practical lessons taught at the University of Debrecen. I
take no legal obligation in the copyright or reproduction of this material. It is solely for
viewing and learning purposes.
Wishing you all the best,
--
Amit Dattani

4. 3rd Year 2nd Semester Oral Surgery Propedeutics Instruments AMIT DATTANI 2012
University of Debrecen, Medical and Health Science Center – Faculty of Dentistry 4
Extraction Forceps
General Notes
 Crown Forceps (above)- beaks don’t touch
 Root forceps (see later) – beaks touch
 Three parts to any extraction forcep: Beak, Hinge, Handle (obvious!)
 Maxillary forceps – straight beaks
 Mandibular forceps – 90 degree bend in beak
Maxillary Extraction Forceps
Incisors & Canines
(Crown forceps)
Dental extraction forceps for maxillary Incisors and canines are straight when viewed from
the side.
 Straight beak
 Same forcep used for maxillary incisors and canines
 (English forcep shown above- that’s what you need to know)

5. 3rd Year 2nd Semester Oral Surgery Propedeutics Instruments AMIT DATTANI 2012
University of Debrecen, Medical and Health Science Center – Faculty of Dentistry 5
Premolars
(Crown forceps)
Forceps for maxillary premolars are similar, to the incisor and canine forceps, but slightly
curved when viewed from the side.
 Used only for upper premolars
 Slight angulation (when viewed from the side)
 Follows curvature of premolars
 Used for both upper premolars
Remember: The upper 1st
premolar has two roots! (Just a reminder)

6. 3rd Year 2nd Semester Oral Surgery Propedeutics Instruments AMIT DATTANI 2012
University of Debrecen, Medical and Health Science Center – Faculty of Dentistry 6
Molars
(Crown forceps)
Forceps for upper molars (three rooted teeth) are different for left and right molars. The
Palatal beak has a SMOOTH concave surface and the buccal beak is POINTED. (this point
buccal beak in placed in the buccal bifurcation when extracting- clever huh?!)
 To distinguish between left and right forcep (patients left or right!):
o Try placing the buccal pointed beak into the buccal bifurcation of the 1st
or 2nd
upper molars
o If the handle is anterior (to the patient) then you are correct, if its
pointing to the posterior side of the patient then it’s the opposite side!
(you will understand this if you try it once or twice in practice)
o E.g. the big right picture above is for the RIGHT SIDE 1st
and 2nd
molar (of
the patient!)
 We use the same forceps for the 1st
and 2nd
molars (on the same side).

7. 3rd Year 2nd Semester Oral Surgery Propedeutics Instruments AMIT DATTANI 2012
University of Debrecen, Medical and Health Science Center – Faculty of Dentistry 7
3rd Molar/Wisdom
(Crown forceps)
 Forceps have broad and smooth beaks
 The forceps are bent in a certain way (Bayonet) to reach the most posterior teeth
(wisdom teeth)
 This provides easier access to them
 One forcep can be used for both sides (upper left and right)
 Only for 3rd
molars!
 (Also called Bayonet forcep- due its shape)

8. 3rd Year 2nd Semester Oral Surgery Propedeutics Instruments AMIT DATTANI 2012
University of Debrecen, Medical and Health Science Center – Faculty of Dentistry 8
Upper Roots
Incisors & Canines
(Root Forceps)
 These forceps can be used canine- canine. (incisors and canines)
 The beaks touch each other
 Used for upper roots only
 Both beaks are rounded
Tip: When extracting, try and reach apically as possible on the root surface
Premolars and Molars

9. 3rd Year 2nd Semester Oral Surgery Propedeutics Instruments AMIT DATTANI 2012
University of Debrecen, Medical and Health Science Center – Faculty of Dentistry 9
(Root Forceps)
 Also known as “Bayonett Root forceps”
 Also known as a “Wisdom Bayonett”
 Used for upper premolars and all molar roots (including 3rd
molar roots)
 Shaped in the way it is (Bayonett) for easier access to the posterior teeth
 Beaks touch- used only for extracting roots!

10. 3rd Year 2nd Semester Oral Surgery Propedeutics Instruments AMIT DATTANI 2012
University of Debrecen, Medical and Health Science Center – Faculty of Dentistry 10
Mandibular Extraction Forceps
Incisors, Canines, Premolars
(Crown forceps)
Forceps for single rooted teeth have smooth, relatively narrow beaks
 Used for lower premolar-premolar (all lower incisors, canines, premolars)
 Beaks don’t touch because they are crown forceps
 Beaks are rounded, not pointed to fit around crown curvature
 90 degree angle between beak and handle (at hinge)
o 90 degree angle - ease of positioning when patient is in an upright
position (patient is in a seated position and dentist is standing)
Practical tip: lower dental chair (vertically) till the lower jaw is at elbow height to the
(standing) dentist.

11. 3rd Year 2nd Semester Oral Surgery Propedeutics Instruments AMIT DATTANI 2012
University of Debrecen, Medical and Health Science Center – Faculty of Dentistry 11
Molars
(Crown Forceps)
Have a bi-lateral pointed beak to adapt to the bifurcation and vertical hinge
 Two pointed beaks
 Beaks do not touch – crown forceps
 Both beaks are pointed so they can be used for the left and right side of the
patient
 All molars can be extracted with this, 1st
- 3rd
. (In case of trismus see further
 Forceps for molars with fused, conically shaped roots have shorter beaks
without pointed tips and a hinge in a horizontal direction
 Also called trismus forceps

12. 3rd Year 2nd Semester Oral Surgery Propedeutics Instruments AMIT DATTANI 2012
University of Debrecen, Medical and Health Science Center – Faculty of Dentistry 12
Lower Root Forceps
 Maxillary and mandibular forceps for removal of broken roots have a similar
shape as those for removal of teeth with a crown, but their beaks are relatively
narrow and meet at the tip.
 Can be used on all lower root extractions

13. 3rd Year 2nd Semester Oral Surgery Propedeutics Instruments AMIT DATTANI 2012
University of Debrecen, Medical and Health Science Center – Faculty of Dentistry 13
Instruments for Incision
Scalpel consists of:
 Sterilizable handle
 Sterile, disposable blade
No 15 – used for intraoral incision
No 12 – pointed (used for stab like incisions)
No 11 – hooked blades (for mucogingival procedures on posterior aspect of teeth)
Scalpel Handle
Scalpel Blades

14. 3rd Year 2nd Semester Oral Surgery Propedeutics Instruments AMIT DATTANI 2012
University of Debrecen, Medical and Health Science Center – Faculty of Dentistry 14
Fixed Blade Scalpel / Conventional Scalpel
Instruments for Elevating Mucoperiosteum
 Raspatories of different size
 Periosteal elevators (Single or Double ended)
Their cutting edge is sharp and thin and can make a clean separation of mucoperiosteum from the
bone with the undermining method.
(Konig) Mucoperiosteal elevator

15. 3rd Year 2nd Semester Oral Surgery Propedeutics Instruments AMIT DATTANI 2012
University of Debrecen, Medical and Health Science Center – Faculty of Dentistry 15
Molt Raspatorium
 They all come in different shapes and sizes
 Use the appropriate shape and size

16. 3rd Year 2nd Semester Oral Surgery Propedeutics Instruments AMIT DATTANI 2012
University of Debrecen, Medical and Health Science Center – Faculty of Dentistry 16
Instruments for Retracting Soft Tissues
 Austin, Minnesota retractors can retract the cheeks and the mucoperiosteal flap
 Middledorpf retractor for cheek retraction
 Langebeck for mucoperiosteal flap retraction
Periosteal elevators, raspatories may often be used for retracting mucoperiosteal flaps
Austin Retractor Minessota Retractor
Langenback Retractor/ Fork Retractor (with
teeth)
Middledorpf Retractor

17. 3rd Year 2nd Semester Oral Surgery Propedeutics Instruments AMIT DATTANI 2012
University of Debrecen, Medical and Health Science Center – Faculty of Dentistry 17
Instruments for Retraction of the Tongue
 Mouth mirror
 Tongue retractor
 Tongue spatules
 Tongue forceps (only in deep sedation)
Mouth Mirror Tongue Retractor
Tongue Spatula Tongue Forceps

18. 3rd Year 2nd Semester Oral Surgery Propedeutics Instruments AMIT DATTANI 2012
University of Debrecen, Medical and Health Science Center – Faculty of Dentistry 18
Instruments for Controlling Bleeding
Hemostats
 Have a relatively long, delicate beaks with parallel grooves on their inner surface to grasp
tissue
 Handles with a locking mechanism, the clamps remain clamped onto the tissues
 Are provided in different size and shapes (straight or curved)
 May be used for picking up small particles from the wound area
Mosquito Hartmann Hemostat Halsted Hemostat
Peak Hemostat Kelly Hemostat

19. 3rd Year 2nd Semester Oral Surgery Propedeutics Instruments AMIT DATTANI 2012
University of Debrecen, Medical and Health Science Center – Faculty of Dentistry 19
Instruments for Grasping Tissues
 Non-traumatic dissecting forceps and angled college forceps are not useful for handling
tissues; these are used for placing and removing gauze packs and foreign materials.
 Delicate tissue forceps with small teeth are used for stabilizing the soft tissues during
suturing.
 Allis tissue clamps have locking handles and beaks with more teeth and permit a stronger
and more convenient grasping of the tissue during dissection.
Forceps
Dissecting Forceps/ Anatomical Forceps (no
teeth)
Adson Forceps
Tissue Forceps/ Surgical Forceps (with teeth) Allis Tissue Clamp

20. 3rd Year 2nd Semester Oral Surgery Propedeutics Instruments AMIT DATTANI 2012
University of Debrecen, Medical and Health Science Center – Faculty of Dentistry 20
Note: You should know what the following is and its use:
Angled College Forceps / Dental Forceps

21. 3rd Year 2nd Semester Oral Surgery Propedeutics Instruments AMIT DATTANI 2012
University of Debrecen, Medical and Health Science Center – Faculty of Dentistry 21
Instruments for Removing Bone
 Ronguer forceps: smaller amount of bone can be cut in a single bit with the sharp blades.
 Chisels (monobevel for cutting bone) and a Mallet with nylon facing are not commonly used
in oral surgery.
 Bone files are used for final smoothing of bone before wound closure; work only on a pull
stroke.
 Different sizes are available for all types of instruments
 Most commonly a handpiece and bur are used to remove alveolar bone
o The (micromotor) handpiece should have high speed and torque to allow relatively
rapid bone removal and efficient sectioning of teeth
o High speed turbine drills must NOT be used for oral surgery because of the danger
of tissue emphysema
o Round and fissue bus of different sizes are most commonly used
Luer Rongeur Forceps Bluementhal Rongeurs
Mallet (also known as bone hammer) and Chisel Bone file (different shapes and sizes available)

22. 3rd Year 2nd Semester Oral Surgery Propedeutics Instruments AMIT DATTANI 2012
University of Debrecen, Medical and Health Science Center – Faculty of Dentistry 22
Surgical motor with integrated cooling system Handpiece for burs

23. 3rd Year 2nd Semester Oral Surgery Propedeutics Instruments AMIT DATTANI 2012
University of Debrecen, Medical and Health Science Center – Faculty of Dentistry 23
Instruments for Removing Soft Tissues from Bone Defects
 Bone curettes – round or oval
o Working part is concave on one side with sharp edges
o They are used in a scraping motion to remove small cysts and granulomas from bony
crypts.
 Some Types:
o Volkmann
o Uffenorde
o Kerpel
Volkmann Curette (most commonly used) Uffenorde Curette
Kerpel Bone Curette
When to use Curettes?
Immediately after extraction of a tooth suspected to have a cyst or granuloma formation

24. 3rd Year 2nd Semester Oral Surgery Propedeutics Instruments AMIT DATTANI 2012
University of Debrecen, Medical and Health Science Center – Faculty of Dentistry 24
Instruments for Suturing Mucosa
Needle Holders
 Have a locking handles
 Short stout beaks and a crosshatched surface for grasping the needle and the sutures
Surgical Needles
 Most commonly are curved needles
 Common sizes 1/4 or 3/8 circle
 Cutting needles have a triangular crossection at the tip (most commonly used in oral
surgery)
Suture Materials
Sutures can be threaded through the eye of the needles or can be purchased already swaged on by
the manufacturer
Resorbable
o Catgut, synthetic sutures
Non-resorbable
o Wire, nylon, silk
Monofilament
o Do not cause a wicking action (inter-twine)
o Difficult to use
o Difficult to tie (stiffer)
Polyfilament
o Wicking action (inter-twined)
o Soft
o Easy to tie
Mayo-Hegar Needle Holder Mathieu Needle Holder

25. 3rd Year 2nd Semester Oral Surgery Propedeutics Instruments AMIT DATTANI 2012
University of Debrecen, Medical and Health Science Center – Faculty of Dentistry 25
Surgical Needles
Scissors
 Scissors for removing sutures have short beaks
 Dissecting scissors: flat points for dissecting tissues
 Iris scissors are small, sharp-pointed and are delicate for fine work
Scissors for Sutures (one pointed and one blunt end) Dissecting Scissors (two pointed ends)

26. 3rd Year 2nd Semester Oral Surgery Propedeutics Instruments AMIT DATTANI 2012
University of Debrecen, Medical and Health Science Center – Faculty of Dentistry 26
Instruments for Holding the Mouth Open
 Rubber bite block in basic oral surgery
 Mouth Props in patients who are deeply sedated
Hesiter Mouth Gag (keeps mouth open) Doyen – Jansen Mouth Gag (keeps mouth open)
Instruments of Irrigation
Irrigation with sterile saline
 Made with a large plastic syringe and a blunt angled needle
 Prevents bone damage by heat buildup during bone removal with a handpiece
 Washes away the bone chips and increases efficiency of the bur
 Provides lubrication for tissues
 Before wound closure the surgical site must be irrigated
Frasier Suction Tip

27. 3rd Year 2nd Semester Oral Surgery Propedeutics Instruments AMIT DATTANI 2012
University of Debrecen, Medical and Health Science Center – Faculty of Dentistry 27
Dental Elevators
 Dental elevators have three major components:
1. Handle
2. Shank
3. Blade
 The biggest variation in the type of elevator is the shape and size of the blade.
 There are three basic types of elevators:
1. Straight elevator
2. Triangular elevator
3. Pick-type elevator
Straight Elevators
 Used to luxate the tooth before the tooth forceps is used
 Their blade has a concave surface on one side, it can be used in the same fashion as a
shoehorn
 The blade can be angled from the shank (working in the more posterior aspects of the
mouth)
Bein Elevator White Elevator Seldin Elevator
Note: You only need to know the Bein Elevator

28. 3rd Year 2nd Semester Oral Surgery Propedeutics Instruments AMIT DATTANI 2012
University of Debrecen, Medical and Health Science Center – Faculty of Dentistry 28
Triangular Elevators
 Provided in pairs (left and right)
 Are used for lower roots
 Are most useful when a broken root remains in the socket and the adjacent socket is empty
 The blade is inserted into the socket, the shank rest on the buccal plate of the bone, then
the elevator is turned with the sharp tip engaging the root cementum

29. 3rd Year 2nd Semester Oral Surgery Propedeutics Instruments AMIT DATTANI 2012
University of Debrecen, Medical and Health Science Center – Faculty of Dentistry 29
How to identify between left and right Barry Elevator?
 Hold the Barry elevator in your left or right hand in the normal grip position (shown in
practices)
 Position the long axis of the handle parallel to your body
 Position the shank of the elevator perpendicular to the front of your body
 Then see if the blade is curving towards or away from you
o Left – pointing towards you
o Right – pointing away from you
Cryer Elevator

30. 3rd Year 2nd Semester Oral Surgery Propedeutics Instruments AMIT DATTANI 2012
University of Debrecen, Medical and Health Science Center – Faculty of Dentistry 30
Pick Type Elevators
 Are you used to elevated broken root tips
 Are fine, pointed elevators with extremely long working ends
 Angled forms for the lower root tips
 Straight forms for the upper root tips
E.g. Crane Pick Elevator:

31. 3rd Year 2nd Semester Oral Surgery Propedeutics Instruments AMIT DATTANI 2012
University of Debrecen, Medical and Health Science Center – Faculty of Dentistry 31
Towel Clamps
Backhaus Towel Clamp Jones Towel Clamp
Sponge and Dressing Clamps
Sponge and Dressing Forceps/ Clamp

32. 3rd Year 2nd Semester Oral Surgery Propedeutics Instruments AMIT DATTANI 2012
University of Debrecen, Medical and Health Science Center – Faculty of Dentistry 32
Probes
Sinus Probe
 Used after extraction of a posterior maxillary tooth
 To check perforation of maxillary sinus insert probe in socket lightly and probe to check for
no opening! LIGHTLY-OTHERWISE YOU WILL MAKE AN OPENING!
 You can also use the nose-blow test and if you hear a hissing sound sinus has been
perforated
Other Instruments
These you should be aware of:
K-wire Bender:
Used for bending and cutting splint wires