Tools

Question 1

Straight Upper anterior forceps

Answer 1

only straight

easy access

3-3

single rooted

Question 2

upper universal forceps

Answer 2

same single rooted tip as upper straight

but curved to allow slightly further back in oral cavity

Question 3

upper molar forceps

Answer 3

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

Question 4

what forceps are these

Answer 4

upper universal forceps and then straight upper anterior forceps

• Straight upper anterior forceps Vs upper universal forceps
  
  • Similar tips
  • Curvature allows access to premolars

Question 5

lower forceps

Answer 5

have 90^o 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

Question 6

cowhorn forceps

Answer 6

engage furcation in mesial and distal roots

• Only really on younger individual – lifts tooth
• Need divergent roots
• No grip, just squeeze

Question 7

‘bayonet’ forceps

Answer 7

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

Question 8

right handed operator stance for extractions

Answer 8

behind pt for lower right

all other in front of pt on their right

Question 9

elevator functions

Answer 9

• 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

Question 10

3 types of elevators

Answer 10

couplands

cryers

warwick james

Question 11

coupland’s elevators

Answer 11

most frequently used

• Hug rounded surface of tooth trying to elevate
• single
• Bigger number = wider the tip (1, 2, 3)

Question 12

cryer’s elevators

Answer 12

• 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

Question 13

Warwick James elevators

Answer 13

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

Question 14

luxators

Answer 14

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)

Question 15

periotome

Answer 15

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

Question 16

3 basic modes of action for elevaotrs

Answer 16

• Wheel and Axle (Rotation)
• Lever
• Wedge

Question 17

wheel and axle motion

Answer 17

most common - Elevators (not luxators – bend tip)

• Buccal elevation
• Twisting on axle
  
  • Elevate tooth upwards

Question 18

lever

Answer 18

• More force
• Can be dangerous – large force on bone – can fracture

Question 19

wedge

Answer 19

• Can be used for luxators if careful of fractured root fragments
  
  • Push down ligaments to displace fractured root out

Question 20

mechanical principles of elevators

Answer 20

• 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

Question 21

Answer 21

Ash periosteal elevators - used to separate the periosteum from underlying bone

Question 22

Answer 22

Bone file – looks nail file – single or double ended

smooth bone

Question 23

Answer 23

Hennry Rake retractor – fancy L shaped thing – flap deflection

Question 24

Answer 24

Howarth’s periosteal elevators – used to separate the periosteum from underlying bone

Question 25

Answer 25

mitchells osteo trimmer – remove sharp bony spicules

Question 26

Answer 26

Victoria curette – remove granulation tissue from socket double spoon

Question 27

Answer 27

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

Question 28

Answer 28

alice tissue forceps – used to hold soft tissue

Question 29

Answer 29

bone nibblers –trim bone and remove bone spicules

Question 30

Answer 30

curved moskito forcepts – picking up fractured/separated instruments or posts or artery clips

Question 31

Answer 31

towel clips – clip things onto trolley

Question 32

Answer 32

fickling forceps - type of needle holder

Question 33

Answer 33

gillies needle holders

Question 34

Answer 34

gillies toothed tissue forceps – used for holding soft tissue whilst suturing

Question 35

Answer 35

kilner need holders – used for suture needle holding

Question 36

Answer 36

lack’s tongue depressor – to keep togue still

Question 37

Answer 37

straight spencer wells forceps – picking up teeth and remove sharp bony spicules, can clip arteries