Surgical instruments are designed to perform either diagnostic or
therapeutic operations; to locate the cause of a problem, or to
treat a problem once it has been found. Each instrument is
designed to perform a specific function. Those functions may be
generally categorized under one of the following uses:
1. To cut or incise:
Instruments used for this purpose are frequently referred to as
“sharps”. They include scissors, knives, scalpels, chisels and
osteotomes, among others.
2. To retract tissue:
Hand-held and self-retaining retractors serve this purpose, as well
as instruments such as skin and bone hooks
3. To grasp, hold or occlude:
These include the many types of forceps, including hemostats,
dressing and tissue forceps, as well as bone holding forceps. Also
included in this group are needle holders.
4. To dilate or probe:
These instruments are used to dilate or enlarge openings or to find
an area or foreign object.
5. To cannulate or drain:
These instruments including catheters, drains and cannulas, are
generally used to drain a wound.
6. To aspirate, inject or infuse:
These instruments serve to remove unwanted fluids as well as
to inject needed fluids into a patient. Among these instruments
are syringes, some needles, trocars and cannulas.
7. To suture or ligate:
Suture or ligation is used to close or rejoin a wound or an area
of operation, e.g., a vessel, a nerve or tissue. There are a
variety of sutures and clips, as well as suture needles and
Clinical Tips for periosteal Elevators
Periosteal elevators are used to reflect mucoperiosteum, to
loosen soft tissue from teeth before extraction, and to
retract small flaps
Pry Stroke: Using the tooth as a fulcrum, the sharp pointed
end of the elevator is used to reflect the MPF by first prying
the IDP free from the underlying bone.
Push Stroke: Using the broad end of the elevator in a
push stroke, the attached gingiva and alveolar mucosa
are reflected to the desired extent.
Pull Stroke: Using the periosteal elevator in a pull stroke
can sometimes shred the periosteum.
Tissue Retractors: Clinical Tips
1. For small flaps, use the periosteal elevator for
2. For large flaps use Minnesota or Austin
3. Place retractor beneath the flap resting on
4. Avoid trapping of flap between retractor and
5. RETRACT PASSIVELY: no attempt is made to
pull the flap out of the field
Dissection Scissors: To cut and dissect tissue
Blunt, Blunt Tip
Beveled Cutting Blade with Regular Cutting
Screw Lock (Lap Joint)
Operating Scissors: To cut sutures, gauze and other
SCISSORS come in a tremendous variety of styles and sizes.
They come in straight, curved and angular versions.
Useful Tips in Usage:
1. The curved patterns are preferred by most surgeons for
dissecting, since they provide a better field of vision for the
areas to be cut.
2. Straight scissors are used when a straight cut is desired,
such as in sutures, nerves, vessels.
3. Scissors are also used to spread and probe the area of
incision (dissection & undermining tissues). The smaller sizes
are used at the surface, the larger sizes deeper in the cavities.
4. Dedicate the different types for their specific purpose for
example, using fine dissecting scissors to cut suture can ruin
the cutting edge.
5. Special care instructions: To maintain scissors in peak
operating condition, they must be sharpened regularly.
Tissue Forceps: To grasp and handle soft tissue
Allis: to grasp and hold
tissue that will be excised
Tissue Forceps: To grasp and handle soft tissue
teeth that are
loose in the
useful to handle
tissue in the
of the mouth
WEIDER Tongue Retractor: very
useful instrument during surgery
for impacted lower third molars
Backhaus Towel Clamp
Hemostat: To clamp and restrict bleeders or
tissue, to control the flow of blood
Fully Serrated Jaws
used in OS is
Straight & Curved Hemostats
has a relatively
long delicate peak
Needle Holder: To hold and guide suture needles securely
Needle Holder: Clinical Tips
Needle holders are available in many styles and sizes.
Shorter ones are used for working close to the surface.
Longer ones are for deeper cavities.
The smaller the needle, the smaller the jaws of the needle
If the needle is too large to be held securely, select a larger
size needle holder. Otherwise, the needle may slip, or the
needle holder may be overstressed, causing fatigue or
Needle Holders Vs Hemostats
1. Needle holders look similar to hemostats, but jaws are
thicker and shorter.
2. Face of shorter beak of needle holder is crosshatched
to ensure positive grip on needle but hemostat has
parallel grooves that do not allow a firm grip on needle.
Bone File: for final smoothing of bone before
suturing the MPF back into position
Bone File: Clinical Tips
1. Use the bone file in a pull stroke, because the
teeth of the file are arranged in such a fashion to
remove bone only in this direction.
2. Avoid cross filing or pushing the bone file,
because this results in burnishing and crushing
3. Carefully Cleanse the instrument by wiping the
grooved ends with a sponge. By failure to do this,
dust or chips may easily remain in the wound.
Bone Rongeur: to remove bone by shearing
on a planned action
Bone Rongeur: Clinical Tips
1. Smaller amount of bone
should be removed in each of
multiple bites but never large
amount of bone in a single
2. A constant cleansing of
the blades is necessary.
3. Rongeurs are delicate and
therefore, NEVER remove
teeth with rongeurs.
Chisels and Gouges: To score, cut, scrape, and sculpt bone
Chisels and Gouges
Osteotomes: To shape and sculpt bone,
or section a tooth
Chisels: To cut a window in the bone
cortex for access or to allow harvesting
of pure soft bone
Gouges: To scoop away strips of soft
bone, especially in bone grafting