This document lists and describes various instruments used in implant dentistry for incising and reflecting soft tissues, removing bone and tissue, grafting, retracting tissues, and drilling osteotomies. Key instruments include scalpels and blades for incisions, periosteal elevators and forceps for tissue reflection and grasping, rongeurs and burs for bone removal, bone scrapers and grafting tools for harvesting and placement of grafts, and osteotomes and piezosurgery units for bone modification and cutting. Proper instrumentation is essential for achieving optimal surgical outcomes in dental implant procedures.

1. Armamentarium in Implantology

2. Instruments to Incise Tissue
• Scalpel and Surgical Blades
• Most common: #3 Salpel and #15 or #15c Blade
• #15 blade- short, rounded cutting edge
• #12 blade- pointed and crescent shaped;
mainly used around teeth or in difficult access areas

3. Instruments to Reflect Tissue
• Reflect mucosa and periosteum to expose bone after incision
• Molt periosteal elevator #9
• 2/4 Molt elevator; more effficient instrument positioned in a
dished out fashion.
• Tissue can be reflected three different ways:
(1) prying motion— pointed end used in a prying motion to elevate
the soft tissue;
(2) push stroke— used after full thickness incision to slide
underneath the flap;
(3) pull or scrape stroke— used to remove tissue tags from the bone
in a scraping motion

4. Instruments to Grasp Tissue
• Used to stabilize soft tissue flaps
• Adson forceps: have small teeth or serrations
• Used to grasp and stabilize soft tissue flaps during
suturing
• Allison forceps: larger and more aggressive teeth used to
hold heavy or high tension tissue; rarely used in implant
dentistry

5. Instruments to remove Bone /Tissue
• Rongeur forceps
• Sharp edged, scoop shaped tip used for snipping away the bone
• Spring between the handles increases the magnitude of forces
• Double action rongeur generates more force
then Single action rongeur

6. Surgical burs:
• Always used with irrigation
• Cross cut fissure burs : make pilot holes in bone
• Special reduction burs for Alveoloplasty
• Straight hand piece

7. • Bone file
Double ended serrated instrument used to remove sharp,
spiny ridges within bone

8. Instruments to remove tissue from
extraction sockets or Bony defects
• Surgical currette: is spoon shaped and have sharp edges that allow scraping
of the bony walls. Eg. Lucas 86 Currette
• scraping removes soft tissue, will also initiate the regional acceleratory
phenomenon (RAP)
• Regional acceleratory phenomenon is a local response to noxious stimulus
by which tissue forms faster than normal regional regeneration process.

9. Bone grafting instruments
• Bone scrapers: used to harvest
autogenous bone from the oral cavity and
deliver the collected bone particles to the
surgical site.
• These instruments consist of a harvesting
blade and collection chamber

10. • Grafting spoon and condenser:

11. Surgical scissors
• Used to cut tissues or sutures and spread tissue
• Dean : angled blades that are 3cm from midscrew
• They have one serreted blade with slight curved handle
• Easy acess to cut sutures and remove diseased tisssue

12. • Iris : very small, extremely sharp scissors with fine tip used for
precision cutting
• Metzenbaum: for delicate tissue and blunt dissection

13. Hemostats
• Has serrated tips that allow for clamping of tissue
or small materials
• Used to constrict blood vessels, retrieve loose
objects in the oral cavity and securely hold small
items

14. Instruments to Retract Tissue
• Used to hold back cheek, tongue or flap which permit visibility to the
surgical site.
• Mouth mirror
• Weider tongue retractor: broad, heart shaped with grooves and
perforations
• Seldin retractor: double ended with round blunt end; used to retract
tissue flap after incision
• Minnesota retractor

15. • Misch “Spoon” cheek and tongue retractor: ergonomically designed to
reduce hand fatigue
• Sinus graft cheek retractor: broad based flap retractor that reduces force
to the infraorbital foramen area.

16. Instruments to hold mouth open
• Bite block
• Molt mouth prop: ratchet designed instrument that allows
variation of opening
• Orringer retractor: spring loaded mouth prop which
maintains upper and lower soft tissue retraction

17. Instruments to hold drapes
• Towel clamp: non perforating clamp used to secure instruments and
surgical materials, such as suction tubing to the surgical drapes

18. Handpiece and Motors
• Surgical motor console: console, foot
pedal, and motor cord

19. Handpiece
• 1:1 handpiece: usually straight
handpiece
• 40,000 - 50,000 RPM
• Used for bone grafting procedures
• 20:1 handpiece: contraangle
reduction implant handpiece to drill
osteotomies and place implants

20. • Piezosurgery units: selectively cuts mineralized
tissue without damaging soft tissue
• Uses high frequency vibration 25-35 kHz
• Advantages: high precision accuracy, minimal
thermal damage, increased healing and less soft
tissue trauma.
• Uses: atraumatic extractions, removal of implants,
bone grafting procedures and sinus augmentation
procedures

21. Osteotomes
• Sinus osteotome: used to raise floor
of maxillary sinus
• Offset osteotomes to increase
osteotomy diameter
• Straight osteotome for bone
spreading