INSTRUMENTS USED FOR INCISING THE TISSUES INSTRUMENTS USED FOR REFLECTING THE MUCOPERIOSTEAL FLAP INSTRUMENTS USED FOR HOLDING THE SOFT TISSUES

1. Dr. Haydar Munir Salih Alnamer
BDS, PHD (BOARD CERTIFIED)

2. The instrument used for making an incision is called a
scalpel. The scalpel has two parts, a blade and a blade
handle.
The most commonly used handle in oral surgery is no. 3
The scalpel is always used in the pen grip.
Blades
• No. 10—For making skin incisions
• No. 11—For making stab incisions (for example, to
drain an abscess)
• No. 12—For mucogingival procedures
• No. 15—For intraoral surgery

4. Pen grasp

6. As the name suggests, dissecting scissors are used
to perform soft tissue dissection in the deeper
layers. The scissors have a blunt nose for
undermining the tissues and a side cutting edge for
cutting the tissues.

9. Lange beck’s Retractor
C-shaped Retractor

10. Dr. Haydar Munir Salih

11. Austin’s Retractor
Cat Paw Retractor

12. Tongue Depressor

13. Dr. Haydar Munir Salih
Dr. Haydar Munir Salih

14. Periosteal Elevators (Molt No. 9, Howarth’s, Dial’s)
As the name suggests these instruments are used for
reflecting the mucoperiosteum. Most of the periosteal
elevators have a broad end on one side and a pointed or
triangular end on the other.
Uses
1. The pointed end is used to release the interdental papillae.
2. The broad end is used for elevating the mucoperiosteal flap
from the bone.
3. The broad end can also be used as a soft tissue retractor.

17. Dr. Haydar Munir Salih
Dr. Haydar Munir Salih

19. Dr. Haydar Munir Sali

20. These forceps are better known as hemostatic forceps
although they are used for catching both arteries and
veins.
They are used to catch hold of bleeding vessels. The
unidirectional, transverse serrations on the blades of
the hemostat prevent the vessel from slipping. The
vessel is crushed between the blades and hemostasis is
achieved.

23. Allis Tissue Holding
Forceps
Babcock’s Tissue Holding
Forceps
Lane’s Tissue Holding
Forceps

25. Mouth Prop Mouth props can be of two varieties: (A) Rubber
and (B) Metal.
The function of the mouth prop is similar to the mouth gag, i.e.
to keep the mouth open during any surgical procedure
performed in the oral cavity.
The block is placed between the mandibular and maxillary
teeth to maintain the mouth open. Usually, there are three or
four blocks of varying vertical heights arranged in an
ascending order, and

28. Heister’s Jaw Stretcher
This instrument is used to forcibly open the mouth. The
instrument has two flat blades that are applied between the
maxillary and mandibular posterior teeth and are
separated by turning a key that is positioned between the
two blades
1. To force the mouth open when there is trismus due to
infection, muscle spasm, hemarthrosis of the
temporomandibular joint following trauma.
2. To give postoperative active jaw physiotherapy after
surgery for TM joint ankylosis, submucous fibrosis

31. Mouth Gag (Doyen’s, Fergusson’s)
This instrument is used to keep the mouth open in
a patient under general anesthesia, during
surgeries of the oral cavity, tonsils and the
pharynx. The flat blades have serrations that rest
on the occlusal surfaces of the maxillary and the
mandibular teeth. The handle has a catch that is
fixed at the required opening.

34.  Curette (Lucas) The term curette comes from a French word curer,
meaning “to cleanse”. It is primarily an exploratory instrument. These
are instruments used to scrape a bony cavity or a soft tissue tract in
order to remove any pathological tissue present within them. A curette
can be single ended or double ended
1. It is used to remove tooth particles or debris from the extraction socket.
2. To enucleate cysts, periapical granulomas, intra- osseous tumors.
3. To remove small sequestra which may develop in healing sockets.
4. To remove proliferative or infected clot from the extraction socket

35. Curette
Volkmann’s Scoop

37. Rongeurs Forceps (Blumenthal, Jensen Middleton)
The rongeurs forceps have curved handles that have a spring
action. The spring increases the force applied and hence
efficiency of the instrument.
There can be either one spring or a double spring (Jensen
Middleton). When the handles are released the instrument
automatically opens up
The tip is angulated forward to the handle and has a concave
inner surface. The beaks are sharp. They can be either side
cutting (Blumenthal) or both side and end cutting

39. Uses:
1. To nibble sharp bony margins following simple or
surgical extraction of teeth, surgical procedures
2. To peel off thinned out bone present over cystic or
tumorous lesions.
3. To trim sharp bony ridges during alveoloplasty
procedures.

41. Chisel
Chisels are unibevelled instruments for cutting bone. They
have a heavy round handle and a long flat working tip. The
edge of the working tip has a bevel on one side. The working
edge is sharp and is flat. To plane the bone, the bevel is kept
facing the bone. To cut the bone, the bevel is kept facing away
from the bone.
Uses
1. To remove chips of bone as in transalveolar extractions
2. To split the tooth in difficult extractions.

42. Osteotome
The osteotome is similar to a chisel, but the edge of
the working tip is beveled.
It splits bone rather than cut or chip the bone as with
the chisel.
Uses
1. Various osteotomy procedures
2. Biopsy of bony lesions
3. Removal or recontouring of the bone.

43. Bone Gouge
The bone gouge has a round handle and a blade that has a sharp
working tip that is concave on the inner side. The working tip is
half round and has a long working area.
Uses
1. To remove cancellous graft material during grafting procedures
2. To make a window in the anterior wall of the maxillary sinus
for access to the maxillary sinus during Caldwell Luc procedure.
3. To remove irregular pieces of bone.

46. Mallet
A mallet is made up of steel, lead or wood. It is similar
to a hammer and is used for giving controlled taps on
the chisel, bone gouge or osteotome.
To be effective, the mallet should be used with a loose,
free swinging movement of the wrist that gives
maximum speed to the head of the mallet without
introducing the weight of the arm or the body to the
blow.

50. Gigli’s Saw
The Gigli’s saw is made by twisting a few pieces of
wires together, so that it acquires a sharp, barbed,
cutting edge when moved to and fro along it’s long
axis.
At the end there is a ring to which the hook of the
handle can be fitted. In Maxillofacial surgery, the
saw was usually used to cut the mandible

52. Drainage is the provision of removal of contents of
body organs, cavities or tissues by mechanical
means.
Functions
1. To allow for pus, fluid collection, blood to escape
from the body cavities.
2. To allow for local introduction of antibiotics,
antimicrobials.

53. Corrugated rubber drain
Penrose drain