DENTAL FORCEPS.pdf

INTRODUCTION TO ORAL SURGERY ASSIS. PROF. Sundus Abdul wadood O&MFS Department  Oral surgery : is a specialized field of dentistry focused on the diagnosis and surgical treatment of various diseases, injuries, and defects in the oral and maxillofacial region. For third-year dental s...

INTRODUCTION TO ORAL SURGERY ASSIS. PROF. Sundus Abdul wadood O&MFS Department  Oral surgery : is a specialized field of dentistry focused on the diagnosis and surgical treatment of various diseases, injuries, and defects in the oral and maxillofacial region. For third-year dental students, understanding the basics of oral surgery is essential for effectively managing common conditions and preparing for more complex procedures in advanced stages. Local Case history Exodontia anaesthesia 1. Patient data 1. Principle of 1. Introduction 2. Medical history exodontia 2. Pharmacology of LA 3. Family history 2. Dental forceps and mode of action 4. Habits 3. Dental elevators 3. Types of LA 5. Chief complain 4. Position for chair , 4. Anaesthetic tools 6. History of Present patient and dentist 5. Anaesthesia of upper illness 5. Simple extraction jaw 7. Post dental history 6. Surgical 6. Anaesthesia of lower 8. Extra oral instruments jaw examination 7. Surgical extraction 7. Advance in LA 9. Intra oral examination 8. Complication of 8. Local Complication extraction 10. Investigation 9. Systemic complication 9. Suturing 11. Diagnosis 10. Introduction to General Anaesthesia 12. Treatment DENTAL FORCEPS  EXTRACTION FORCEPS The extraction forceps are instruments used for removing the tooth from the alveolar bone These forceps are designed in many styles and configurations to adapt to the variety of teeth for which they are used. When applied and used correctly, they can simultaneously provide the wedging force of an alveolar bone, allow for slow expansion of the bony socket, mobilise the tooth along its strongest axis, grasp and deliver the tooth. This multifunctional application can lead to difficulty in the use of a forceps for the beginners– there must be a harmonious balance between the squeezing, twisting, and levering forces that are applied through the instrument, and each type of force must be used at the correct magnitude and in the correct stage of an extraction.  FORCEPS COMPONENTS 1. The handles 2. The Hinge 3. The Blade Material: to provide strength and corrosion resistance during sterilization. Forceps Components The handle is long and usually textured, and is designed to be gripped in the palm, secured with the thumb on one side and four fingers on the other. This design allows the operator to apply maximum grip strength on the handle to transmit this force to the Blades and tooth. The handle is longer than the Blades, allowing for magnification of forces applied around the tooth axis when using a rotatory motion  Forceps Components The hinge is the mechanical joint that allows the extraction forceps to open and close. Inadequate maintenance of forceps over time may lead to loosening of the hinge, reducing the efficacy of the instrument. British pattern forceps have a hinge directed horizontally to the handle, whilst American pattern forceps have a hinge directed vertically. Although the Blades of each pattern are similar, the hinge orientation may alter the direction of force applied through the forceps.  Forceps Components The Blades are the most important variable component of the dental extraction forceps. ▪ Practically, each concave Blade should be considered as an elevator, as sharp, and as purpose designed to wrap around one aspect of a tooth’s root surface. ▪ The Blades, when used together, should therefore almost exactly wrap around the tooth’s cementoenamel junction. ▪ Blades may lie at the same axis as the handle, or with an angle of up to 90 degrees, depending on the purpose of the instrument and the tooth location for which it is designed. ▪ Choosing the correct forceps for a dental extraction is therefore entirely dependent on the Blade design; the type of Blade that will best match the root structure of the tooth, and the angulation that will best allow for biomechanical advantage depending on the location of the tooth in the mouth and the patient position. Forceps Components  HOLDING OF THE FORCEPS FOR UPPER Grip on the Forceps: 1. The dentist holds the forceps with the palm facing upwards (underhand grip). 2. The index finger and thumb are placed on the handles for controlled movements, while the rest of the fingers support the instrument.  HOLDING OF THE FORCEPS FOR LOWER Grip on the Forceps: 1. For the lower teeth, the forceps are held with the palm facing downwards (overhand grip). 2. Dentist holds the instrument firmly, with the thumb and index finger controlling the handles and the rest of the fingers supporting the instrument. MAXILLARY FORCEPS  UPPER STRAIGHT FORCEPS An long upper straight forceps with thin and long Blade can be used for maxillary central and lateral incisors. Short-Bladeed upper straight forceps, sometimes referred to as ‘stubbier’ forceps, are the gold standard for removing upper canine teeth, as the shorter Blade allows for greater grip force to be applied to the canine. Upper straight forceps can be used, but their thinner, longer Blades may not provide sufficient force to the tooth. Blades: The Blades are designed to fit around the tooth, usually with a serrated or smooth surface for a firm grip. They have rounded tip to engage the tooth effectively without damaging adjacent structures. Handles: The handles are straight with the Blade, designed to provide a secure grip and allow for the application of necessary force. MAXILLARY FORCEPS  UPPER PREMOLAR FORCEPS The forceps of maxillary premolar are slightly S-shaped when viewed from the side and essentially straight when viewed from above. Curved Blades: The jaws of upper premolar forceps are often curved or angled to better access the premolar region of the mouth. This curvature helps in turning around the dental arch and reaching the tooth more effectively with the long axis. Wider Blades: The Blades are generally wider and stronger compared to anterior forceps. This design provides a better grip on the larger surface area of the premolar teeth, which are broader than anterior teeth but not as wide as molars. Serrated or Textured Surface: The inner surfaces of the Blades may have serrations or texture to enhance grip and prevent slippage during extraction. Ergonomic curved Handles: The handles are typically ergonomically designed to allow for a firm and comfortable grip. This curved to provide better control and help to be away from lower teeth and lower lip. UPPER PREMOLAR FORCEPS  UPPER MOLAR FORCES Design same as premolar but differ in Blades The forceps have smooth, concave surface palatal blade for the palatal root A Blade with a pointed hook buccally that will fit into the buccal bifurcation. Molar forceps come in pairs: a left and a right.  MAXILLARY FORCEPS UPPER MOLAR Upper left or right molar forceps are designed specifically for the typical root configuration of upper molars; that is, the Blades of the forceps are designed to adapt around two buccal roots and one palatal root. Maxillary Forceps Upper Molar  ROOTS FORCEPS TO THE MAXILLA The forceps used for extracting upper roots are designed to fit the shape and alignment of the upper jaw. Since the maxillary bone is less dense, these forceps are typically narrower and finer to grip the roots efficiently without damaging the surrounding bone. Features: Handles: The handles are often straight or curved to allow better angulation when accessing the roots of the upper teeth. Narrow Blades: The Blades are narrow and fine, designed to slip into the periodontal space around the root. They are often angled to provide a better grip on roots, especially in the posterior teeth. Angled Blades: Upper root forceps typically have Blades that are angled upwards to match the natural inclination of the upper jawStraight Root Forceps: Used for anterior teeth roots, where access is more straightforward.Bayonet Root Forceps: Specially designed with a bayonet-shaped curve, ideal for accessing and extracting roots of upper molars, where the anatomy of the maxillary arch creates a more challenging angle. Long Blades: Designed to reach deep into the socket, especially for posterior roots. Straight Root Forceps: Used for anterior teeth roots, where access is more straight forward. Bayonet Root Forceps: Specially designed with a bayonet-shaped curve, ideal for accessing and extracting roots of upper molars, where the anatomy of the maxillary arch creates a more challenging angle. UPPER ROOT FORCEPS FORCEPS TO MAXILLARY PRIMARY TEETH  A brief comparison of the Maxillary (Upper) Primary Forceps and Mandibular (Lower) Primary Forceps: Mandibular Maxillary (Upper) Feature (Lower) Primary Primary Forceps Forceps Slightly curved for Curved for downward Handle Design upward angulation grip Rounded, smaller, and Rounded, smaller, and Blade Shape angled upward straight Shorter, designed for Shorter, but broader for Blade Size smaller crowns mandibular teeth Blade Upward angulation for Straight for vertical Angulation the upper arch access Movement Rotational and slight Vertical traction and Technique bucco-lingual bucco-lingual Application Designed for less dense Designed for denser Focus maxillary bone mandibular bone Anterior and posterior Anterior and posterior Teeth Accessed upper primary teeth lower primary teeth MANDIBULAR FORCEPS  MANDIBULAR FORCEPS LOWER ANTERIOR FORCEPS DESIGN Straight Handles: Designed for vertical and lateral force application, providing easy access to anterior teeth. Narrow Blades: The Blade of the forceps form a right angle with the handle. Tapered to grip smaller crowns of lower incisors and canines. Straight Blades: Align with the vertical orientation of lower anterior teeth for precise control. Serrated Inner Surface: Ensures a strong grip on the tooth, reducing slippage. Smaller Size: More delicate, tailored for the smaller size of lower anterior teeth. Movements: Apply vertical traction with slight bucco-lingual movement for controlled extraction. Lower anterior forceps are used to extract the mandibular anterior teeth, which include: 1. Central incisors 2. Lateral incisors 3. Canines (cuspids) LOWER ANTERIOR FORCEPS  LOWER PREMOLAS FOECEPS Straight Handles: Provide a firm grip for applying vertical and Bucco-lingual forces. Narrow, Slight Curvature Blades: The Blade of the forceps form a right angle with the handle. : Some forceps have a minor curve for better access to the premolar area. Serrated Inner Blades: Ensures a strong, non-slip grip on the tooth.  EXTRACTION MOVEMENTS The anterior and premolar forceps are designed to extract mandibular teeth, which generally have single roots, using vertical traction and side-to-side movements.  DEFENCES BETWEEN LOWER ANTERIOR AND PREMOLAR FORCEPS Lower Premolar Lower Anterior Feature Forceps Forceps Handle Shape straight Straight Narrow and Narrow with a straight for Blade Shape slight curve for incisors and premolars canines Broader to fit Narrower to fit Blade Width larger premolar smaller anterior crowns teeth Blade tip Space between Contact two the two blade blade Vertical traction Vertical traction Primary with slight with slight rotation Movements rotation and and Bucco-lingual Bucco-lingual  FORCEPS FOR MANDIBULAR MOLARS Two forceps options are available for removal of lower molar teeth. Hawksbill forceps are designed to engage a large portion of the circumference of the cementoenamel junction, like other forceps, allowing maximum rotational forces to be applied favorably. They are useful when the crown of a molar tooth is intact but tend to fail and cause root fracture if there is crown compromise. Cowhorn forceps engage the furcation of the tooth only; whilst this increases the likelihood of crown fracture, this fracture tends to propagate between the roots and effectively sections the mesial and distal portions of the tooth. These forceps also allow for subgingival engagement in situations where there is extensive crown decay. FORCEPS MOLARS MOLAER  EXTRACTION MOVEMENT FOR LOWER MOLAR The lower molarforceps are designed to extract mandibular molar teeth, which generally have multiple roots, using vertical traction , side-to-side movements and figure – 8 – movements.  FIGURE OF -8- MOVEMENTS It sounds like you’re describing the movement of a lower molar crown along specific curve lines. If I understand correctly, you’re tracking the path of the crown from one part of the tooth to another, following these steps: 1.From mesiobuccal to distolingual 2.From distolingual to mesiolingual 3.From mesiolingual to distobuccal In a Figure 8 drawing, this might illustrate how the crown moves or adjusts along different surfaces of the tooth.  LOWER ROOT FORCEPS Lower root forceps rely on bucco-lingual movements (side-to-side) and vertical traction to loosen and remove roots from the socket. The straight design helps in applying downward force efficiently. General Design Considerations: Long, Narrow Blades: Both upper and lower root forceps have long, narrow Blades to reach deeper into the socket for root fragment removal. Strong Grip: Serrated or grooved Blades improve grip on the root, reducing the risk of slipping. Tapered Tips: The tips of the Blades are tapered to allow for precision in gripping small or fractured root fragments. MODIFIED FORCEPS FOR LOWER MOLAR MODIFIED FORCEPS FOR LOWER MOLAR  PHYSICS FORCEPS Operate as an elevator, rather than forceps, using first-class lever mechanics. One handle is connected to a “bumper,” which acts as the fulcrum, that is placed deep in the vestibule. The other handle is connected to the “Blade,” which is positioned most often on the lingual or palatal root of the tooth into the gingival sulcus. No aspect of the instrument grasps the crown and there is no advanced elevation needed. Once the instrument is properly placed, the handles are rotated a few degrees with only wrist movement in a slow, steady and controlled manner — no squeezing! Indications: ▪ badly decayed or broken down teeth, ▪ endodontically treated teeth, fractured or fragile teeth, ▪ curved or long rooted molars and cuspids, ▪ any tooth that would historically be challenging with conventional instrumentation.  REFRANCE MISCELLANEOUS MCQs - OMFS MCQs (dental-mcqs.com) Choose this link, then right click and go to open link https://dental-mcqs.c om/miscellaneous-m cqs-omfs-mcqs/ Click here on pdf to open the file THANK YOU