There are many different instruments needed for the extraction of a tooth and they vary greatly for many reasons including the number of teeth needing to be pulled, the location of the tooth within the oral cavity and the reason for the procedure. The degree of complexity will determine the tray setup you bring to your operatory, but here are Patterson’s recommendations for a simple anterior extraction.
Local anesthetic is a necessary piece to any oral surgery procedure. When choosing your aspirating syringe, find one that fits your hand comfortably as many aspirating syringes come in different sizes. You also need to pick whether you are more comfortable with a CW or A type. CW types have finger holders next to the grip whereas A types do not.
The local anesthetic you choose will depend on your patient and the procedure. The epinephrine in an anesthetic helps minimize bleeding in the operatory field. Therefore, a higher level of epinephrine (epinephrine 1:100,000) is preferred during operative or surgical procedures when improved visualization of the surgical field is desirable.
A cotton-filled gauze will provide more absorbency during an oral surgery procedure than a standard non-woven gauze would. These sponges are uniformly filled, lint free and perfect to send home with the patient for post-op care.
Patterson Disposable Stainless Steel Scalpels, Patterson Surgical Scalpel Handle, Patterson Surgical Blades
Scalpels come in two main varieties, disposable and autoclavable. The choice between these two ultimately comes down to personal preference and budget. If you decide that an autoclavable scalpel handle with disposable blades is the right fit for your office, a blade remover is recommended to reduce the risk of accidental injury.
A periosteal elevator uses a lifting and prying motion to loosen the tooth and break ligaments from the socket. They will separate and retract the tissue from the tooth after an incision has been made. This differs from a luxating elevator, which follows the gum line down to get deeper and loosens by rocking and cutting.
When to comes to tooth extraction, the right extraction forceps is needed. For a simple anterior extraction, a universal forceps will suffice. A 150 universal is used for maxillary anterior teeth and the 151 universal is used for mandibular anterior teeth. Posterior teeth and more complicated removals would use a more tooth-specific forceps with a beak angle fitted for the tooth that needs to be removed.
Sutures come in both absorbable and non-absorbable forms. You can also purchase sutures that come with or without the needle and are available in a variety of different lengths, diameters and sizes. The suture you choose will be dictated by the procedure and the size of the extraction site.
Needle holders offer many advantages. They stop needle rotation from occurring, prevent slippage of the sutures, and allow more force to be applied behind the needle. They also allow for the needle to reach into interproximal spaces that fingers would not be able to access.