PERIODONTAL SURGICAL INSTRUMENTS
EXCISIONAL AND INCISIONAL INSTRUMENTS
• Knives
• Periodontal (Gingivectomy) knives
• Interdental knives
• Scalpel
• Handles
• Blades
• Electrosurgery
• Electrosection
• Electrocoagulation
Gingivectomy
POCKET MARKING INSTRUMENTS
I- (Crane kaplen pocket marking forceps)
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II- Periodontal probe & Explorer
Periodontal knives (Gingivectomy knives)
1. Kirkland knife
(Primary Incision of Gingivectomy and used also for shaving the
soft tissue after Gingivectomy)
2. Orban knife
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(Secondary Incision of Gingivectomy)
Other surgical instruments
Scalpel, Scissors, Bone rongeurs
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MUCOPERIOSTEAL ELEVATORS
Surgical curette
SURGICAL HOES AND CHISELS
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NEEDLE HOLDERS (Traditional Needle Holder, Castroviejo Needle
Holder)
OTHER ADJUNCTIVE INSTRUMENTS
ELECTROSURGERY (RADIOSURGERY)
High frequency radio current 1.5-7.5 million cycle/second
Single wire electrode
Incision
Excision
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Loop electrode
Tissue planning
Bulk electrode
Coagulation
Suturing
Definition:
Suture material is an artificial fiber used to keep wound together
until they hold sufficiently well by themselves by natural fiber
(collagen), which is synthesized and woven into a stronger scar.
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Goals:
a. Provide an adequate tension of wound closure without
dead space but loose enough to obviate tissue ischemia and
necrosis.
b. Maintain hemostasis.
c. Permit primary intention healing.
d. Provide support for tissue margins until they have healed
and the support is no longer needed.
e. Reduce postoperative pain.
f. Prevent bone exposure resulting in delayed healing.
Classification of Suture Materials:
A. According to fate:
Absorbable
- Vicryl
- Cat gut
Non-absorbable
- Silk
- Poly propylene
B. According to source:
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Natural
- Cat gut
- Silk
Synthetic
- Vicryl
- Poly propylene
C. According to structure:
Monofilament
- Polypropylene
- Nylon
Multifilament.
- Nylon
D. According to tissue reaction:
Reactive
- Silk
Not reactive
- Polypropylene
Most commonly used:
Silk: High potential for infection and inflammatory
reaction due to high potential for plaque accumulation.
Polypropylene: Monofilament, excellent tensile
strength, no inflammatory reaction, and difficult to
handle.
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Vicryl : Absorbable
Suture Needles
Needle Size
Suture size
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Diameter of surface material it is measured in sizes from 1-
0 to 10-0.
10-0 is the smallest diameter and least amount of tensile
strength.
Suturing techniques
1- Simple interrupted
2- Vertical mattress suture technique.
3. Horizontal mattress suture technique.
4- Figure of 8
5- Sling
6- Cross over
General clinical principles
A. Proper location on the needle body for grasping by the needle
holder.
B. The needle should enter the tissue approximately 2-3 mm
front the wound edge or papillae tip.
C. When penetrating through tissues, the needle should enter
at right angles to the tissue.
D. Sutures should always be inserted through the more mobile
tissue flap first.
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E. The tissues should not be closed under tension, since they will
tear or necrosis around the suture. If tension is present the
tissues should be undermined to relieve it.
F. Don’t cut the knot too short so that it will cause injury to oral
mucosa.
Suture removal
The time to suture removal depends on the location and the
degree of tension the wound was closed under. This varies
between surgeon and situation, but as a general rule sutures
on the gingiva and oral cavity are usually removed between
ten and fourteen days post-operatively.
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