Читать книгу The Veterinary Dental Patient: A Multidisciplinary Approach - Группа авторов - Страница 27

In most cases, oral surgery will mean extraction. More information on this topic is provided in Chapter 22. The oral surgery kit has been developed and presented in textbooks by several specialists (Niemiec, Verstraete, Reiter), and oral surgeons have their own preferences in terms of type, size, and brand. Nevertheless, all agree that the following should always be included: blade holder, tissue forceps, periosteal elevator, tissue scissors, suture scissors, and needle holder (Figure 1.28). The part of the needle holder that grasps the suture should be delicate or it can weaken the material, causing it to break after a few sutures. Oral needle holders must not be used for materials larger than 4/0 or they will immediately lose good attachment to sutures and needle.

Tissue scissors with serrated cutting edges provide a better margin of the cut mucosa and gums, but they should never be used for sutures. Suture scissors should preferably be blunt‐ended in order not to harm the tissue while cutting the sutures.

The surgical kit may have medium/large canine and cats/small dogs variations and be packed together with diagnostic instruments. For surgery in the caudal area of the mouth or oropharynx, instruments must be long enough for comfortable operation.

Figure 1.24 (a) Mouth props extending a dog's jaws. (b) Selection of props in different sizes for dogs and cats.

Figure 1.25 Mirror (a) reflecting light into the caudal part of the oral cavity and (b) showing the other side of a tooth.

Figure 1.26 Magnification helps greatly with dental procedures.

Figure 1.27 Charting: filling in (a) a paper dental chart and (b) an electronic veterinary dental scoring system.

Figure 1.28 The oral surgical general kit includes, from left: periosteal elevator, suture scissors, tissue scissors, needle holder tissue forceps, blade holder, and periodontal probe.

Figure 1.29 Extraction kit: luxators (left) and elevators (right), as well as extraction forceps.

Source: Emilia Klim.

Figure 1.30 Rescue kit ‐ From left: four superslim luxators and elevators, mosquito titanium forceps, root tip forceps, and root tip elevator.

Figure 1.31 Selection of burs for extraction.

Source: Emilia Klim.

Figure 1.32 Periodontal kit. From bottom: mirror, three curettes, periodontal probe, and two scalers.

A necessary addition to this kit is an extraction package that contains an assortment of luxators and elevators, as well as extraction forceps (Figure 1.29), and possibly a separate set of instruments dedicated to solving complications, such as root‐tip forceps and root‐tip elevators (Figure 1.30).

There is also an option for a combination luxator and elevator, called an extractor. In this author's hands, it does not fulfill expectations, but it may be worth trying, particularly under the supervision of someone familiar with its use.

An additional element of an extraction kit is a selection of burs, typically used during surgical extractions. The most common varieties of burs are round, pear‐shaped, and fissure, in both standard and surgical lengths (Figure 1.31).