The next step in magnifying the operating area is the use of an operating microscope, which further improves the assessment of surgical tissues.
During oral assessment, it is important to record all observations on a dental chart appropriate to the species and age of the patient. Regardless of whether two‐ or four‐handed dentistry (i.e., with or without an assistant) is performed, filling in the chart is obligatory (Figure 1.27).
High‐quality photography can further augment the diagnostic process. It can be used for presentation to the owner, for communication with a referring veterinarian, for comparison at distant follow‐up, and for illustration of publications or presentations. This is a matter of personal preference, but the camera should preserve natural colors and provide sufficient magnification and focal distance. The latter can be difficult in compact cameras, which require very small distances for macro mode, where lenses and external optics may get foggy from the humid oral environment.
Figure 1.19 Advantages of 3D versus 2D imaging. (a) The sequestrum revealed next to the infected root of the 208 (arrow) would not be identified in a standard radiograph. (b) The extent of neoplastic growth is better assessed in 3D than in intraoral radiograph.
Figure 1.20 Device combining a scaler and a polisher.
Figure 1.21 Dental unit main board, including (from left) suction, three‐way syringe, high‐speed handpiece, low‐speed handpiece, second high‐speed handpiece, and illuminating wand.
Figure 1.22 (a) Combination of a UNC probe and explorer in a single instrument. (b) and its pen grasp.
Figure 1.23 Series of combined probes and explorers. (a) Probes. From left: UNC 15, Michigan, Niemiec, UNC 17, Williams. (b) Whole instruments.
1.10.2 Surgical Kit
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.