Whether you’re just starting out in AOX surgery, or are a seasoned veteran, I want to share with you a quick look at 5 surgical instruments I feel are of vital importance to performing quality full-arch surgery.
These are instruments & equipment that I use every surgery and quite frankly, could not operate at a high level without.
While there is definitely more than one way to perform AOX surgery, I have found the instrumentation below to be the most effective.
1. Orringer Retractor
In my opinion there is simply not a better retractor on the market for AOX surgery. This is because the Orringer allows you (and more importantly your assistant) to control the view of the surgical field by manipulating the retractor. Other, quite frankly more popular retractors, such as the OptraGate do NOT allow your assistants to adequately control surgical field visualization.
2. Double Action Rongeurs
While a saw is efficient, it is very expensive and can be dangerous if not in well trained hands. I have found the double action rongeurs (as shown above) to be second to none in terms of efficiency and safety for bulk bone reduction.
*I will note that unwanted alveolus fracture can absolutely occur in untrained hands and I would not recommend an instrument this powerful to untrained surgeons. This style of rongeur will generate a significant amount of force. I think that those with either OMFS training or ~100 arches under their belt, and with proper technique, can benefit immensely from this instrument.
3. Surgical Drill (An actual surgical drill…)
If you’re going to be doing AOX surgery, it is my humble opinion that you should use an actual surgical drill.
If you don’t have a true surgical drill and/or don’t feel confident using a surgical drill – it is my, likely unpopular opinion, that you should not be performing full-arch surgery.
It is normal for a surgeon to require practice and training with a surgical drill before feeling comfortable and being able to operate it safely. And this is absolutely ok.
But if this is you – please take a step back and improve your surgical skills to be able to confidently handle the instrumentation indicated for the procedure – before going down the full-arch path.
A surgical drill will provide improved torque, less overheating of the bone, and will not “blow air” (like a dental handpiece) into the surgical wound which can cause significant post-op complications.
For reference I use a Bien-Air handpiece, motor, and unit.
4. Perio Probe (20 mm)
A perio probe is absolutely indispensable in AOX surgery. I wrote an entire article on “why” that you can access here. Please note that the 20mm length (tip to base) is critical. A shorter perio probe is not as advantageous.
5. Tapered Implants
While the majority of surgeons use a tapered implant system, there are still some that prefer using parallel walled implants or only slightly tapered implants. To each their own. As I’ve said, there is absolutely more than one way to do this surgery.
However, I’ve expanded on my rationale in the article here – as to why I feel a generously tapered implant is significantly advantageous in AOX surgery.
Matthew Krieger DMD
P.S. You can view my full surgical set-up here.
“There is no such thing as good enough. You, your team, and your equipment must be the best. That is how you will win victories.”
Gene Kranz
Q & A with Dr. K
“I have been reading your blogs and I must say they have been a tremendous source of knowledge. I am wondering if you run any courses on AOX??” |
Thank you for reaching out and thank you for your support of the blog!
At the moment I do not have any AOX courses that I offer (other than information via the blog and newsletter).
I have been working on putting together an online course and then had some concerns about ensuring teaching was adequately understood and implemented appropriately without a hands-on portion and therefore shifted to an in-person course. As I have begun to learn there is quite an “overhead” associated with an in-person course due to facility fees, course team, cadavers, equipment etc. and figuring out how to make this happen at a reasonable price for attendees, without too large a group, and not “donating” my time has been a challenge.
I am working on it though.
Stay up to date via this newsletter. I will make any “course” announcements here.
Thank you for your interest and support!