Small Animal Surgical Emergencies. Группа авторов

2.37, Figures 2.36–2.39).

      Instrument Sterilization

Most dental instruments can undergo the same cleaning/disinfection routine as standard surgical instruments, with the exception of motorized instruments, such as handpieces, which cannot tolerate any means of immersion. Thus, only the external surfaces of motorized instrumentation can be cleaned manually, using a lint‐free cloth, and well‐soaked with a suitable cleanser/disinfectant spray, as defined in the manufacturer's instructions. Materials that contain hardening properties (i.e., cement) should be debrided from instruments promptly after use to avoid material from bonding to the instrument. Otherwise, debris congestion could inhibit sterilization by obstructing heat or chemical vapor from penetrating the soiled area. All other dental instrumentation should be pretreated with a foaming, enzymatic disinfectant spray, followed by a thorough rinse. Instruments should be processed in an ultrasonic cleaner for a full clean and rinse cycle. If the clinic does not own an ultrasonic cleaner, it is imperative that the instruments are meticulously scrubbed and rinsed thoroughly. Instruments should be dried, inspected for surface damage, and assessed for sharpness, prior to placing them inside a wrapped perforated instrument cassette or a paper/plastic sealed pouch. Finally, instruments should be stored neatly in a clean environment to avoid risk of contamination. Veterinary practices equipped with a washer sterilizer on site may use this method to aid in the complete decontamination of reusable instruments. Washer sterilizers facilitate an automated cleaning process consisting of water and detergent, followed by a rinse and dry cycle, and conclude with an immediate‐use steam sterilization cycle, known as “flash” sterilization. Flashed instruments are typically not intended to be stored for future use. However, the respective technique is satisfactory for instrumentation designated for use in non‐sterile procedures only. All hinged instruments should be unlocked prior to processing and lubrication. Refer to the instrument manufacturer's instructions for reprocessing guidelines. Sterilization and disinfection methods of dental surgery instruments are categorically classified as critical, semi‐critical and non‐critical. Critical refers to instruments that penetrate bone and mucosa and semi‐critical refers to instruments that contact the oral mucosal. Both of these categories require heat sterilization. Non‐critical refers to skin contact; these instruments should be immersed in disinfectant.

Box 2.34 Large Dental Surgery Set

       Mosquito hemostats (10)

       Kelly hemostats (3 curved)

       Minnesota retractors (2)

       Blade handles (no. 3, No. 4)^a

       Backhaus towel clamps (5 small)

       Backhaus towel clamps (2 large)

       Allis tissue forceps (2)

       Metzenbaum scissors (long, short)^a

       Mayo scissor

       Needle drivers (2)^a

       Rat tooth forceps (2)^a

       Ligature suture scissor (small)^a

       Extraction elevator set

       Extraction forceps

       Periosteal elevators (4 sizes)

       Rongeur (single action, small)

       Bone curette

       Periodontal probe/Explorer

       Basin

       X‐ray detectable gauze (10)

^a Included in a small dental set.

      Box 2.35 Periodontal Extraction Cassette

       Mirror

       Periodontal probe/explorer

       Sickle scaler

       Universal curettes

       Periosteal elevators (small, medium, large)

       Freer periosteal elevator

       Root tip pick (no. 10 or 11)

       Winged elevators (1 mm, 2 mm, 3 mm, 4 mm, 6 mm)

       Bone curette

       Extraction forceps

       Root tip forceps

       Blade handle (no. 3)

       Rat tooth forceps

       Metzenbaum scissors (curved)

       Ligature suture scissor (short)

       Needle driver

       Burrs (assorted sizes):Cross‐cut fissureFriction grip, surgical lengthRound diamond

      Box 2.36 Orthodontic Supplies

       Wire cutter and twister

       Cerclage wire (canine: 22–26 gauge, feline: 24–48 gauge)

       Pumice flour

       Prime&Bond® NT™ (Dentsply Sirona, Ontario, Canada; Figure 2.38):TPH Spectra® ST flow, flowable composite restorativeCaulk 34% tooth conditioner etch gel syringes (3 ml)Disposable applicator tips (blue needle tips)Brush handleDispensing well

       3M™ ESPE™ Protemp™ Plus temporary material cartridge introductory kit:4 : 1/10 : 1 Garant™ dispenser (Figure 2.39)Garant mixing tips (blue 50 ml)67 g cartridge of shade (shade color clinician discretion)16 g catalyst of RelyX™ Temp NE36 g base of RelyX Temp NE2 g syringe of Filtek™ Supreme Ultra with tipsMixing pad

       Low‐speed hand piece

       Interdental wiring or splinting supplies:Adhesive tape muzzlingCircumferential wiringSplinting

       Glass Ionomer Cement:Dentin conditionerBrushesKetac™‐Fil with applicatorsVarnish

       Light Cure Composite:CompositeCuring light and shield3M ESPE Visio™ bondUnfilled resin (Prime&Bond)Acid etch gelBrushes

       Mandrel polishing disksDental burrs:White stonePear shapedRound diamond

Box 2.37 Instruments and Supplies for Pulpectomy

       Periosteal elevator

       Glass slab

       Explorer

       Spoon excavator

       College pliers

       Dappen dish

       Spatula

       Beaver tail

       Retrograde