An Extension of Our Hands

Are your surgical instruments as expert as the hands that hold them?

— Mauro Labanca, MD, DDS, FICD
Dental Key Opinion Leader and Guest Blogger for Hu-Friedy

Throughout my career, I have worked in many operatories. I worked as a consultant in operatories that were beautiful, where great efforts were made to have the best furnishings, the latest technology, the most up-to-date computers or CT. But when I asked for a periosteal elevator or a Klemmer? That’s when things got funny!

If I requested a Cocker, I was looked at as if I’d asked for a cute puppy with long, fluffy ears. Needle-forceps were used as if they were a Klemmer and vice versa. Cement spatulas were used in place of periosteal elevators. The dental mirrors had certainly seen better days (they were non-rhodium plated or had grooves in them like a well-played record). There were probes that couldn’t be used because they were broken or crooked, and so on.

This made me realize what little importance most of my colleagues, even the very best and the most demanding, gave to surgical instruments. Allow me to take this opportunity to share here my passion for quality dental instrumentation.

I, like many colleagues, have spent a lot of time, money, and energy learning how to practice (how well, it is for others to say) a profession that is essentially manual, where my hands do the actual work the patient requires of me. In fact, the word “surgery” comes from Greek words that mean “work with the hands.” Our job is clearly very different from that of a psychologist, who needs only a chair and his brain to do a good job.

As I see it, the surgical instrument is an extension of my hand, through which I channel the precision of my movement and the finesse of my work.

Which makes me wonder: Shouldn’t we place the same importance on the instruments we use as we do on the work we do when using them? And shouldn’t they meet the same high standards both our patients and we expect of our work? If I consider myself highly skilled, I should have the instruments to match – just as a tennis player does with her racket, a fisherman with his fishing rod, and so on. Let’s not lose sight of this important detail, if only out of respect for the patients who put their trust in us.

The newest laser or surgical motor is fine, but we can’t forget that a thorough examination is done using a dental mirror and probe that are in good working order. Likewise, an atraumatic extraction performed with great care is done using high-quality pliers. A flap that properly corresponds to the periosteum can only be obtained if the periosteal elevator is up to the job.

Instruments should never be purchased based on price point alone. When buying, carefully consider the instrument and the brand’s merits and reputation to avoid ending up with something of such poor quality it’s almost unusable. Similarly, it is important to have a complete kit of instruments, ensuring that you always have the precise elevator or rongeur that you need in the moment. And don’t cut corners with instrument maintenance, either. Quality instruments that are well cared for will always return the investment and the favor, which means quality results for your practice and your patients.

When confronted with patient questions about the cost of a procedure, you want to be able to tell them that you pay careful attention to all of the details of their surgeries – from your own training, to outfitting your operatory, to purchasing only the best instruments possible.

When you have quality instruments, you perform at your best, you provide atraumatic, pain-free treatment, and – above all – you meet the expectations of yourself and your patients.

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Together with Hu-Friedy, Prof. Labanca has developed several custom surgical instruments, including a bone curette for bone grafting procedures, a periosteal, a set of malleable steel retractors, and a black-line, non-stick plugger.

 

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In 1986 Mauro Labanca MD, DDS, FICD earned his Medical Doctor degree from the University of Milan, where he also qualified in Dentistry and General Surgery. He has practiced Oral Surgery and Implantology since 1992 in his private dental office located in Milan, Italy. He is an International Speaker and Key Opinion Leader for many leading Dental Companies.

Professor Labanca is an active member of EAO (European Academy of Osseointegration) and IADR (the International Association for Dental Research) and an International member of AAP (American Academy of Periodontology).

He is the Regent of the ICD (International College of Dentists) for the Italian Section, Registrar of the European Section, and International Councilor.

He is co-author of the Atlas of Anatomy and Surgery in Dentistry (Elsevier-Masson) with a second edition, the book Clinical Neurochemical and Experimental Aspects of Orofacial Pain in Dentistry, the DVD The Dental Anatomy and Surgery in a Daily Practice. He is author of the DVD Sutures in Dentistry: Materials and Knotting Techniques, now in its the second edition, and of the book Anatomically Oriented Oral Surgery (Quintessence Edition).