Bone Chisels and Surgical Mallets in Dentistry

Key points

• Single-bevel chisels remove and shape bone; double-bevel chisels split teeth and bone along a line.
• The mallet gives short, controlled taps while the surgeon guides the blade and the mandible is supported.
• Enamel chisels for cavity preparation are restorative instruments, covered under hand cutting instruments.

What is a bone chisel used for in dentistry?

A bone chisel removes, shapes or splits hard tissue in oral surgery. Typical jobs are taking off bone over an impacted tooth, splitting a multi-rooted or impacted tooth so the pieces can be lifted out separately, reducing tori and exostoses, and flattening a ridge in an alveoloplasty before the rongeur and bone file finish it. Smaller hand chisels, pushed or pulled without a mallet, recontour interdental bone in periodontal osseous surgery. A grooved Partsch chisel can also shave off thin curls of bone for a small graft, which is then handled with the bone graft instruments.

Rotary burs in a surgical handpiece, and piezo-surgical units, now do much of this work, but a sharp chisel still removes bone quickly, without heat, and leaves a clean surface. That's why most surgical extraction trays still carry a chisel and mallet; the oral surgery and extraction instruments guide sets them beside the rongeurs, files and elevators.

What is the difference between a bone chisel and an enamel chisel?

Bone chisels are surgical instruments for bone and tooth sectioning; enamel chisels are restorative instruments for shaping cavity walls. The names overlap, so the table sets out which is which. Enamel chisels, hatchets and hoes have their own guide, dental hand cutting instruments, and this page covers only the surgical chisels.

What types of bone chisel are there?

How do you use a chisel and mallet?

Reflect a full-thickness flap with a periosteal elevator and retract it so the blade only meets bone. The surgeon holds the chisel firmly, with the fingers close to the blade for control, and sets the edge where the cut should start; with a single-bevel chisel the flat face rides along the plane of bone that is to be kept. The assistant then taps the end of the handle with the mallet in short, light, square blows from the wrist, and the surgeon resets the angle between taps.

When a tooth is split, a double-bevel chisel is seated in a groove or furcation and one sharp tap is usually enough. Throughout, the surgeon or assistant supports the mandible from below so the force goes into the bone, not into the temporomandibular joints.

Warn the patient about the noise and the sensation. Peñarrocha and colleagues have reported benign paroxysmal positional vertigo after osteotome and mallet work in the maxilla, so heavy or repeated blows should be avoided and the patient asked about dizziness afterwards.

Which chisel for which procedure?

• Impacted third molars: a single-bevel chisel to remove bone over the crown and a double-bevel chisel to split the tooth, alongside elevators.
• Alveoloplasty and exostoses: a flat Partsch chisel for the bulk, then a rongeur and bone file to smooth the ridge.
• Mandibular and palatal tori: a bur to score the torus, then a chisel to lift off the segments.
• Periodontal osseous surgery: Ochsenbein, Fedi and Rhodes back-action chisels on the periodontal surgery tray.
• Ridge splitting for implants: a thin chisel to open the crest before osteotomes widen it.

What should you look for in a surgical mallet?

• Weight: about 150–200 g gives enough force for chisels and osteotomes without heavy blows.
• Faces: replaceable plastic or PTFE faces soften the impact and protect the handle ends of chisels and osteotomes from mushrooming; solid steel heads transmit more force.
• Handle: a wooden, knurled metal or solid steel handle; choose the grip that stays secure in wet gloves.
• Length: around 16–19 cm keeps the blow controlled from the wrist.
• Spare inserts: worn or cracked faces should be replaced, so check that inserts are available for the model.

What does the Equate range include?

Equate lists 37 surgical chisels. The 23 straight chisels include Partsch flat chisels in 14 cm and 17 cm with 3, 4 and 5 mm blades, Partsch grooved chisels, single-cut and double-cut chisels of 3, 6 and 9 mm, fine 1–2.5 mm chisels, a 5 mm straight-centre chisel and 3.8 mm and 7.5 mm long-tip chisels. The 9 curved designs include left and right curved 5 mm chisels, curved long-tip chisels, Partsch grooved 14 cm chisels, a Rhodes 36/37 back-action chisel, a 13KL surgical chisel and a scaler chisel. Periodontal hand chisels add the Fedi N.1 and N.2, the Zerfing, and the Ochsenbein N.3 and N.4.

For striking, there are 6 surgical mallets from 16 cm to 19 cm, with replaceable plastic inserts or solid steel heads and wooden, knurled or steel handles, a pack of replacement inserts, and 150 g and 190 g surgical hammers with PTFE faces. The chisels are made of passivated stainless steel, ultrasonically cleaned, shape-, boil- and performance-tested and individually packed, designed in Finland, and clinics can request samples and a quote through the oral surgery range.

How do you clean, sharpen and maintain bone chisels and mallets?

Chisels cut bone, so they are critical items: clean them promptly, process them in an ultrasonic bath or washer-disinfector and heat-sterilise them after each patient, as the CDC's 2003 dental guidelines require. Follow the manufacturer's reprocessing instructions for each material, which ISO 17664-1 requires manufacturers to provide; this matters for mallets with plastic inserts or wooden handles.

A dull chisel needs more blows and bruises bone, so check the edge under light before each use. Sharpen on a flat stone, keeping the original bevel angle and a straight edge, or send the instrument for professional regrinding. Retire a chisel whose blade is chipped, cracked or ground short, and replace mallet inserts that are split or deeply dented.

Equate Bone Chisels and Surgical Mallets in Dentistry options

Curved Long-Tip Bone Chisel - 3.8mm

EI-0552

Curved Long-Tip Bone Chisel - 7.5mm

EI-0553

Bone Chisel Double Cut 3 mm

EI-0554

Bone Chisel Double Cut 6 mm

EI-0555

Fedi N.1 Periodontal Chisel 1.8mm - Solid Handle 6mm

EI-1895

Fedi N.2 Periodontal Chisel 2.0mm - Solid Handle 6mm

EI-1896

Ochsenbein N.3 Bone Chisel - Solid Handle 6mm

EI-1897

Ochsenbein N.4 Bone Chisel 2.2mm - Solid Handle 6mm

EI-1898

Rhodes Back-Action Chisel 36/37 - Solid Handle 6mm

EI-1899

Zerfing Solid Handle 6mm

EI-1903

Partsch Flat Bone Chisel 14 cm x 4 mm

EI-2415

Partsch Flat Bone Chisel 14 cm x 3 mm

EI-2416

Buying in your market

• UK & Ireland
• North America
• DACH
• Nordics & Scandinavia
• Baltics
• GCC
• Turkey

Frequently asked questions

References

1. Hupp JR, Tucker MR, Ellis E. Contemporary Oral and Maxillofacial Surgery, 7th edition. Elsevier, 2018 (instrumentation for bone removal and tooth sectioning; management of impacted teeth)
2. Newman MG, Takei HH, Klokkevold PR, Carranza FA. Newman and Carranza's Clinical Periodontology. Elsevier (resective osseous surgery and periodontal surgical instruments)
3. Ochsenbein C. A primer for osseous surgery. International Journal of Periodontics and Restorative Dentistry 1986;6(1):8–47
4. Peñarrocha M, Pérez H, García A, Guarinos J. Benign paroxysmal positional vertigo as a complication of osteotome expansion of the maxillary alveolar ridge. Journal of Oral and Maxillofacial Surgery 2001;59(1):106–107
5. Peñarrocha M, García A. Benign paroxysmal positional vertigo as a complication of interventions with osteotome and mallet. Journal of Oral and Maxillofacial Surgery 2006;64(8):1324
6. Kohn WG, Collins AS, Cleveland JL, et al. Guidelines for Infection Control in Dental Health-Care Settings, 2003. MMWR 52(RR-17), Centers for Disease Control and Prevention
7. ISO 17664-1:2021 Processing of health care products: information to be provided by the medical device manufacturer for the processing of medical devices, Part 1: critical and semi-critical medical devices
8. Boyd LB. Dental Instruments: A Pocket Guide, 7th edition. Saunders/Elsevier, 2020. Chapter 17, Oral Surgery Extraction Instruments (photographs used under licence)
9. Steel B. Lingual split versus surgical bur technique in the extraction of impacted mandibular third molars: a systematic review. Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology 2012;114(3):294–302

Related

• Dental Rongeurs and Bone Files
• Dental Osteotomes for Implant Site Preparation
• Dental Hand Cutting Instruments: How Hatchets, Hoes, Chisels and Trimmers Differ and How to Use Them
• Periosteal Elevators: Molt 9, Freer, Buser and Other Patterns
• Surgical Extraction Tray Setup
• Periodontal Surgery Tray Setup
• Oral Surgery and Extraction Instruments

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