BASIC ARMAMENTARIUM FOR MINOR ORAL SURGERY

To retract tissue: Hand-held and self-retaining retractors serve this purpose, as well as instruments such as skin and bone hooks... To grasp, hold or occlude:These include the many typ

BASIC ARMAMENTARIUM FOR MINOR ORAL SURGERY

DR FOUAD ALBELASY

TYPES OF JOINTS

Lap Joint Box Joint

Double Action Joint

TYPES OF HANDLES

Ring Handle Ring handle with one extra large Handle

Grooved Handle

Grooved Handle with Horn

Hollow Handle

RETAINING SYSTEMS

Ratchet Lock Single Spring

Double Spring

Single Spring with Roller

Double Spring with Ball & Socket

Cam Ratchet

Bar RatchetBar & Wingnut

TYPES OF BLADE TIPS

Blunt, Blunt Blunt, Blunt with Bevel

Blunt with Retaining Hook

Blunt with Rounded Probe End

Serrated Dissector End

Blunt, One hook

End

Fine Straight Jaw Round Jaw

Punch Upward through

Cutting

Punch Upward Oblique

INSTRUMENTS CLASSIFICATION BY USAGE

Surgical instruments are designed to perform either diagnostic or therapeutic operations; to locate the cause of a problem, or to treat a problem once it has been found Each instrument is designed to perform a specific function Those functions may be generally categorized under one of the following uses:

1 To cut or incise:

Instruments used for this purpose are frequently referred to as

“sharps” They include scissors, knives, scalpels, chisels and osteotomes, among others.

2 To retract tissue:

Hand-held and self-retaining retractors serve this purpose, as well

as instruments such as skin and bone hooks

3 To grasp, hold or occlude:

These include the many types of forceps, including hemostats,

dressing and tissue forceps, as well as bone holding forceps Also included in this group are needle holders.

4 To dilate or probe:

These instruments are used to dilate or enlarge openings or to find

an area or foreign object.

5 To cannulate or drain:

These instruments including catheters, drains and cannulas, are generally used to drain a wound.

6 To aspirate, inject or infuse:

These instruments serve to remove unwanted fluids as well as to inject needed fluids into a patient Among these instruments are syringes, some needles, trocars and cannulas.

7 To suture or ligate :

Suture or ligation is used to close or rejoin a wound or an area of operation, e.g., a vessel, a nerve or tissue There are a variety of sutures and clips, as well as suture needles and ligating

instruments.

SOFT TISSUE INSTRUMENTS

Scalpel Handle #4: To hold scalpel

blade

Scalpel Blade Seating Area

Grooved Grip Area

Shank

Pattern Number

Scalpel Blades: from right to

left; # 15, #12, #11, and #

10

Mounted Scalpel Blades on Scalpel

Handles

Disposable Scalpel

Clinical Tip: Because scalpel blades dull rapidly after being pressed against bone they should be changed between incisions if more than one flap

is to be reflected.

Periosteal Elevators

Molt # 9 & Woodson

# 1

Seldin

Clinical Tips for periosteal

Elevators

Pry Stroke: Using the tooth as a fulcrum, the sharp pointed end of the elevator is used to reflect the MPF by first prying the IDP free from the underlying bone

Push Stroke: Using the broad end of the elevator in a push stroke, the attached gingiva and alveolar mucosa are reflected to the desired extent

Pull Stroke: Using the periosteal elevator in a pull stroke can sometimes shred the periosteum

Periosteal elevators are used to reflect mucoperiosteum,

to loosen soft tissue from teeth before extraction, and to retract small flaps

Tissue Retractors

Seldin

Austin

Minnesota

Tissue Retractors: Clinical

Dissection Scissors: To cut and dissect tissue

Blunt, Blunt

Tip Beveled Cutting Blade with Regular Cutting

Edge Screw Lock (Lap Joint)

Shank

Finger Rings

Dissection Scissors

Iris: small sharp-pointed scissors

Metzenbaum: longer, delicate, blunt-nosed scissors

Operating Scissors: To cut sutures, gauze and

other materials

Stitch Scissor

Operating Scissor

SCISSORS come in a tremendous variety of styles and sizes They come in straight, curved and angular versions

Useful Tips in Usage:

1 The curved patterns are preferred by most surgeons for dissecting, since they provide a better field of vision for the areas to be cut

2 Straight scissors are used when a straight cut is desired, such as in sutures, nerves, vessels

3 Scissors are also used to spread and probe the area of incision (dissection & undermining tissues) The smaller sizes are used at the surface, the larger sizes deeper in the cavities

4 Dedicate the different types for their specific purpose for example, using fine dissecting scissors to cut suture can ruin the cutting edge

5 Special care instructions: To maintain scissors in peak operating condition, they must be sharpened regularly

Tissue Forceps : To grasp and handle soft tissue

Grooved grip area

Spring

Adson tissue that will be excisedAllis: to grasp and hold

Tissue Forceps : To grasp and handle soft

of the mouth

WEIDER Tongue Retractor: very

useful instrument during

surgery for impacted lower third

molars

Jones Towel Clamp

Foerster Dressing Forceps Backhaus Towel Clamp

Hemostat: To clamp and restrict bleeders

or tissue, to control the flow of blood

Fully Serrated Jaws

curved hemostat

Straight & Curved Hemostats

has a relatively long delicate peak

Hartmann-Mosquito Forceps

Halsted-Mosquito Forceps

Needle Holder: To hold and guide suture needles securely

for suturing

Groove &

Crosshatching

JawsBox Lock

Shank

Ratchet

Finger RingsScissor cutting

blades

Needle Holders Vs Hemostats

1 Needle holders look similar to hemostats, but jaws

are thicker and shorter

2 Face of shorter beak of needle holder is crosshatched

to ensure positive grip on needle but hemostat has

parallel grooves that do not allow a firm grip on

needle

Needle Holder: Clinical Tips

Needle holders are available in many styles and sizes

Shorter ones are used for working close to the surface

Longer ones are for deeper cavities

The smaller the needle, the smaller the jaws of the needle holder

If the needle is too large to be held securely, select a

larger size needle holder Otherwise, the needle may slip, or the needle holder may be overstressed, causing fatigue or breakage

INSTRUMENTS FOR BONE

SURGERY

Bone Curette: To curette or remove soft tissue

from bony cavities

Volkmann

Brun

Halle

Bone Curette

Bone File: for final smoothing of bone before suturing the MPF back into position

Bone File: Clinical Tips

1 Use the bone file in a pull stroke, because the

teeth of the file are arranged in such a fashion

to remove bone only in this direction

2 Avoid cross filing or pushing the bone file,

because this results in burnishing and

crushing of bone

3 Carefully Cleanse the instrument by wiping

the grooved ends with a sponge By failure to

do this, dust or chips may easily remain in the wound

Bone Rongeur: to remove bone by shearing on a planned action

Bone Rongeur: Clinical Tips

1 Smaller amount of bone should be removed in each

of multiple bites but never large amount of bone in a single bite.

2 A constant cleansing of the blades is necessary.

3 Rongeurs are delicate and relatively expensive therefore, NEVER remove teeth with rongeurs.

Chisels and Gouges: To score, cut, scrape, and sculpt bone

Osteotomes : To shape and sculpt bone,

or section a tooth

cortex for access or to allow harvesting

of pure soft bone

bone, especially in bone grafting

Chisels and Gouges

Plastic

working end

Stainless steel working end

Shank

Phenolic handle

Cheek Retractors