Basic armamentarium for minor oral surger

1. BASIC ARMAMENTARIUM
FOR MINOR ORAL SURGERY
DR. FOUAD ALBELASY

2. TYPES OF JOINTS

3. Lap Joint
Box Joint
Double Action Joint

4. TYPES OF HANDLES

5. Ring Handle Ring handle with one extra large Handle
Grooved Handle
Grooved Handle with Horn
Hollow Handle

6. RETAINING SYSTEMS

7. Ratchet Lock
Single Spring
Double Spring

8. Single Spring with Roller
Double Spring with Ball & Socket
Double Leaf Spring
Sliding Ring

9. Cam Ratchet
Bar Ratchet
Bar & Wingnut

10. TYPES OF BLADE TIPS

11. Blunt, Blunt Blunt, Blunt with Bevel
Sharp, Blunt Sharp, Sharp
Fine Tip Blunt Fine Tip Sharp

12. Blunt with Retaining Hook
Blunt with Rounded Probe End
Serrated Dissector End
Blunt, One hook End

13. Fine Straight Jaw Round Jaw
Square Jaw
Straight on Flat
Punch Upward through
Cutting
Punch Upward Oblique

14. INSTRUMENTS
CLASSIFICATION BY USAGE

15. 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

16. 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.

17. 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.

18. SOFT TISSUE
INSTRUMENTS

19. Scalpel Handle #4: To hold scalpel blade
Scalpel Blade Seating Area
Grooved Grip Area
Shank
Pattern Number

20. Scalpel Blades: from right to
left; # 15, #12, #11, and # 10
Mounted Scalpel Blades on Scalpel Handles

21. 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.

22. Periosteal Elevators
Molt # 9 & Woodson # 1
Seldin

23. 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

24. Tissue Retractors
Seldin
Austin
Minnesota

25. Tissue Retractors: Clinical Tips
1. For small flaps, use the periosteal elevator
for retraction
2. For large flaps use Minnesota or Austin
retractor
3. Place retractor beneath the flap resting on
sound bone
4. Avoid trapping of flap between retractor and
bone
5. RETRACT PASSIVELY: no attempt is made to
pull the flap out of the field

26. Dissection Scissors: To cut and dissect tissue
Blunt, Blunt Tip
Beveled Cutting Blade with Regular Cutting Edge
Screw Lock (Lap Joint)
Shank
Finger Rings

27. Dissection Scissors
Iris: small sharp-pointed scissors
Metzenbaum: longer, delicate, blunt-nosed scissors

28. Operating Scissors: To cut sutures, gauze and other
materials
Stitch Scissor
Operating Scissor

29. 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.

30. Tissue Forceps: To grasp and handle soft tissue
Grooved
grip area
Spring
Serrated tips
Jaws
Adson
Allis: to grasp and hold
tissue that will be excised

31. Tissue Forceps: To grasp and handle soft tissue
Russian: is
specially useful
for grasping
teeth that are
loose in the
mouth
Pickup: is
useful to handle
tissue in the
posterior aspect
of the mouth

32. WEIDER Tongue Retractor: very
useful instrument during surgery
for impacted lower third molars
Jones Towel
Clamp
Foerster Dressing Forceps Backhaus Towel Clamp

33. Hemostat: To clamp and restrict bleeders or
tissue, to control the flow of blood
Fully Serrated Jaws
Box Lock
Shank
Ratchet
Finger Rings
The hemostat
most commonly
used in OS is
curved hemostat

34. Straight & Curved Hemostats
 The Hemostat
has a relatively
long delicate peak
Hartmann-Mosquito Forceps
Halsted-Mosquito Forceps

35. Needle Holder: To hold and guide suture needles securely
for suturing
Groove &
Crosshatching
Jaws
Box Lock
Shank
Ratchet
Finger Rings
Scissor cutting
blades

36. 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

37. INSTRUMENTS FOR BONE
SURGERY

38. Bone Curette: To curette or remove soft tissue from
bony cavities
Volkmann

39. Brun
Halle
Bone Curette

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

41. 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.

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

43. 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.

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

45. Osteotomes: To shape and sculpt bone,
or section a tooth
Chisels: To cut a window in the bone
cortex for access or to allow harvesting
of pure soft bone
Gouges: To scoop away strips of soft
bone, especially in bone grafting
Chisels and Gouges

46. Mallet
Plastic
working end
Stainless steel
working end
Shank
Phenolic handle

47. Cheek Retractors
Farabauf Kilner