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

Double Leaf Spring

Sliding Ring

Cam Ratchet

Bar Ratchet

Bar & Wingnut

TYPES OF BLADE TIPS

Blunt, Blunt

Blunt, Blunt with Bevel

Sharp, Blunt

Sharp, Sharp

Fine Tip Blunt

Fine Tip Sharp

Blunt with Retaining Hook

Blunt with Rounded Probe End

Serrated Dissector End

Blunt, One hook

End

Fine Straight Jaw

Round Jaw

Square Jaw

Straight on Flat

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 Scalpe

l

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

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

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

Serrated tips

Jaws

Adson

Allis:

to grasp and hold

tissue that will be excised

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

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

Box Lock

Shank

Ratchet

Finger Rings

The hemostat
most commonly
used in OS is
curved hemostat

Straight & Curved Hemostats



The Hemostat

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

Jaws

Box Lock

Shank

Ratchet

Finger Rings

Scissor 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

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

Mallet

Plastic

working end

Stainless steel

working end

Shank

Phenolic handle

Cheek Retractors

Farabauf

Kilner