Post on 25-Oct-2014
BASIC ARMAMENTARIUM FOR MINOR ORAL SURGERY
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 HookBlunt with Rounded Probe End
Serrated Dissector EndBlunt, One hook
End
Fine Straight Jaw Round Jaw
Square JawStraight 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 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 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
AdsonAllis: 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 Hemostats1. 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 TipsNeedle 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 toothChisels: To cut a window in the bone cortex for access or to allow harvesting of pure soft boneGouges: 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