Published on February 17, 2014
BASIC ARMAMENTARIUM FOR MINOR ORAL SURGERY
Lap Joint Box Joint Double Action Joint
Ring Handle Ring handle with one extra large Handle Grooved Handle with Horn Grooved Handle Hollow Handle
Single Spring Ratchet Lock Double Spring
Single Spring with Roller Double Spring with Ball & Socket Double Leaf Spring Sliding Ring
Cam Ratchet Bar Ratchet Bar & Wingnut
Blunt, Blunt Sharp, Blunt Fine Tip Blunt Blunt, Blunt with Bevel Sharp, Sharp Fine Tip Sharp
Blunt with Retaining Hook Blunt with Rounded Probe End Serrated Dissector End Blunt, One hook End
Fine Straight Jaw Square Jaw Punch Upward through Cutting Round Jaw Straight on Flat Punch Upward Oblique
INSTRUMENTS 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 Periosteal elevators are used to reflect mucoperiosteum, to loosen soft tissue from teeth before extraction, and to retract small flaps 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.
Tissue Retractors Austin Seldin 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 Serrated tips Jaws Grooved grip area Spring Adson Allis: to grasp and hold tissue that will be excised
Tissue Forceps: To grasp and handle soft tissue Russian: is Pickup: is specially useful for grasping teeth that are loose in the useful to handle tissue in the posterior aspect mouth 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 Jaws Scissor cutting blades Groove & Crosshatching Box Lock Shank Ratchet Finger Rings
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 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.
INSTRUMENTS FOR BONE SURGERY
Bone Curette: To curette or remove soft tissue from bony cavities Volkmann
Bone Curette Brun Halle
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
Chisels and Gouges 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
Mallet Stainless steel working end Plastic working end Shank Phenolic handle
Cheek Retractors Farabauf Kilner
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