Armamentarium for basic oral surgery

ARMAMENTARIUM FOR BASIC ORAL SURGERY

DEEPTHI P.R.INTERN DEPT. OF ORAL SURGERY

CONTENTS Introduction Instruments for Transferring Sterile

Instruments Instruments for Incising Tissue Instruments for Elevating Mucoperiosteum Instruments for Retracting Soft Tissue Instruments for Controlling Hemorrhage Instruments for Grasping Tissue Instruments for Removing Bone Instruments for Removing Pathologic Tissue

CONTENTS Instruments for Suturing Mucosa Instruments for Holding the Mouth Open Instruments for Suctioning Instruments for Irrigating Instruments for Extracting the Teeth -Local Anesthetic instruments -Dental elevators -Extraction forceps Instrument trays Conclusion References

INTRODUCTION Myriad of instruments- oral surgical

procedures Variety of purposes: -hard tissue -soft tissue

INSTRUMENTS FOR TRANFERRING STERILE INSTRUMENTSCHEATLE FORCEPS Long handles Long, angulated beaks: serrated Beaks: dipped in antiseptic solution Lift up sterile instruments from autoclave/

drum

TRANSFER FORCEPS Heavy, right-angled – heavy jaws

SWAB HOLDING FORCEPS

Long handles, straight beaks- fenestrated ends

Rings : end of handles Working end- inner aspect: serrated Pick up sterile gauze- transfer to tray Hold gauze dipped in antiseptic solution-

scrub the surgical field

INSTRUMENTS FOR INCISING

TISSUE

INSTRUMENTS FOR INCISING TISSUE

SCALPEL: Handle- No. 3, No.7 Differently shaped Disposable, sterile sharp blade:

1. No.15- most commonly usedo Relatively smallo Around teeth through mucoperiosteum


2. No.10- similar to No.15o Large skin incisions3.No. 11o Sharp, pointed o Small stab incisionso Incising an abscess4.No.12o Hookedo Mucogingival procedureso Posterior aspect of teeth/ maxillary

tuberosity


Blade loaded

Blade removed

Remember.. Pen Grasp: Allow maximal control Hold mobile tissue firmly Press down firmly Single- patient use: dulled easily Several incisions : single operation- 2nd

blade Dull blades: no clean sharp incisions

INSTRUMENTS FOR ELEVATING MUCOPERIOSTE

UM

INSTRUMENTS FOR ELEVATING MUCOPERIOSTEUM

Mucosa & Periosteum reflected in single layer: Periosteal Elevator

I. No.9 Molt periosteal elevatoro sharp, pointed end: reflect papillae from

between teeth, loosen soft tissues via gingival sulcus

o Broader, flat end: elevating the tissue from bone

o Thin, sharp cutting edge- clean separation of periosteum from bone


Round ended Molt periosteal elevator o Single/double ended

Reflection of soft tissue- 3 methods1. Prying motion: pointed end to elevate soft

tissue2. Push stroke: broad end slid under the flap-

separates mucoperiosteum from bone3. Pull/ Scrape: tends to shred periosteum ,if not

careful


Also used as retractor Periosteum elevated Broad blade pressed against bone: flap

elevated into reflected position

II. Woodson periosteal elevator Relatively small & delicate Loosen the soft tissues via gingival

sulcus


III. Howarth’s Periosteal Elevatoro Double-endedo One end: flat, broad, spatulate- sharp

edgeo Other end: Rugine end; flat &

rectangular. Small tip – sharp projection perpendicular

o Reflection & retraction : mucoperiosteal flaps

o Reflection: periosteum


IV. Moon’s Probeo Right angled- narrow working edgeo Flat handle & blade; blade perpendicular

to handleo Narrow working edge; blunt & rounded

tipo Mucoperiosteal elevation : prior to

extractiono Objective symptom: anesthesia

INSTRUMENTS FOR

RETRACTING SOFT TISSUE

INSTRUMENTS FOR RETRACTING SOFT TISSUE

Good vision & access Cheeks, tongue & mucoperiosteal flaps

Right angle Austin retractoro ‘L’-shaped- no handleo Retraction of small intraoral flaps:

removal of impacted teeth


Offset broad Minnesota retractor

Both Austin’s & Minnesota : retract cheek & mucoperiosteal flap simultaneously


Before flap- retractor held loosely in the cheek

After flap reflection- retractor placed on the bone & used to retract the flap

Seldin retractoro Similar to a periosteal elevatoro Leading edge: dull- shouldn’t reflect

periosteum


Periosteal elevator- primary instrument for retraction

-positioned on the bone & held to reflect tissueMouth Mirroro Common –Retract tongueWeider Retractoro Broad, heart-shapedo Serrated on one side: firmly engage tongue,

retract it medially & interiorlyo Don’t position posteriorly- gagging


Langenback’s Retractoro ‘L’ shaped retractor- long handleo Retraction of flap edges : improved

visualization of deeper layers & structures

o Different sizes: handle length & blade width


Tongue Depressoro ‘L’- shaped; no handleo Broad, flat, rounded bladeo Retraction & depression of tongueo Improve visibility- posterior pharyngeal

wall & tonsillar region, lingual side of mandible

o Removal of throat packo As cheek retractor


Towel clipo Hold the tongueo Biopsy: performed on the posterior

aspect; by holding the anterior tongueo Profound L/A

INSTRUMENTS FOR

CONTROLLING HEMORRHAGE

INSTRUMENTS FOR CONTROLLING HEMORRHAGE

Arteries & veins- bleeding : pressure not enough

Hemostato Variety of shapeso Small or delicate/ Largero Straight/ Curvedo Curved hemostat- commono Long, delicate beak to grasp tissue & a

locking handle

INSTRUMENTS FOR CONTROLLING HEMORRHAGE

Locking handle: clamps onto a vessel; then let go & remains clamped onto tissue

Removes granulation tissue Picks up root tips, pieces of calculus,

fragments of amalgam restorations, any other small

particles dropped into the mouth Small hemostat: Mosquito forceps Eg: Crile, Spencer Wells, Halstead mosquito

artery forceps

INSTRUMENTS FOR

GRASPING TISSUE

INSTRUMENTS FOR GRASPING TISSUE

Soft tissue stabilization- pass suture needle

Adson’s Tissue Forceps/ Pickupso Delicate forceps o Small teetho Gently hold tissue & stabilizeo Don’t grasp too tight- crushingo Non-toothed


Tissue Holding Forcepso Toothed/ Non- toothedo Toothed: periosteum, muscle,

aponeurosiso Non- toothed: fascia, mucosa,

pathological tissues


Stillies forcepso Longer, but similar to Adson’so 7”-9” longo Easy grasp of tissue in the posterior part, with

enough part protruding beyond the lips: controlCollege/Cotton forcepso Angledo Small fragments of tooth/amalgam/foreign

materialo Placing/removing gauze packs


Allis Tissue forcepso Locking handles - proper placement - held by asst. :necessary tensiono Teeth which will firmly grip the tissueo Removal of large amounts of fibrous tissue:

Epulis fissuratumo Never : tissue to be left in mouth- crushing

injury


Russian Tissue forcepso Large, round-endedo Teeth elevated from socketso Round end: positive grip, avoids

slippage; unlike hemostato Placement of gauze: isolation


Babcock’s Tissue Holding Forcepso Non-toothed bladeso Long beaks- broad working edgeo Smooth, non-serrated edgeso Rings- locking mechanismo Hold delicate tissues: mucosa, lymph

nodeso Holding cyst lining during enucleation

INSTRUMENTS FOR REMOVING

BONE

INSTRUMENTS FOR REMOVING BONE

Rongeur forcepso Most commonly usedo Sharp blades- squeezed together;

cutting/pinching through boneo Leaf spring between the handle :

instrument opens when hand pressure is released

o Repeated cuts without manually reopening


2 major designs: Side-cutting Side-cutting & end-cutting/ Blumenthal rongeurs - most dentoalveolar surgical procedures - inserted into sockets: interradicular

bone - sharp edges of bone


Large amounts of bone, quickly & efficiently

Do not : -remove large amounts of bone in single

bites - use to remove teeth Small amounts- multiple bites


Chiselo Monobevel chisel: bone is removedo Bibevel chisel: teetho Success: sharpness- sharpen before

sterilisationo Carbide tips- use more than once, before

sharpening


Cylindrical handle- serrated with flat end: struck with mallet

Flat & rectangular: cutting edge in different sizes

Single bevel- cutting edge


Transalveolar extraction/ removal of impacted tooth

Shape/ contour irregular bony surfaces Bevel faces- bone to be cut Cutting edge- perpendicular to bone


Osteotome Splitting bone Cylindrical handle- serrated for good grip Flat end- tapped with mallet Flat & rectangular blade Bibivelled cutting edge- converge to a

sharp edge


Osteotomy cuts: orthognathic surgery/ refracturing malunited fractures

Osteoplasty/ bone recontouring Split impacted tooth for easy removal


Surgical Mallet Cutting bone with osteotome/ chisel Stainless steel- strong cylindrical handle Tapped : ‘pull-back’ action- force from

wrist Tapped with controlled force; made to

spring back from chisel/ osteotome # jaw: inadvertent force


Bone fileo Final smoothing of bone

before suturing of mucoperiosteal flap: small

o Double-ended: small & large

o Removes bone: pull strokeo Avoid push motion-

burnishing & crushing the bone


Bur and Handpieceo Surgical removal of teetho High-speed + sharp carbide burs:

cortical bone removalo No. 557,703 fissure burs; No.8 round buro Large bone bur : acrylic bur- large bone

removal (torus)


o Completely sterilizable in a steam autoclave: ensure on purchase

o Relatively high speed & torque: rapid bone removal & efficient sectioning

o Must not exhaust air into the operative field

o Avoid high-speed turbine drills used in restorative dentistry:

tissue emphysema

INSTRUMENTS FOR REMOVING PATHOLOGICAL TISSUE

Periapical Curetteo Angled, double-endedo Removal of granulomas/small cysts from

periapical lesionso Small amounts of granulation tissue

debris from tooth sockets

INSTRUMENTS FOR REMOVING PATHOLOGICAL TISSUE

Sinus Forceps Handles with rings at the end No lock/ ratchet Narrow, long, slender beaks Inner surface- transverse striations: close to

the tip Draining pus from an abscess Inserted by blunt dissection & opened up No lock: blind insertion & closure- injure

structures

INSTRUMENTS FOR SUTURING

MUCOSA

INSTRUMENTS FOR SUTURING MUCOSA

Flap returned to its original position & held by sutures

I. Needle holdero Instrument with a locking handle, short,

stout beak o I/O use: 6” or 15cm recommendedo Beak- shorter & stronger than hemostato Face of the beak crosshatched : positive grasp; unlike hemostat


o Held in the proper fashion: control & direct


Thumb & ring finger through the rings Index finger along the length of the

holder Second finger- aids in controlling the

locking mechanism Index finger through the finger ring:

dramatic decrease in control

COMPARISON Hemostat: Beaks smaller than sinus

forceps, longer than needle holder; transverse striations; ratchet

Needle holder: Criss-cross striations; ratchet

Sinus forceps: striations only near the tip; no ratchet


II. Suture needleo Mucosal closure: ½ circle or 3/8 circleo Curved: pass through a limited space;

twisted wristo Large variety of shapeso Very small – very largeo Tips: (i) tapered- sewing needle (ii) triangular – cutting needle


o Cutting needle: pass through mucoperiosteum more easily than a tapered needle

o 1/3 – cutting; remaining- round

o Tapered : vascular, ocular

o Care: cut through tissues lateral to the track


o Suture material: usually swaged ono Held 2/3rd – between the tip & the base: - enough exposed to pass through the

tissue - grasp in the strong portion to prevent

bending


III. Suture materialClassified based on: Diametero Oral mucosa: 3-0 (000) - withstand tension intraorally - easier knot tyingo 6-0 < 5-0 < 4-0 < 3-0< 2-0 < 0o 6-0: conspicuous planes- face: less

scarring


Resorbability o Nonresorbable : silk, nylon, vinyl &

stainless steelo Resorbable primarily made of gut- serosal surface of

sheep intestines - plain catgut: resorbs in 3-5 days - chromic gut: 7-10 days


Synthetic: long chains of polymers- braided - polyglycolic acid - polylactic acidAdvantages Easy to handle & tie Rarely untied Cut ends: soft & nonirritatingDisadvantages ‘Wick’ oral fluids- underlying tissues Bacteria + saliva


3-0 Black silk Appropriate strength Easy to tie Well tolerated by tissues Easily recognizable – removal Wicking- not significant3-0 chromic suture- removal not needed


IV. Scissorso Short cutting edgeso Long handleso Thumb & ring fingerso Held same as needle holderDean scissorso Slightly curved handleso Serrated blades

Tissue scissors Iris scissors & Metzenbaum scissors Straight or curved blades Iris: small, sharp pointed, delicate Metzenbaum: undermining soft tissue &

cutting; sharp or rounded tips Don’t cut sutures: dull the edges- less

effective & more traumatic Iris: Very fine skin sutures

INSTRUMENTS FOR

HOLDING THE MOUTH

OPEN

INSTRUMENTS FOR HOLDING THE MOUTH OPEN

Soft, rubberlike block- patient rests teeth Patient opens to comfortably wide

position- block inserted: holds in the position

Protects patient’s TMJ, while mandibular teeth


Various sizes: various sized patients & varying degrees of opening

Wider opening- position more posteriorly Pediatric-sized block: adequate over

molars

INSTRUMENTS FOR HOLDING TE MOUTH OPEN

Side-action Mouth prop/ Molt Mouth prop

Used for wider mouth opening Ratchet-type action: opening wider as

handle is closed Caution : great pressure to joint/teeth-

injury Deeply sedated Mild trismus


Mouth Gag Forcefully open mouth: trismus Broad, serrated blades: rest on occlusal

surface of molars: instrument opened : slow, gradual force

Keep mouth open: procedures under G/A

Fergusson Ackland mouth gag

Remember.. Avoid opening too wide: stress on TMJ

Stretch injury

Long procedures: remove periodically; move the jaw; rest the muscles

INSTRUMENTS FOR

SUCTIONING

INSTRUMENTS FOR SUCTIONING

Adequate visualization: blood, saliva, irrigating solutions suctioned

Surgical suction: smaller orifice than usual- rapid evacuation of fluids

Several designs of orifice: soft tissue not aspirated & injured


Fraser suction: Hole in the handle Hard tissue cut; hole covered to remove

the solution rapidly Soft tissue suctioned: hole uncovered

to prevent injury


High Volume Suction Tip Large bore tubes with slight angulation-

end Autoclavable stainless steel/ plastic Disposable plastic tubes Suck out large volumes of irrigation

fluids, blood clots & debris


Saliva Ejector Low volume suction tip Disposable plastic- different designs Flexible- bent & adapted under tongue Buccal vestibule: partially retracts cheek

INSTRUMENTS FOR HOLDING TOWELS & DRAPES IN POSITIONTowel clip Holds together, drapes placed around a

patient Stabilizes suction tubes, micromotor etc. Hold & retract tongue: unconscious patient Locking handle + finger & thumb rings Sharp/blunt action ends Curved points- penetrate towels & drapes Caution: not to pinch patient’s skin

J Bachaus Towel clip

Schaedel Towel clip

INSTRUMENTS FOR IRRIGATING

Bone removal: Steady stream of irrigation- sterile saline or water

Cools the bur Prevents bone-damaging heat buildup Increases efficiency of bur: - washes away bone chips - lubrication Completion of procedure: before suturing

INSTRUMENTS FOR IRRIGATING

Large plastic syringe + blunt 18-gauge needle

Sterilized multiple times before disposal Blunt & smooth needle: not damage soft

tissue Needle angled : efficient direction of the

stream

INSTRUMENTS FOR EXTRACTING TEETH


LOCAL ANESTHETIC INSTRUMENTSSyringe

Types:1. Non- disposable syringes

LOCAL ANESTHETIC INSTRUMENTS

2. Disposable syringes

3. Safety syringes


4. Computer Controlled Local Anesthetic Delivery System


Cartridge Glass cylinder with L/A & other ingredients 1.8ml/1.7ml/2.2ml

RubberDiaphragm Silicon

rubber plunger

Al cap Neck Color coded band


Needle Single piece of tubular metal; plastic/

metal syringe adaptor + needle hub


Long: 32mm & Short: 20mm needles 27gauge long & 30 gauge short:

commonly purchased – dental use 25 gauge: preferred for high risk of

positive aspiration 30 gauge: not specific; local infiltration


Additional Armamentarium Topical antiseptic Topical anesthetic Applicator sticks Sterile gauze 2”x2” Hemostat


DENTAL ELEVATORSI. Luxate teeth from the surrounding bone Makes extractions easierII. Expands alveolar bone: Buccocervical plate of bone- tooth with

limited & obstructed path of removalIII. Remove broken/ surgically sectioned roots IV. Remove interradicular boneV. Split teeth once a bur groove has been

placed

DENTAL ELEVATORSPARTS

DENTAL ELEVATORSHandle: 2 designs Heavy pear-shaped Crossbar: right angles to the shankGeneral rules: Adjacent tooth- not the fulcrum; unless to

be extracted Crest of the alveolar bone: fulcrum Controlled force- correct direction- adequate support to the adjacent tooth Finger guard: support adjacent tissues

DENTAL ELEVATORSBasic grips: Palm grip: heavy forces; handle rests

against heel of palm

Finger grip: delicate applications

DENTAL ELEVATORSHandle: Generous size: comfortably held Substantial, controlled force Cross-bar/ T-bar handles: cautionShank: Connects handle to the working end Substantial size; strong enough to transmit

forceBlade: Working tip Transmit the force to the tooth, bone or both

DENTAL ELEVATORSTYPES

I. Based on the shape & size:1. Straight2. Triangle/ Pennant-shape3. Pick

II. Based on their form:4. Straight5. Angular6. Crossbar

DENTAL ELEVATORSIII. Based on their use:1. Remove entire tooth2. Remove roots broken at the gingival

line3. Remove roots broken half way to the

apex4. Remove the apical third of the root5. Reflect mucoperiosteum

DENTAL ELEVATORSStraight Most commonly used Blade: concave surface on one side-the

tooth to be elevated Small- No.301:beginning the luxation of

an erupted tooth

DENTAL ELEVATORS

Large:No.34S (common),No.46,No.77R -displace roots from the sockets -luxate more widely spaced teeth -smaller sized elevator: less effective Angled straight elevator: posterior

aspect Eg : Miller elevator, Potts elevator

DENTAL ELEVATORSStraight Elevator: Coupland’s Large, pear-shaped handle Straight shank Blade: concave/ convex surface & an

inclined plane Concave groove on one side Sharp & straight tip

DENTAL ELEVATORS Impacted/ malaligned teeth Wedge & 1st order lever principle 450 to long axis: concavity facing the

tooth Crest of the interseptal bone: fulcrum Applied to the long axis: wedged into the

PDL space- luxate the tooth

DENTAL ELEVATORSStraight elevator: Hospital Blade, handle & shank: same plane Handle: flat & triangular- deep criss-cross

grooves Blade: flat with vertical serrations; other side-

convex with pointed tip Serrated flat side: faces the tooth to be extracted 450 to the long axis/ wedged into the PDL space:

vertically along the long axis Wedge & 1st order lever

DENTAL ELEVATORSApexo elevators ‘Offset’/ angulated elevator Blade at an angle – shank Blade ends- sharp pointed tip Large pear-shaped handle Pairs- right & left Remove root fragments Wedge principle

DENTAL ELEVATORSTriangular Second most commonly used Pairs: left and right Broken roots in the tooth sockets +

adjacent empty socket Fractured lower 6:distal root left in the

socket-elevator tip in the socket; shank on the buccal plate-wheel and axle rotation

Eg : Cryer

DENTAL ELEVATORSCryers ‘Offset’ blade: at an angle to the shank Curved & triangular blade Heavy pear shaped handle Pairs

DENTAL ELEVATORS Impacted molars: buccal furcation &

luxated Fractured root tips: maxillary molars Erupted maxillary molars Bur hole- drilled onto the tooth & tip

engaged- purchase point

DENTAL ELEVATORSCrossbar elevator Offset blade- similar to cryers Handle perpendicular to shank Maximum mechanical advantage due to

crossbar handle & offset blade

DENTAL ELEVATORS Rotational forces: wheel & axle principle Impacted mandibular teeth Caution: impacted mandibular 8- #angle

mandible Removal of mandibular root fragments Not used in maxillary arch

DENTAL ELEVATORSPickRemove roots1. Crane pick: heavy version-lever to

elevate the broken roots Purchase point: 3mm deep into the

root, using bur Tip of the pick inserted- buccal plate of

the bone as fulcrum

DENTAL ELEVATORS

2.Root tip pick/apex Delicate Tease small root tips Don’t use: wheel- and- axle/lever Very small root end : insert the tip into

the PDL space- root tip & socket wall


Extraction forceps Removing the tooth from the alveolar

bone Many styles and configuration: variety of

teeth Each basic design: multiple variation

EXTRACTION FORCEPS COMPONENTS

EXTRACTION FORCEPSHandles Adequate size -comfortable handling -sufficient pressure & leverage Serrated surface -positive grip -prevent slippage

EXTRACTION FORCEPSHolding handles: -Maxillary: palm underneath; beaks superior

-Mandibular: palm on top; beaks point down

EXTRACTION FORCEPS Straight/ curved

better fit

EXTRACTION FORCEPSHinge Connects the handle – beaks Transfers & concentrates : force

Types American: horizontal English: vertical

EXTRACTION FORCEPSBeaks Greatest variation Adapt: tooth root near C/R junction root & not the crown Different beaks: single/2/3- rooted teeth Close adaptation: improved control,

decreased chance of fracture

EXTRACTION FORCEPSWidth of the beaks Narrow: incisors Broader: lower molarsBeaks angled: held parallel to the long axis Maxillary: Parallel to the handles Maxillary molar: Bayonet fashion- posterior

aspect with beaks parallel Mandibular forceps: Perpendicular to the

handles

MAXILLARY FORCEPS Single-rooted: incisors, canines, premolars 3-rooted: molarsMaxillary Universal Forceps: No.150o Slightly S-shaped: from side- incisors &

premolarso Straight: from aboveo Beaks curved: meet only at the tipo Modification: No.150A- premolarso No.150S: Primary teeth

No.150, 150A, 150S

MAXILLARY FORCEPS Straight forceps No. 1 forceps: easier for upper incisors

MAXILLARY FORCEPS

Maxillary molars: -smooth, concave surface: palatal root -pointed: bifurcation -right & left -offset: posterior & correct position -No.53

MAXILLARY FORCEPSUpper Cowhorn forceps: No.88o longer, accentuated, pointed beakso Severely carious crownso Deeper into trifurcation: sound dentino Caution: crush alveolar bone; # large

amounts of buccal bone – intact teeth

MAXILLARY FORCEPSNo.210S Forcepso 2nd & 3rd molars- single conical rooto Smooth beaks: offset

MAXILLARY FORCEPSRoot Tip Forceps: No.65o Offset – very narrow beakso Broken molar roots, narrow premolars,

lower incisors

MAXILLARY FORCEPSRoot Forceps

MANDIBULAR FORCEPS Single-rooted: Incisors, canines, premolars Two-rooted: molarsLower Universal Forceps: No.151o Handles- No.150o Beaks: pointed inferiorlyo Smooth & narrow: meet only at the tipo Fit near the cervical line- grasp rooto No. 151A: Premolar o No.151S: Primary mandibular teeth

No.151, 151A, 151S

MANDIBULAR FORCEPSEnglish Style Vertical-Hinge Forcepso Single-rootedo Great force generatedo Root fracture

MANDIBULAR FORCEPSLower Molar Forceps: No.17o Single forceps: both sideso Straight-handledo Beaks: obliquely downwardo Pointed tips – centre: bifurcationo Remainder: sides of the furcationo Not for fused, conical roots: 151

MANDIBULAR FORCEPSLower Cowhorn Forceps: No.87o Two pointed, heavy beaks: bifurcationo Forceps positioned: handles pumped up

& down- tooth elevatedo Beaks squeezed into furcation: buccal &

lingual cortical plates- fulcrumso Alveolar bone #, damage to maxillary

teeth

MANDIBULAR FORCEPSRoot Forceps

BASIC EXTRACTION PACK

Local anesthesia syringe Needle Cartridge No.9 Periosteal elevator Periapical curette Straight elevator: small & large College pliers Curved hemostat Towel clip Austin/Minnesota retractor Suction tip 2x2 inch/4x4 inch gauze Forceps

SURGICAL EXTRACTION TRAY

Additional items Needle holder & suture Suture scissors Blade handle & blade Adson tissue forceps Bone file Tongue retractor Cryer elevators Rongeur Handpiece & bur

BIOPSY TRAY Basic tray without elevators Blade handle & blade Needle holder & suture, suture scissors Metzenbaum scissors Allis tissue forceps Adson tissue forceps Curved hemostat

POSTOPERATIVE TRAY Irrigation: syringe, suction tip Suture removal: Scissors, College

pliers, Cotton applicator sticks, gauze

INSTRUMENT ARRANGEMENT

TRAY Flat, sterilized wrapped with sterilization

paper Opened preserving sterility Requires large autoclave CASSETTE More compact

Surgeon must be well versed with the identification, indications for use as well as the techniques of using the different basic instruments

The quality of the instruments- as crucial as the knowledge & skill of the surgeon

Use of good quality instruments is inevitable in ensuring the expected standard of care: expensive

The surgeon & the assistants must handle, store & use the instruments with utmost care

REFERENCES Contemporary Oral & Maxillofacial

Surgery- 5th edition : Hupp, Ellis, Tucker Handbook of Local Anesthesia- 5th

edition: Stanley F. Malamed Textbook of Oral & Maxillofacial Surgery-

2nd edition: Chitra Chakravarthy Dental Instruments: A Pocket Guide- 2nd

edition: Linda R. Bartolomucci Boyd

Thank you for the PATIENT LISTENING

Armamentarium for basic oral surgery

Health & Medicine

Transcript of Armamentarium for basic oral surgery