ARMAMENTARIUM BASIC

ORAL SURGERY
Yohanes Yoppy Purnomo, drg., Sp.BM
Topik : Pengenalan instrumen
(Instrumentation for Basic Oral Surgery)

Tujuan :
 Mahasiswa mampu mengidentifikasi instrument/ armamentarium
basic oral surgery
 Mahasiswa mampu memahami dan melakukan/
mengimplementasikan jenis, grasping, dan tujuan penggunaan
instrument/ armamentarium basic oral surgery.
 History

 Surgery literally means ‘handicraft’.

 Hands and teeth were the natural ‘instruments’ that ancient ‘Man’ used to
counter diseases, injuries and any foreign bodies.
 Gradually instruments made of the organic materials like bamboo, shell,
animal teeth and bones were invented.

barber surgeons  academic surgeons

(Company of Barbers in 1462 by Edward IV  30 years later)

“As flute is for musicians, instruments are for surgeons. A best musician plays with best
flute; similarly a best surgeon performs with the best instruments.”
Ahmed, S., et. al. Atlas of Oral and Maxillofacial Surgical Instruments. New Delhi: CBS Publishers & Distributors; 2018.
The basic components of the extraction
forceps
MAXILLARY
 MAXILLARY ANTERIOR FORCEPS

Indication
Used for removal of maxillary central incisor, lateral incisor
and canine teeth.
 MAXILLARY PREMOLAR FORCEPS

Indication
• Used for removal of maxillary
premolar teeth.
 MAXILLARY MOLAR FORCEPS

Indication
Used for removal of maxillary molar
teeth.
 MAXILLARY COWHORN FORCEPS

Indication
• Used for removal of maxillary molar teeth.
 MAXILLARY ANTERIOR ROOT FORCEPS

Indication
• It is used to remove the maxillary root stumps.
 BAYONET FORCEPS OR ROOT FORCEPS

Indication
• It is used to remove the maxillary root
stumps.
 MAXILLARY THIRD MOLAR FORCEPS

Indication
• It is used to remove the maxillary 3rd molars.
MAXILLARY POSTERIOR ROOT FORCEPS

Indication
• It is used to remove the maxillary root stumps.
MANDIBULAR
 MANDIBULAR ANTERIOR FORCEPS

Indication
• Used for removal of mandibular central
incisors, lateral incisors and canines.
 MANDIBULAR ROOT TIP FORCEPS

Indication
• Used for removal of mandibular root tip
 MANDIBULAR PREMOLAR FORCEP

Indication
• Used for removal of mandibular
premolars.
 MEAD FORCEPS/MANDIBULAR MOLAR
FORCEPS

Indication
• Used for removal of
mandibular molars.
 MANDIBULAR THIRD MOLAR FORCEPS

Indication
• Used for removal of third mandibular molars.
 COWHORN FORCEPS

Indication
Used for removal of mandibular
molars which are grossly carious
with intact furcation.
The correct handling of extraction
forceps
 Forceps Extraction & Movements

 The extraction movements - three

movements: buccal/labial, lingual/palatal,
and rotatory.
 Final movement is the movement by which
the tooth is removed from its bony socket
 It should be always directed outward and
occlusally to avoid traumatizing the opposing
tooth,
 The extraction forceps blade should be
applied to the carious side first, and the first
movement made toward the caries.
 elevator’s components

Indications
• Luxate teeth from the surrounding bone making extractions easier.
• Remove broken/surgically sectioned roots.
• Remove inter-radicular bone.
PRINCIPLES OF DENTAL ELEVATION
There are three principles of dental elevation:
 Lever principle
 Wedge principle
 Wheel and axle principle
STRAIGHT ELEVATOR
COUPLAND’S STRAIGHT ELEVATOR
APEXO ELEVATOR
 Miller

Modified miller
 Potts Elevator

Crane Pick Elevator

WINTER CRYER (STRAIGHT PATTERN)
WINTER CRYER (CROSSBAR PATTERN)
Special instrument
Set of instruments necessary
for simple tooth extraction
 Patient and surgeon Position
Height of the Dental chair:
 In Maxillary Tooth extraction: the chair should be adjusted
so that the site of operation is about 8 cm (3 in.) below the
shoulder level of the operator.
 In Mandibular Teeth Extraction: the chair should be
adjusted so that the site of operation is about 16 cm (6 in.)
below the level of the operator’s elbow.

Position of the operator:

 Extraction of any tooth except the right mandibular Molars,
premolars & canine, the Surgeon is positioned front and
right.
 For the right mandibular Molars, premolars & canine teeth
the Surgeon is positioned behind and to the right of the
patient.
Role of operator’s hand

 The opposite hand plays an important role in supporting and stabilizing the
lower jaw when mandibular teeth are being extracted.
 The opposite hand supports the alveolar process and provides tactile
information to the operator concerning the expansion of the alveolar
process during the luxation period.
Set of instruments necessary
for surgical tooth extraction
CUTTING INSTRUMENTS
 SCALPEL/SURGEON’S KNIFE

Indications for Different Surgical Blades

• Blade no. 10: Used for large skin, muscle and mucosal incisions.
• Blade no. 11: Used for stab incision for draining an abscess, precision cutting, stripping the tissue
• Blade no. 12: It is hook shaped. Used for mucogingival procedures and also in posterior aspects of
teeth/maxillary tuberosity.
• Blade no. 15: Most commonly used for intraoral incisions.
 CHISEL

Indications
• To cut the bone
• To chip off bone in transalveolar extraction
• For odontectomy.
 SURGICAL MALLET (MEAD’S)

Indication
• Used for giving controlled taps on
chisel/osteotome/bone gouge.
 SURGICAL BURS

Parts of burs:
a. Head
b. Shank
c. Handle
SURGICAL HANDPIECE
 MOLT’S NO. 9 PERIOSTEAL ELEVATOR

Indications
• Pointed end used to release the dental papilla around teeth (by prying motion).
• Broad end used for elevating the mucoperiosteal flap form bone (by push stroke).
 AUSTIN’S RETRACTOR

Indication
• This is the most commonly used instrument for the retraction of flap during removal
of impacted third molar and periodontal surgery.
 MINNESOTA RETRACTOR

Indication
• It is commonly used instrument for the retraction of flap during removal of impacted
third molar and periodontal surgery.
 STEEL BOWL

Indication
• Stainless steel bowl is used to carry irrigation solutions like saline and betadine in
preoperative, intraoperative and postoperative procedures.
 BONE CURETTES

Indications
• It is used to curette the granulation tissue and also cystic lining.
• It is used for final smoothening of bony socket before suturing.
 SUCTION CANNULA

Indications
• They maintain a clean surgical field by sucking away blood, secretions, pus,
cystic fluids, debris, and flushing solutions
 SYRINGES FOR IRRIGATION

Indication
• Irrigation of surgical field and prevent the heating of bone while bone
reduction.
 BONE RONGUER AND BONE NIBBLERS:

 Types
 i. Side cutting
 ii. Side cutting and end cutting
 BONE FILE

Indication
• It is used for final smoothening of bone before suturing
of the flap.
 MOUTH PROPS

Indication
• To hold the patient’s mouth open during dental procedures under local and
general anesthesia
 HEISTER’S JAW OPENER

Indication
• To keep the mouth open during oral surgical procedures under local and general
anesthesia. For physiotherapy after TMJ ankylosis surgery, oral submucous fibrosis
surgery.
 DOYEN’S MOUTH GAG

Indication
• It helps to keep the mouth of the patient open during surgical procedures.
 FERGUSON’S MOUTH GAG

Indication
• It helps to keep the mouth of the patient open during the surgical
procedures.
BIBLIOGRAPHY

 Ahmed, S., et. al. Atlas of Oral and Maxillofacial Surgical Instruments. New
Delhi: CBS Publishers & Distributors; 2018.
 Islam, A. Handbook of Oral & Maxillofacial Surgery Undergraduate 3rd
Edition. Bogura: TMSS Medical College; 2022.
 Fragiskos FD. Oral surgery. Springer Science & Business Media; 2007 Mar 8.
 Datarkar. A. N. Exodontia Practice. New Delhi: Jaypee; 2007.