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Armamentarium

the collection of equipment and


methods used in the practice of
medicine
Surgical instrument
Def : a special designed tool or device for
performing specific actions and carrying out
desired effects during a surgery or operation.
Most made of high grade steel.
Each has particular purpose and should be
handled with extreme care.
Each tool has to be sterilized.
Based on the sterile factor :
Critical instruments
Sterilized the instrument by using :-
Autoclave
Pemanasan kering
Sterilisasi kimia
Instruments used in oral surgery
1. Instruments for anaesthesia,airway
maintenance
Laryngoscope
Endotracheal tube
Cricothyrotomy set
Tracheostomy set
2. Instruments for gaining surgical asepsis

Cheatle forceps
F(x) : used to pick up
sterile instruments
from a tray.
A long angulated
instrument
Stored in a container
with antiseptic solution
Swab Holding Forceps
This is also an instrument with long handles
but straight beaks which are fenestrated in the
ends.
It is used for holding the swab dipped in an
antiseptic solution and paint the surgical area
with antiseptic.
Towel Clips
Instruments used to hold the patients drapes in place
Also used to clip
on the suction tubes, drills on to the drapes to hold them in place.
It can also be used to hold tongue and retract it forward in an
unconscious patient.
Type : Backhouse towel clip and Pincher type
3. Instruments for gaining surgical access

Surgical scapels
Composed of handle and blades
F(x) : used to incise or excise soft
tissues
Various shapes and sizes
Used in pen grasp technique

Blade handles
Common : number 3 and beaver
style
Has a receiving slots for the blade
Blades
Bard Packer (BP) blades
number 11 blade - for stab incision for drainage of an
abscess.
number 12 blade - for placing crevicular incision for
periodontal procedures.
number 10 blade - for skin incisions
Number 15 blade for carrying out surgeries in
mucogingival areas and others
Mayo
scissors

Dissecting scissors
Dissecting scissors can be used for incising soft tissue
flaps, excising pathological soft tissue and can be used
for blunt dissection into the deeper layers.
Deans suture cutting scissors are used for cutting
suture materials.
Dissecting scissors usually have narrower blades than
a suture cutting scissors and may be straight or
curved, sharp ended or blunt ended scissors.
4.Instruments for reflection of
mucoperiosteal flap
Periosteal elevator
F(x) : to separate a bone or tooth from the fibrous membrane
Used to gain access to retained roots or surrounding bone
Is a double ended instrument, one broad end another sharp
end
Common used Molt No.9 and Seldin NO.23

Broad end elevate the Pointed end -Elevate


flap fr undelying bone dental papilla
5.Instruments used for retraction
F(x) : to hold back or retract organ or tissue to gain exposure to
operative site
Tissue retractor
Tongue and cheek retractor
Langenbeck retractor
Cats paw retractor
Autins retractor
Obwegessors ramus retractor
Skin hook
Chin retractor
Alar retractor
Tongue depressor
Langenbeck retractor
L shaped with long handle
Used for retraction of soft tissues and incision
edges to have a better visibility of deeper
structures
It comes in different sizes depending upon
length of the handle and width of the blade
Tongue Depressor
Also a L shaped retractor without handle.
It has broad, flat rounded blade.
Used for the retraction and depression of the tongue to
improve visibility of the posterior pharyngeal wall and
the tonsillar region.
also be used for cheek retractors.
Austins Retractor
Also an L shaped retractor without handle.

Used basically for the retraction of small


intraoral flaps as in case of removal of an
impacted tooth
Cats paw retractor
The end resembles a cats paw
Used for retraction of small amount of soft
tissues
Obwegessors ramus retractor
Similar to langenbecks except fesor
the V shape end
Helpful to engage the anterior
border of ramus and to retract soft
tissues

Skin hook
Alar retractor
Used to retract the ala of the nose during
rhinoplasty

Chin retractor
In case genioplasty
6.Instruments used for holding
Needle holder
Haemostat
Kochers artery forceps
Tissue forceps
Adsons tissue holding forceps
Allis tissue holding forceps
Needle holder forceps
F(x) : hold needles during suturing
procedure
Have blunt, serrated beaks with distinct
groove in each beak
Groove provide space for the
replacement and retention of the
needle.
At the end of handles have notched-
locking device

Kochers artery forceps


Used to grasp heavy tissue
Have straight or curved end
May used as clamp
Other name : Ochsner
Haemostat
Haemostatic clamp
A set of scissors with a locking clamp
replacing the blade
Type : Kelly, Crile and Halstead
F(x) : to control bleeding
The handles has a catch to clamp the vessel
Adsons tissue holding forceps
Can be either toothed or non-toothed
Toothed : have serration at tip which help a better grasp
Non-toothed : do not have serration
F(x) : to stabilize the soft tissue flaps during suturing
Small blood vessel can be held with it

Allis tissue holding forceps


Used when a larger amount of fibrous tissues have to be
removed
Have locking handles and teeth that will grip the tissues
firmly
7.Instruments for bone remova;
Rongeurs
Chisel
Osteotome
Mallet
Bone file
Hand piece and burs
Osteotome
This is an instrument used for splitting bone.
It has bi-bevelled edge and comes in various
sizes depending on the width of cutting edges
and the length of the instruments.
Used to perform osteotomy cuts and in certain
cases may also be used to split impacted teeth
to facilitate removal.
Chisel
Instruments used for cutting bone.
Used for transalveolar extraction and for the removal of
impacted teeth.
It has single bevellel on its working edge.
While cutting bone, the bevellel is made to face towards bone
which is to be cut.
In mandible, the grain pattern is important while using a chisel,
It may be necessary to place stops cuts to prevent unnecessary
bone removal.
Ronguer
This is also called bone nibbler.
Used for removal of sharp edges of the bone on the
alveolar ridge as in case of alveoloplasty.
It can be used to remove sharp margins of the bone
around a surgical wound after extraction or removal of
cyst or tumor.
It may be of end cutting or side cutting variety.
The bone is held firmly and crushed for removal.
Bone File
This is an instrument which has
sharp serrations on its working edge.
It is used for the smoothening of
sharp edges of bone.
After cutting bone with a burr or a
rongeur, the ends may need to
smoothened or rounded off prior to
closure. This is done with a bone file.
Mallet
An osteotome and chisel are used
with mallet.
It is usually made of steel and is
used with a light pull-back action
with force coming from the wrist.
Burrs and Handpiece
This is a rotary cutting instrument
which is attached to a micromotor.
The burrs may be round, straight
fissured or tapered depending on the
need.
Used for cutting bone for transalveolar
extraction, removal of impacted teeth.
Also used for removal of bone enclosing
a cyst or tumor. Used for making
osteotomy.
The bone is cut under copious saline
irrigation to prevent heating of the bone
and bone necrosis
8.Instruments for wound debriment
Surgical curretes
Sharp, spoon-shaped
Used to clean out infected cavities and remove debris
from tooth sockets

Bone scoop (Volkmanns scoop)


Similar to surgical curretes
Used for debriding contents from an abscess cavity,sinus
or fistula tract
Used to scoop out bones
Listers sinus forceps
Used for probing and forcing an entry into an
abscess sac or for stretching an opening into
an abscess by Hiltons operation
Helps in draining of abscess
9. Miscellanous instruments
Mouth prop
Bite block
Mouth gag
Foleys self-retaining catheter
Ryles tube
Infant feeding tube
Trocar
Surgical diarthermy
cryosurgery
Mouth prop
Device for maintaining the jaws of a dental
patient in an open state
It used when the operator need to open the
mouth larger.
Trocar
Mouth gag
Basic setup

a. Forceps holding air


b. Instrument forceps (in jar)
c. Periosteal elevator - Molt #9
d. Root elevators - 34S and 301
e. Extracting forceps - appropriate one
f. 2" x 2" gauze sponges
Supplementary items
determined by procedure, as well as preference of the dentist.
a. Oral surgical burs
b. Surgical knife
c. Apical fragment root elevators - paired for posterior
d. Curettes - paired for posterior
e. Rongeur
f. Surgical scissors
g. Suture material
h. Suture scissors
i. Bone file
j. Gingival retractors
k. Oral surgical mallet
l. Oral surgical chisel
m. Dental surgical burs
n. Apical fragment root elevators
o. Iodoform impregnated gauze