simple collection with examples including simple and complicated extraction instruments.

1. ‫الرحيم‬‫الرحمن‬‫هللا‬‫بسم‬
Basic
armamentarium in
oral surgery
By
Abdusalam alrmali
BDS,DDS,MDS

3. CONTENTS
Instruments for Transferring Sterile inst
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

4. 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

6. INSTRUMENTS FOR
HOLDING TOWELS &
DRAPES IN POSITION

8. Other use

10. INSTRUMENTS FOR
TRANFERRING
STERILE
INSTRUMENTS

11. CHEATLE FORCEPS

12. INSTRUMENTS FOR
INCISING TISSUE

13. Name,number:
Bard-Parker handle no. 3
Bard-Parker Blades (nos, 11, 12, and 15)

14. Shape & use :
 The most commonly used handle no 3.
 Their tip has slotted part to receive a
variety of different shape blades.
 No 15 blade is the most commonly used
for intraoral incision.
 No 15 blade resemble no 10 in shape
but is relatively small than it.

15.  No 11 blade is a sharp pointed tip
blade, used for stab incision (incising
abscess).
 No 12 is hooked in shape (only curved)
used intraoral for inaccessible area as in
maxillary tuberosity
 Handle with blade called scalple
 Surgeon hold the scalple in pen grasp

16. INSTRUMENTS FOR INCISING TISSUE

17. Scalpel is held in a pen grasp
to allow maximal control

18. Correct way for loading

19. Blade loaded
Blade removed

20. Scalpel with no 15 blade used to make
incision around teeth & through
mucoperiosteum

21. Scalpel with no 15 blade used to make
incision around teeth for palatal gingiva
Contraindication to do vertical incision in the palate

22. No 11 blade used for
extra & intraoral stab
incision (incising
abscess)

23. Scalpel with no 12 blade used for
intrasulcular incision

24. Instruments for Elevating
Mucoperiosteum

25. Name,shape,use,action

26. Periosteal elevator no 9
most widely used before extraction & for
reflection of MPF
 This instrument has a sharp, pointed
end and a broader flat end.
 The pointed end is used to refelect
dental papilla between teeth, and the
broad end is used for elevating the
tissue from the bone.

28. Pointed tip is used in a praying
motion to elevate papilla between
teeth

29. Push stroke with the broad end with
convex surface toward the flap

31.  Another use for retraction of
mucoperiosteal flap with aid of broader
end

33. INSTRUMENTS FOR
RETRACTING SOFT
TISSUE

34.  These instruments used to
retract the cheek, tongue, &
MPF to have good vision and
access to perform good
surgery.

35.  Minnesota retractor

36. Weider tongue retractor

37. Kocher-Langenbeck retractor

38. Farabeuf retractor

39. Austin retractor (right angle)

45. INSTRUMENTS FOR
CONTROLLING
HEMORRHAGE

46. Hemostat (Artery forceps):
has long, delicate peak & locked
handle
Straight
Curved
Most commonly used

47. Use :
 To clamp the vessel and stop bleeding
 To remove granulation tissue & tooth
fragment , calculus, fragments of
amalgam
 To drain abscess

48. Main use

49. Other use:

52. Other use:

53. Other use:

54. Other methods for hemostasis

58. INSTRUMENTS FOR
GRASPING TISSUE

59. Adison forceps (toothed)

60. Use :
 Most commonly used forceps for
stabilizing soft tissue.
 They are delicate forceps with small
teeth
 Care should be taken to avoid crushing
the tissue.

62. Correct way for holding

64. Non-toothed: (plain) used for
stabilizing delicate mucosa

65. Allis tissue forceps :
locked handle & teeth in the blade

66. Used to grip abnormal fibrous
tissue firmly

67. Never use it to grasp normal
tissue

68. INSTRUMENTS FOR
REMOVING BONE

69. Rongeur forceps

70. This is the most commonly
used instrument for removing
bone
 Have sharp blades
 Have a spring betwwen handle, help in
reopen the instrument when the hand
pressure is released
 There are two major designs, a side-
cutting & side and end –cutting forceps.

71. A side-cutting & side and end
–cutting forceps are used

73. B. Chisel & mallet:
Unibevel
Grooved
Bibevel

74. Use :
 Unibeveled chisel used for cutting bone
 Bibeveled chisel used for secting teeth
& splitting bone (osteotome)
 Grooved used for collecting bone

77. C. Burs and handpiece:
High speed, high torque
straight surgical hand piece
Surgical carbide burs (fissure & round)

80. D. Bone file:
used for smoothen small, sharp
edeges in pull action

82. INSTRUMENTS FOR
REMOVING
PATHOLOGICAL
TISSUE

83. Surgical curette:
Angled, sharp concave face & smooth
convex back instrument used to remove
tissue from bony defects.
Ex. Granulation tissue or cyst

85. INSTRUMENTS FOR
SUTURING MUCOSA

86. Needle holder

87. Shape & Use :
 Beaks are shorter & stronger than
beaks of hemostat.
 Face is crosshatched. Why ?
 Face of hemostat is parallel grooves.
Why?

88. Difference between needle holder &
artery forceps in serrations

89. Different types of suture
material are available:

90. 3/0, 4/0 black silk are most
widely used

91.  Types of needles”
 A. cross section
 B. degree of curve
(size) of needle

92. Holding needle in last 1/3.
why?

93. Correct way for holding :

99. Surgical scissors: straight or curved

100. Correct way for holding

101. Use:
 Used for cutting sutures.
 Cutting excess tissue before suturing
 Undermining edges before suturing

103. INSTRUMENTS
FOR HOLDING
THE MOUTH
OPEN

105. INSTRUMENTS FOR
SUCTIONING

107. INSTRUMENTS FOR
IRRIGATING

109. Quiz

113. Case presentation
and video

117. Video

119. INSTRUMENTS FOR
EXTRACTING TEETH

120. Armamentarium for LA

121. Needle adaptor
Syringe barrel
Piston with harpoon
Thumb ringFinger grip
Thumb bar

125. The cartridge (carpule)
Nitrogen bubble
Silicon rubber stopper
Glass tube
neck
Aluminum cap
Rubber diaphragm

126.  Glass cylinder with L/A & other
ingredients
 1.8ml/1.7ml/2.2ml

127. bevel
shankPlastic syringe adaptor
Syringe end

132. How to make it aspirated?

133. Local Anesthetic
carpule
 Local anesthetic drug
 Vasoconstrictor
 Reducing agent (antioxidant)
 Vehicle

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

158. Upper straight
Or: upper
anterior forceps
lower anterior
forceps
Quiz

159. Upper premolar
forceps
Lower premolar
forceps

160. Upper molar forceps

161. Lower molar forceps

162. Remaining root forceps

163. Bayonet forceps

186. Quiz

187. 1. Sterile gauze
2. Local anesthesia syringe, needles, and
cartridges
3. Surgical aspirating tip
4. Cotton pliers
5. Mouth mirror
6. Periosteal elevator
7. Straight elevators
8. Surgical curette
9. Hemostat
10. Extraction forceps (selected for
specific tooth/teeth)

188. VIDEO

189.  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

190. REFERENCES
 Contemporary Oral & Maxillofacial
Surgery- 5th edition : Hupp, Ellis, Tucker
 Handbook of Local Anesthesia- 5th
edition: Stanley F. Malamed
 Dental Instruments: A Pocket Guide- 2nd
edition: Linda R. Bartolomucci Boyd

191. 191

192. Thank you for
your attention