Instruments used in oral and maxillofacial surgery

Instruments used in oral and maxillofacial surgery
Copyright (c) Dr. Ko Ko Maung
Department of Oral & Maxillofacial Surgery
University of Dental Medicine, Yangon

3. Aseptic technique
it is necessary to sterilize and keep
sterile all instruments,
material supplies that come in contact
with the surgical site.
Every item handled by the surgeon and
the surgeon’s assistants must be sterile

5. •The patient’s skin and
the hands of the
members of the
surgical team must be
thoroughly scrubbed,
prepared, and kept as
aseptic as possible.

6. Donning of glove

7. Instruments used in Maxillofacial
Surgery
•Instruments for wash down (Disinfection)
•Instruments for surgical draping (isolation of surgical field)
•Instruments for cutting
•Instruments for retraction
•Instruments for hemostasis
•Instruments for tissue holding
•Instruments for scraping (curettage)
•Instruments for bone surgery
•Instruments for suturing
•Instruments for dressing
•Instruments for cleft surgery
•Instruments for exodontia
•Instruments for anesthesia

8. Instruments for wash down
(Disinfection)
•Sponge forcep or holder
•Gallipot a small glazed pot used by apothecaries for
medicines,
•Kidney tray

9. •After the patient is anesthetized and positioned on the operating
room table, the preoperative skin prep is done by the surgeon,
assistant surgeon, or circulator.
• This means the skin of the operative site and an extensive area
round the site is mechanically cleansed again with an antiseptic
solution prior to draping.
•A sterile skin prep tray is opened on the prep table.
•Usually, the prep tray is disposable, but the prep tray always
contains two or more towels, small basin for solutions, sponges
(these sponges must not be confused with the counted sponges on
the instrument tray), and applicators.

10. Sponge Holder

11. Kidney
Tray
Gallipot

12. Scrubs with a circular, ever-
widening motion

13. Sponge Holder

14. Instruments for surgical draping
•Towel clips
–Spring type
–Lock type
–Surgical Towels
– square towel
– split towel
– draw sheets

15. Towel Clips
Spring Type Lock Type
Suction Tip

16. Sterile Draping secured with tower clips

17. Adson’s Tissue Forceps ( Tooth & Non-tooth )

19. Instruments for cutting
•Scapel A knife used in surgical dissection.
•Blade holder (Bard Parker Handle )
•Detachable surgical blade
•Disposable or Single Use Scapel
•Lancet A surgical knife with a short, wide, sharp-
pointed, two-edged blade.

20. Bard-Parker Blade Holder
No. 7
No. 3

21. Surgical Blades
10 11 12 15

22. Blade Holder and Scapels

23. Instruments for cutting
•Scissors
Tissue scissors
Suture scissors
Dressing scissors
Serrated scissors
Heavy scissors
Pointed
Round
Curved
straight

24. Mc Indoe’s Tissue Scissors

25. Mc Indoe’s
Tissue
Scissors
Suture Scissors
Dressing
Scissors

26. Flat on End Serrated Gum Scissors

27. Instruments for retraction
• Retractors
–An instrument for drawing aside the edges of a wound or for
holding back structures adjacent to the operative field.
Skin Hook

28. Retractors

30. Hernia
Retractor
Prong
Retractor
Austin’s
Retractor
Tongue
Depressor

31. Austin’s Retractor
Periosteal Elevator

32. Langenbeck’s Retractors

33. Skin Hook Nasal Hook

34. Tissue Holding Instruments
• Forceps An instrument for seizing a structure, and
making compression or traction. Cf. clamp.
•Tissue Forceps
•Dissecting Forceps
•Tweezers
•An instrument with pincers that are squeezed
together to grasp or extract fine structures.

35. Gillie’s Dissecting Forceps (Tooth & Non-tooth)

36. Allis’s Tissue Forcep

37. Instruments for hemostasis
•Artery forceps
– straight
– curved
–Mosquito
•a small hemostat, straight or curved, with or without
teeth; used to hold delicate tissue or for hemostasis.
mosquito forceps. Also known as mosquito clamp

38. Artery Forcep

40. •Serration = artery
forcep
•Rasp like surface
•Groove
•Needle holder

41. Bone Instruments
•Periosteal Elevator & Raspatory
•Bone Cutter
•Bone Holder
•Bone Curette
•Bone File
•Bone Chisel
•Osteotome
•Bone saw

42. Periosteal Elevator

43. Howarth
Periosteal
Elevator

44. Raspatory
Plastic
Instrument

45. Periosteal elevator

46. Chisel, Mallet & Osteotome

47. Chisel Osteotome

49. Curved Chisel

50. Bone Gouge

51. Rongeur
Strong biting forceps for
nipping away bone

52. Bone-holding Forceps

53. Bone Holding

54. Gigli’s Saw

55. Bone
File
Alveolectomy
File

56. Williger’s
Curette

57. Hemingway’s Curette
Molt’s Curette

58. Special Instruments
•Instruments for circumferential wiring
•Instruments for nasal bone fracture
•Instruments for Malar complex fracture

59. Wire
Cutter
Wire
Twister
(Spancer
Well
Artery
Forcep)

60. Tongue Depressor
Wire
Twister
Wire
Cutter

61. Bone Awl

62. Ash
Forcep
Walsham
Forcep

63. Bristol’s Elevator

64. •Rowe’s elevator
•Howarth’s raspatory
•Artery forcep
•15 blade and handle

65. Bristol’s Elevator

66. Gillies Temporal Approach

67. Instruments for I&D
•Sinus forcep
•Blade (# 11 - # 12 )and Blade holder
•Curette
•Drainage tubes
•Kidney tray

68. Sinus
Forcep

69. Sinus Forcep

70. Instruments for suturing
•Needle holders
•Dissecting forcep
•Suture scissors

71. Mayo Halsted’s
Needle Holder

72. Gillie’s
Needle Holder

73. Gillie’s Dissecting Forceps (Tooth & Non-tooth)

74. Root elevators
•Straight
•Curved
•Apex elevator
•Root tip pick

75. Coupland’s Elevator Bein’s Elevator

76. Winter’s Exolever
Warwick Jame’s
Elevator

77. Irrigation Syringe

78. Instruments for cleft surgery
•Calibrator
•Marking ink and pencil
•Dingmann mouth gag
•Fine skin hook

79. Calibrator

80. Dingman’s Mouth Gag

81. Dingmann’s Mouth Gag

84. Instruments for anesthesia
•Anesthetic face masks
•Laryngoscope
•Laryngeal forcep
•Endotracheal tubes
•Guedel airways
•Nasopharyngeal airways
•Throat packs
•Mouth gags and props

85. Laryngoscope
Face Mask

87. Orotracheal
Tube
RAE tube
Plain Cuffed

88. Nasotracheal Tube

89. Endotracheal tube intubation:Endotracheal tube intubation:
Vocal cordVocal cord
Lift forward & upwardLift forward & upward
Sellick maneuverSellick maneuver
Length: 19~23cmLength: 19~23cm
CuffCuff
Check position: stethoscope, CXRCheck position: stethoscope, CXR

90. Laryngoscope and Orotracheal tube

91. Orotracheal Intubation
Plain Cuffed

92. Magill’s
Forcep

94. Fergusson’s Mouth Gag

95. Mouth Gag

96. Mushin’s Mouth Prop

97. Oxygen therapy:Oxygen therapy:
Nasal cannulaNasal cannula
Simple Simple
maskmask
Ventri Ventri
maskmask
Non-Non-
rebreathing rebreathing
maskmask
FiOFiO
22
24%24% 100%100%

98. Airways:Airways:
OropharyngealOropharyngeal
airwayairway
Nasopharyngeal Nasopharyngeal
airwayairway