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The Itinerant Oral Surgeon’s Armamentarium

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Putting together your equipment and instrument kit is not a simple task. 

It’s a common question any graduating OMFS has in mind as they realize the most productive route to building their career is to travel. While some practice owners might supply everything from A – Z, that is not practical most of the time. This is why it’s crucial to research and choose the right instruments and equipment early. 

In a competitive market, Oral Surgeons who are equipped and prepared usually beat out their colleagues for job opportunities. It’s become the norm for any oral maxillofacial surgeon to travel carrying their own instruments, motors, implants, and surgical implant kits. 

Fitting everything into a “one size fits all” model, which would work for every practice you travel to, all the while focusing on clinical use can be a daunting task. Instruments get lost. You can’t find certain things when you need them. And what about carrying a small grip stock of surgical sundries in case the practice “forgets” to order something for the day of treatment? 

Delaying a case is the last thing any surgeon would want due to a missing item. This is a factor that can really hurt your productivity, especially because you and the patient won’t be able to reconnect for an average of another month. 

Meet Dr. Sirish Makan, fellow OMFS who has been working with Synergy Specialists for about 5 years. We’d like to provide you with some of his insights and advice on how he prepares his armamentarium for traveling Oral Surgery with Synergy Specialists. 

This is the specific setup that he carries and comfortably handles a packed schedule. While this was designed to fit the method of his practice style, you are not required to carry the same setup. It is meant to serve as a guide on how to formulate an efficient, travel-based set up for yourself. 

Synergy Specialists can help streamline your instrument and equipment kit setup so you can effectively deliver in-office specialty. 

Instruments

Main Surgical Kit x6

2 Bite Blocks

Aspirating Syringe

Blade Handle

Periosteal Elevator

46R Elevator

60B Elevator

Curved Kelly

12 Frazier Suction with stylet

Individually Wrapped Items/Cassettes

190/191 Elevators x3

150AS Forcep x3

23 Forcep x3

74N Forcep x3

1/2/3/ Elevators x3

Suture Kit (Needle Holder/Dean Scissors/Semkin Pickup with teeth) x3

Curettes x3

Bone File x3

Rongeur x3

Internal Sinus Lift Kit x1

External Sinus Lift Kit x1

Nobel PureSet Implant Kits (able to place Active or Parallel CC) x2

*This is in addition to the sedation equipment and meds which I bring on my end, unless the practice Synergy matched me with is fitted more as an OMFA practice in which case they will have all that. It’s worth mentioning that I utilize a minimal tray like this because it reduces weight in traveling and is a pure reduction in overhead/tracking. It’s also less costly to buy them and less things to keep track of. 

Small Equipment

Regarding the electric handpiece. There are only 3 options that most people utilize. Electric handpieces, which commonly are from Bien Air, NSK or some other manufacturer), impact air, or 45 degree handpieces that typically plug into normal high speed units, and the Hall style drill. Each has their own pros and cons, but neither will provide a better post op outcome for the patient when compared to the other. The lightest to travel with and least headache is definitely the Impact Air style handpiece, but you are restricted in types of cases. The Hall style drills are the next lightest to carry around, but it requires the office to have a nitrogen tank in the office and you do have to have extra hoses. They are also loud. The electric handpiece that I use is more to carry, but better torque and anecdotally, less maintenance. It also allows me to easily switch between implant and surgical attachments.

The sedation monitor is one thing that is cost dependent. This is something where Synergy has a deal worked out with Edan monitors as a preferred vendor, In general new monitors typically run around $5000. May even make sense to have 2 of them as a backup. 

Implants & Surgical Kits

The implant system is very user specific. Synergy Specialists recommends carrying a major brand-name implant system to mitigate any possibility that the patient will face trouble when servicing a failed implant by another dentist in the future. This is why most surgeons carry a major brand name like Nobel Biocare which is my preferred system. 

Using Synergy Specialists’ special pricing discount for their network of specialists, the cost difference doesn’t end up being significantly more, especially when you consider that the cost of implants are usually split 50/50 with the practice. 

I also carry 2 surgical kits with me at all times, because you never know when the practice will schedule a back to back consultation for implants. What if both cases convert to treatment? 

You need to be prepared so the sterilizing process doesn’t impede your production. The sterilizer unit of the practice must also have a wide enough chamber for your cassette. Most chambers are wide enough to fit inside a standard implant cassette, but always make sure to confirm with the practice owner that the autoclave unit needs to be large enough. 10” wide is the standard level chamber width that works, with models such as The Midark M10, and The Tuttnauer 2340+ series autoclave. The Midmark M9, not the Tuttnauer 1730 will fit. 

Regenerative & Membrane

A traveling Oral Surgeon has a tremendous amount of gear to carry these days. Biologics is not really recommended to carry in your own grip stock, unless you want to deal with the refrigeration process when you get home from cases each night. 

Practices should always furnish bone particulate and putty, since it requires a special cold environment to retain its osseointegration effect. A good compromise should you encounter a practice that seems to act “penny wise and pound foolish” as they say, is to offer to bring the membrane material since that doesn’t need to be frigid, while the practice supplies the bone particulate. 

Be careful about using jumbo 5CC vials twice over, since The FDA has been clamping down on cross contamination, and patients who know will ask. Instead consider using the syrginable material from Citagenix which is FDA approved to recap and use for the next patient. 

Getting Access to the Right Supplies at the Best Price 

The Synergy Formulary program gives Specialists access to exclusive deals, such as 45% off retail with Nobel Biocare, free surgical kits for the first set of ten implants purchased, and lot’s more on the instrument side. 

To get free custom formulary built for your unique needs, schedule a consultation with a member of our team. We’ll be happy to walk you through all the unique vendors we recommend for success as a traveling oral surgeon. 

Dr. Makan is always available for discussion with fellow OMFS. He can be reached at SMakan@Gmail.com

To join our network, fill out a registration form today. 

Darius Somekhian

Darius Somekhian

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