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25

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Branch of dentistry that focuses on diagnosis and treatment of diseases, ... Tongue and Cheek Retractors. 8. Mouth Prop. 9. Hemostats. Multiple uses. Retract tissue ... – PowerPoint PPT presentation

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Title: 25


1
25
  • Oral and Maxillofacial Surgery

2
Oral and Maxillofacial Surgery
  • Branch of dentistry that focuses on diagnosis and
    treatment of diseases, injuries, and malformations

3
Oral and Maxillofacial Surgery Team
  • Surgeon
  • Receptionist and business staff
  • Dental assistant
  • Nurse anesthesiologist or anesthesiologist

4
Scalpel Setup
5
Retractors
  • Tissue
  • Cheek and lip
  • Tongue

6
Tissue Retractors
7
Tongue and Cheek Retractors
8
Mouth Prop
9
Hemostats
  • Multiple uses
  • Retract tissue
  • Remove small root tips
  • Clamp blood vessels
  • Grasp loose objects

10
Needle Holders
  • Similar to hemostat
  • Function similar to hemostat

11
Surgical Scissors
12
Surgical Aspirating Tips
13
Surgical Curettes
14
Surgical Chisel and Mallet
15
Surgical Bone File
16
Rongeurs
17
Periosteal Elevators
18
Elevators
  • Loosen and remove teeth, retained roots, and root
    fragments
  • Types
  • Apical
  • Root tip picks

19
Extraction Elevators
20
Root Tip Picks
21
Extraction Forceps
  • Used to remove teeth from alveolar bone
  • Hinged with various handles and beak styles

22
Asepsis in Oral Surgery
  • Infection control is critical
  • Increased risk of exposure to blood in surgery

23
Patient Considerations
  • Review
  • Medical records
  • Dental records
  • Referring dentist notes
  • Radiographs
  • Treatment options
  • Patient consent
  • Financial arrangements

24
Oral Surgery Procedures
  • Uncomplicated extractions
  • Removal of permanent or primary teeth that have
    erupted into the oral cavity
  • Also known as routine or simple extractions

25
Simple Extraction Setup
26
Oral Surgery Procedures
  • Multiple extractions and alveoplasty
  • Multiple extractions are performed to prepare
    patient for partial or dentures
  • Bone and soft tissue of the edentulous ridge is
    contoured and smoothed

27
Multiple Extractions Setup
28
Oral Surgery Procedures
  • Extractions of impacted teeth
  • Tooth may be partially or fully covered by tissue
    or bone
  • Tooth has not erupted into the oral cavity
  • Extraction is difficult due to depth, position,
    or angulation of tooth in bone

29
Problems Caused by Impacted Wisdom Teeth
If the jaw grows long enough, the wisdom teeth
can erupt and be used.
Wisdom teeth ( 3 above) develop inside the bone.
Crowns form first, then the roots.
If the jaws are not long enough by age 16, wisdom
teeth stay trapped (impacted) inside the bone.
30
Problems Caused by Impacted Wisdom Teeth
Impacted wisdom teeth can cause (A) Infection of
the gums over or around them
(B) Infection in the bone around them
(C) Destruction of the next tooth
31
Problems Caused by Impacted Wisdom Teeth
Looking down on the biting surfaces of the lower
teeth (E) Other teeth pushed out of line (arrows)
(D) Destruction of the bone by formation of a cyst
32
Removal of Boney Impaction
  • Handpieces and surgical burs required to gain
    access

33
Oral Surgery Procedures
  • Biopsy procedures
  • Total or partial removal of tissue from
    suspicious areas for microscopic examination and
    diagnosis
  • Three types
  • Excisional, incisional, exfoliative

34
Incisional Biopsy
  • Removal of small section of lesion and a small
    border of normal tissue
  • Used when lesions are larger than 1 cm

Normal tissue
Normal tissue
35
Excisional Biopsy
  • Complete removal of lesion including border of
    normal tissue
  • Performed on smaller lesions

Normal tissue
Normal tissue
36
Exfoliative Cytology
  • Smear biopsy
  • Nonsurgical procedure
  • Removal of a layer of cells from surface of lesion

37
Exfoliative Cytology
  • Cells spread on a glass slab for microscopic
    examination
  • Often done in addition to other forms of biopsies

38
Oral Surgery Procedures
  • Dental implant surgery
  • Method for replacing missing teeth
  • Screw or framework placed into jaw bone
  • Tooth shaped restoration is screwed into
    framework

39
Oral Surgery Procedures
  • Treatment sequence for implants
  • Patient meets with restorative dentist
  • Referral to oral surgeon
  • Diagnostic consultation
  • Decision on treatment plan
  • Stages of treatment depend on technique used

40
Dental Implant
41
Oral Surgery Procedures
  • Types of implants
  • Subperiosteal
  • Endosteal
  • Mini Implant

42
Postoperative Patient Care
  • Given verbally and written
  • Lists expectations, what to do, and what to avoid

43
Postsurgical Complications
  • Alveolar osteitis (dry socket)
  • Cause is loss of blood clot from extraction site
  • May be the result of insufficient blood supply,
    infection, or trauma
  • Occurs three to five days following surgery

44
Treatment of Dry Socket
  • Irrigate tissue with warm saline solution
  • Pack extraction site with iodoform gauze
  • Rx analgesic and antibiotics
  • Procedure repeated every one to two days

45
Treatment for Alveolitis
46
Temporomandibular Joint Disease
  • Muscles, bones, and joints of mandible fail to
    function properly

47
Temporomandibular Joint Disease
  • Signs and Symptoms
  • Pain around ear
  • Tenderness of the masticatory muscles
  • Popping and clicking noise when opening and
    closing the mouth

48
Temporomandibular Joint Disease
  • Signs and Symptoms
  • Crepitus or tinnitus
  • Limited movement of mandible
  • Trismus
  • Headaches or neckaches

49
Temporomandibular Joint Disease
  • Diagnosing
  • Dental and medical history
  • Examination of joint
  • Radiographs
  • Dental study casts

50
Temporomandibular Joint Disease
  • Treatment
  • Application of ice and heat
  • Learning to rest jaw
  • Medications
  • Stress management
  • Physical therapy
  • Occlusal splinting
  • Orthodontics
  • Steroid injections
  • Arthrocentesis
  • Arthroscopic surgery
  • Open joint surgery

51
Hospital Dentistry
  • Trauma
  • High risk patients
  • Patients with mental or physical disabilities
  • Extensive surgeries

52
Advanced Chairside Functions
  • Suture removal
  • Hold tissue in original position
  • Prepare patient and equipment
  • Examine site
  • Consult with dentist
  • Remove with care to avoid trauma or infection

53
Advanced Chairside Functions
  • Types of Sutures
  • Simple
  • Continuous simple
  • Sling
  • Continuous sling
  • Mattress
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