Oral Surgery Notes PDF

Faculty Of Dentistry ALTHADY UNIVERSITY ❖ Introduction. 1-Definition 2-scope ❖ Principle of oral surgery. ❖ Art of diagnosis. 1-History Taking. 2-Clinical Examination. 3-Clinical Diagnostic Aids. 4-Diagnostic Investigation. 5-Biopsy.  TOPICS ❖ INFICTION CONTROL. ❖ Anesthes...

Faculty Of Dentistry ALTHADY UNIVERSITY ❖ Introduction. 1-Definition 2-scope ❖ Principle of oral surgery. ❖ Art of diagnosis. 1-History Taking. 2-Clinical Examination. 3-Clinical Diagnostic Aids. 4-Diagnostic Investigation. 5-Biopsy.  TOPICS ❖ INFICTION CONTROL. ❖ Anesthesia in oral surgery. ❖ Management of medically compromised patient in oral surgery. ❖ Armamentarium used in oral and maxillofacial surgery.(instruments ). ❖ Minor oral surgical procedures. ❖ Exodontia. ❖ Suturing and suture material. ❖ Drugs in dentistry  Introduction Definition Scope The scope of oral and Oral and maxillofacial surgery maxillofacial surgery depends is branch of dentistry, that on the qualifications and deals with the art of diagnosis capabilities of the person. and treatment of various diseases, injuries and defects involving the orofacial region.  PATIENT assessment THE SURGICAL ASSISTANT ; THE SURGICAL SETTING ▪ Dental Operatory ▪ Surgical Suite ▪ Operating Room SURGICAL ASEPSIS Because surgical procedures invade open tissue, the surgical team must follow a sterile technique. Sterile field Site where surgical instruments and accessory items are placed during a surgery. Surgical scrub Type of hand wash used to lessen the chance of infection. Proper gloving When assisting in an invasive procedure, you must wear sterile gloves. PREPARING FOR SURGERY : Advanced preparation Have all patient records and radiographs in order. Have consent forms signed and available. Information requested from patient’s physician has been received. Check for laboratory cases. Surgical setups prepared and sterilized. Provide preoperative instructions for taking any premedication. PREPARING FOR SURGERY Treatment room preparation Place protective barriers. Keep surgical instruments in their sterile wraps until ready for use. Have appropriate pain control medications set out and ready for administration. Have postoperative instructions ready to provide to the patient. Patient preparation Update medical history and laboratory reports. Check with the patient that any prescribed premedication was taken as directed. Place radiographs on view box. Take vital signs to determine a baseline. Seat and drape the patient. Position the chair. PATIENT PREPARATION During the surgery Maintain the chain of asepsis. Transfer and receive instruments. Aspirate and retract as needed. Maintain a clear operating field with light. Monitor the patient’s vital signs. Steady the patient’s head and mandible if necessary. Observe the patient’s condition, and anticipate the surgeon’s needs. PATIENT PREPARATION After surgery Stay with the patient. Give verbal and written postoperative instructions. Schedule a postoperative visit. Update the patient’s treatment records. Return the patient’s records to the business assistant. Breakdown and disinfect the treatment area. POSTOPERATIVE CARE Control of bleeding A 2 x 2 gauze is folded and placed to control bleeding, encourage clot formation and healing. Keep gauze in place at least 30 minutes. If bleeding does not stop, call the dental office. Do not disturb the clot with your tongue or by rinsing your mouth vigorously. Strenuous work or physical activity is restricted that day. POSTOPERATIVE CARE Control of swelling The use of ibuprofen before and after surgery. During the first 24 hours, a cold pack is placed in a cycle of 20 minutes on and 20 minutes off. After the first 24 hours, external heat applied to the area of the face to increase circulation in the tissues and to promote healing. After the first 24 hours, patient can begin gently rinsing the oral cavity with warm saline solution.  INDICATIONS FOR ORAL AND MAXILLOFACIAL SURGERY Oral and maxillofacial surgery essentially deals with the. treatment of the following conditions. Extractions of decayed teeth that cannot be restored. Surgical removal of impacted teeth. Extraction of nonvital teeth. Preprosthetic surgery to smooth and contour the alveolar ridge. Removal of teeth for orthodontic treatment. Removal of root fragments. PREPARING FOR SURGERY: Treatment room preparation Place protective barriers. Keep surgical instruments in their sterile wraps until ready for use. Have appropriate pain control medications set out and ready for administration. Have postoperative instructions ready to provide to the patient. PREPARING FOR SURGERY: Patient preparation Update medical history and laboratory reports. Check with the patient that any prescribed premedication was taken as directed. Place radiographs on view box. Take vital signs to determine a baseline. Seat and drape the patient. Position the chair.. Simple and complicated extraction of teeth and related management.Treatment of cysts and tumors of both odontogenic and non odontogenic involving the jaw bones..Management of disorders of maxillary sinus..Initial and definitive management of traumatic injuries of soft and hard tissues of the orofacial region..Salivary gland diseases and their management..Management of developmental deformities (clefts of lip and palate.).Management of orofacial infections..Preprosthetic surgical procedures.Dental implantology..Tempromandibular joint disorder.  Art Of Diagnosis History taking: Steps of history taking: 1-obtaining general information. 2-chief complaints. 3-past and present medical history 4-personal and family history. Clinical examination. 1-patient vital signs. 2-four aspects of examination: inspection, palpation, percussion, and auscultation.  ART OF DIAGNOSIS Clinical diagnostic aids. 1-radiological examination: Intraoral radiographs. Extraoral radiographs. Diagnostic investigation 1-Routine hematological investigations: Hb/CBC. 2-coagulation tests: PT/INR Biopsy: punch biopsy ,incisional and excisional biopsy.  Management of medically compromised patient in oral surgery. classification of physical status: ASA According To The American Society Of Anesthesiologists adopted the physical classification that identifies the risk to a patient undergoing a surgical procedure. ASA I: patient without S. D ASA II: P with mild S.D ASA: P with sever S.D that limits activity but is not incapacitating. ASA III: patient with incapacitating systemic disease. ASA Iv: a moribund patient not expected to survive 24 hours with or without surgery. ASA E: Emergency operation of any kind. Management of medically compromised patient in oral surgery. Patient on oral anti coagulants. Patient with prosthetic heart valve. Require antibiotic prophylaxis (I e c). Heart pacemaker. Hypertension patient. Diabetes mellitus. Hypoglycemia-hyperglycemia. Hyperthyroidism. Pregnancy and lactation. According to FDA category. A B C D.  Conclusion 1-a knowledge of the patient medical background must be obtained. 2-the surgeon should also have knowledge about the medications taken by the patient. 3-a written consent for the surgical procedure has to be obtained from a specialist in field prior to the procedure. 4-adequate and necessary preoperative investigations must be performed. 5-The patient should be explained about the risks and benefits of the procedure ,with regards to his general condition and a witnessed written condition for the procedure should be obtained from the patient. 6- Functional life support in the dental office.