chapter 25 oral and maxillofacial surgery
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Chapter 25 Oral and Maxillofacial Surgery
Surgeon
OMFS Oral and
maxillofacial surgery (surgeon)
Abbrev. OS
Oral surgeon General dentist w/
4 additional years of training, education.
Assistant
OMFSA Assistant Certification
DANB (not necessary)
2nd assistant is often utilized.
Six-handed dentistry
Treatment
Procedures Extractions Biopsy Tumor removal Implants Oral / facial surgery TMJ / TMD Orthognathic
Extractions
Extractions 3rd molars
Most common tx Single tooth Multiple teeth Supernumerary Impactions
ST = soft tissue Pb = partial bony Fb = full bony
Impaction
Soft tissue impaction Crown is erupted
through bone Under the gingiva
Tx Incise gingiva Section if necessary Luxate / subluxate Extract
Impaction
Partial bony impaction Crown is partially
erupted through bone, under gums.
Tx Incise gingiva Section tooth Extract pieces of
tooth.
Impaction
Full bony impaction Crown of tooth
(entire tooth) is covered w/ bone.
Tx Incise gingiva Remove bone to
expose tooth. Section tooth Remove pieces
Biopsy
Biopsy Surgical removal of
tissue for examination.
5 main types Excisional Incisional Smear Punch Needle
Biopsy
Excisional biopsy Complete removal
of the lesion and… Normal tissue to
compare Done on small
lesions. < 10mm
Biopsy
Incisional biopsy Small section of the
lesion is removed and….
Normal tissue to compare
Done on large lesions
> 10mm
Smear biopsy Aka Exfoliative cytology
Layer of cells are swabbed from mucosa.
DNA Paternity
Biopsy
Punch biopsy Core of tissue is
‘punched out’ of the center of a lesion
Needle biopsy Needle is used to
draw fluid from lesion
Tumors
Tumor removal ‘oma’ = tumor
Cysts Granuloma Carcinoma Fibroma Lymphoma Osteoma
Implants
Implants 2 main types Endosteal
In the bone Subperiosteal
On top of the bone Osseointegration
Implant fuses w/ the alveolar bone.
Abutments for Crowns, bridges Dentures
Temporomandibular joint
TMD Temporomandibula
r disorder / dysfunction
Popping Clicking Grinding Lock open / close Dislocation
Oral / facial surgery
Surgery due to: Genetics
Cleft palate
Disease Cancer
Trauma Car accident Fight Animal attack
Orthognathic surgery
Ortho = straight Gnathia = jaw
Surgery to correct Malocclusion Function
Chewing Breathing Speech
Coordinates tx w/ orthodontist.
Alveoplasty
Alveo = alveolar bone
Plasty = reshaping / recontouring Done w/ multiple
extractions Dentures
Full Partial
Related terms
Ostectomy Removal of bone
Osteoplasty Reshaping bone
Ankylosis Tooth fuses to bone
Alveolitis Dry socket
Ankyloglossia Tongue tied Lingual frenum is
attached at/near tip of the tongue
Tx: frenectomy
Stages of healing
Blood clot Forms
Granulation tissue Forms
Trabeculi Forms
Bone 4 -5 months females 5 -6 months for males
Conclusion
Understanding why oral surgery is done and when is very important.
You are the ‘expert’, and should be able to explain ‘it’ to your patients.
Never diagnose, refer difficult questions to your dentist.
Any questions????????
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