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????????