Oral and maxillofacial surgery I.
Dental speciality that deals with diagnosis
and surgical treatment of diseases, injuries
and deformities of the face and jaws.
Oral surgery
• Focused on oral cavity only
- Teeth
- Supportive tissues
- Alveolar bone
- Soft tissues
Maxillofacial surgery
• Focused on maxillo facial area
-jaws including teeth and other surrounding
tissues
- facial region
- traumatology, oncology,heavy otrhodontic
anomalies
Principles of surgery in the mouth
• Oral cavity – forgiving environment
- Saliva
- Blood supply
Asepsis
• Avoidance of pathogenic microorganisms
Aseptic technique:
- Sterile instruments, gloves, cloths,
„no touch technique“
Before surgical procedure
• Changing room – clean cloths
• Surgical washing of hands before the
procedure (sterie brush - scrubbing,
soap,desinfection)
• Sterile coat, cap, face mask, gloves
Antisepsis
• Is the applicationof an agent which inhibits
the growth of microorganism while in contact
with them.
Example: preparation of operating field
Disinfection
• Is the inhibition or destructions od pathogens
on various surfaces.
Sterilisation
• Destruction of all forms of live of microbs.
Dry heat sterilization (hot circulating air)
Hor steam sterilization (autoclaves)
Three basic techniques in surgery
• Avoid introducing infection – always using
sterilized instruments, wearing gloves
• Avoid being infected yourself by operative site
–wear gloves, face and eyes protection
• Reduce the contamination load to the site
(e.g. chlorhexidin mounthrinse)
Cross infection control
• Infectious aerosol – high vacuum suction
• Cleaning and sterilizing (decontamination,
wash, dry, sterilize)
• Imunization agains hepatitis B
Waste disposal
• Infectious waste
• Common waste
• Sharp waste
• Amalgam
Surgical procedures
Routine extractions
Multiple routine extractions
Surgical extractions
Third molar extractions
Exposure of impacted canine
Frenectomy
Periodontal surgery
Gingivectomy, osteoplastic
Biopsy
Surgical procedures
Incision
-intraoral
-extraoral (outside) incision
-window incision
Incision is a treatment of abscess (evacuation of pus)
Implantation (application of implant, graft)
Surgical procedures
Plastic operation of jaw
Palathoplasty
Labioplasty
Vestibuloplasty…….
Surgical procedures
Incision
Raise of the flap
Operation field
Operation
Suture
Damage tissue
Extracting teeth
(exodontia) - indication
Indications:
Caries
Trauma
Periodontitis
Endodontic reasons
Retention, semiretention if it causes
inflammation and pain
Extraction of teeth - contraindication
• Serious systemic diseases (blood diseases –
absolutely contraindicated
• Serious disintegration of face (noma,
ulcerative disintegration – absoluetly
contraindicated
• Others (relative contraindications) – diseases
of circulation, arteficial valves, antithrombotic
medication)
Principles of extraction
Interruption, rupture of preiodontal
Ligaments and extraction - the tooth
is pulled out.
Instruments for extraction
• Elevators
To dilatate sockets, facilitate extraction, remove
impacted teeth.
• Forceps
To release the tooth – „swinging/ and pull
motion.
For extraction – we must know
tooth morphology