Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
50 Cards in this Set
- Front
- Back
|
Oral and Maxillofacial Surgery |
- Dental surgical speciality that diagnoses and treats conditions of the mouth, face, jaws, and associated areas - Involved in the diagnosis and surgical treatmend of diseases, injuries and defects affecting the hard and soft tisse of the head and neck region |
|
|
Indications for Oral and Maxillofacial Surgery |
- Extraction of decayed teeth that cannot be restored - Sugical removal of impacted teeth - Extraction of nonvital teeth - Preprosthesis surgery to smooth and contour the alveolar ridge - Removal of teeth for orthodontic treatment - Removal of root fragments - Removal of cysts and tumors - Biopsy - Treatment of fractures of the mandible or maxilla - Surgery to alter the size or shapde of the facial bones - Surgery of the temporomandibular joint - Reconstructive surgery - Cleft lip and cleft palate repairs - Salivary gland surgery - Surgical implant procedures |
|
|
Oral and Maxillo Facial Surgeon (OMFS) |
- DDS who specialized in surgeries of the head and neck region - Also referred to as oral surgeon - 4-6 yrs postgraduate training in a hospital-based residency - Finishes surgical-medical year because program completion, with an emphasis on surgical techniques, anesthesiology and oral medicine |
|
|
Surgical Assistant Responsibilities |
1. Patient assessment and monitoring 2. Use of specialized instruments 3. Surgical asepsis 4. Surgical procedures 5. Pain control techniques |
|
|
Surgical Setting |
1. Private dental office 2. Hospital or outpatient surgical suite |
|
|
Outpatient |
Patient seen and treated by a physician, then sent home for recovery |
|
|
Surgical Preparation |
- Understanding of aseptoc protocol, knowledge of needed supplies, and familiarity with the instruments used for a procedure are critical - Routine based procedure |
|
|
Private Practice |
- Oral surgeon's private practice medicodental-surgical office consists of treatment areas similar to those in a general practice - Offices will have a surgical suiet that resembles an operating room, but on a much smaller scale - Specific items used only for surgical procedures, such as monitoring equipment, pain control units and mobile trays, replace items seen in a general practice - OMFS in an office setting is considered as having minor surgery and is being seen as an outpatient |
|
|
Operating Room |
Environment is spacious enough to accomodate: 1. Operating table 2. anesthesiology equipment 3. Mobile surgical trays, holding instruments and supplies 4. Overhead lighting 5. Monitoring equipment 6. Standing room for the surgeon, surgical assistant, roving assistant and anesthesiologist |
|
|
Adcanced Preparation |
- Check that the patient record and radiographs are in order - Have necessary consent forms signed and available for review - Verify that any information requested from the patient's physician has been received - If a prosthesis will be delivered to the patient, determine whether the dental laboratory has returned it - Verify that he appropriate surgical setups have been prepared and sterilized - Contact the patient and provide preoperative instructions for taking any needed premedication and for eating or drinking after midnight - Instruct patient to have someone drive him or her and stay during procedure |
|
|
Treatment Room Preperation |
- Prepare the treatment room by placing protective barriers on anything that may be touched during the procedures - Keep surgical instruments in their sterile wraps until ready for use. If a surgical tray has been set out, open it and place a sterile towel over the instruments - Have the appropriate pain control medications ready for administration (local anesthesia, nitrous oxide/oxygen inhalation, intravenous sedation) - Have the necessary postoperative instructions ready to provide to the patient |
|
|
Patient Preparation |
- Update the patient's medical history and all laboratory reports - Check that the patient has taken prescribed predmedication. If not, the surgeon should be altered immediately - Have radiographic images on screen - Take vital signs to determine a baseline - Prepare any additional monitoring equipment to be applied - Seat and drape patient - Adjust the chair into a comfortable reclining position. If general anesthesia is to be administered, place patient in a suprine position |
|
|
During Surgery |
- Maintain chain of asepsis - Assist in the administration of nitrous oxide and intravenous sedation - Transfer and receive instruments - Aspire and retract as needed - Maintain a clear operating field with adequate light - Monitor the patient's vital signs, oximtery, and electrocardiogram (ECG) - Steady the patient's head and mandible if necessary during use of a mallet and chisel - Observe the patient's condition, and anticipate the surgeon's needs |
|
|
Posoperative Surgery |
- Stay with the patient until he or she has recovered sufficiently to leave the office - Give verbal and written postoperative instructions to the patient and the responsible person who is accompanying the patient - Confirm a posoperative visit as directed by the dentist - Update the patient's treatment records, including a copy of any new prescription given to the patient - Return the patient's records to the bussiness assistant - Break down and disinfect the treatment area - Transport all contaminated items to the streilization center |
|
|
Forceps Extractions |
- Often described as "routine" or "simple" extractions - Misleading because all extractions are surgical procedures - Use of these terms implies that the extraction can be completed without extensive instrumentation - Performed on a tooth that is fully erupted and has a solid, intact crown which is grasped firmly with forceps - Most "routine" forceps extractions do not require placement of sutures |
|
|
Multiple Extractions and Alveoplasty |
- Indicated when a patient will be receiving a partial denture, a full denture or implants - Even though the teeth are fully erupted and the procedure is a routine forceps extraction procedure, the end result required for the patient's alveolar ridge changes the procedure - When several teeth have been extracted within the same quadrant, the alveolar crest remains intact, and the surgeon must perform an alveoplasty to contour and smooth the affected area |
|
|
Alveoplasty |
Surgical shaping and smoothing of the margins of the tooth socket after extraction of a tooth, generally in preparation for placement of a prosthesis |
|
|
Removal of Impacted Teeth |
- Term complex extraction is used when conditions require additional skill, knowledge, and instrumentation to remove a tooth - Extraction of an impacted tooth is an example of a complex extractions |
|
|
Impacted tooth |
Toot that has not erupted |
|
|
Soft Tissue Impaction |
- Indicates that the tooth is located under the gingival tissue - Oral condition in which a tooth is partially to fully covered by gingival tissue |
|
|
Hard Tissue Impaction |
- Indicates that the tooth is partially or totally covered by tissue and bone - Oral condition in which a tooth is partially to fully covered by bone and gingival tissue |
|
|
Biopsy |
- Process by which tissue is removed and examined to distinguish malignant (cancerous) from nonmalignant (noncancerous) lesions in the oral cavity - 3 most common biopsy procedures are incisional biopsy, excisional biopsy, and exfoliative biopsy |
|
|
Incisional Biopsy |
- Section of suspect oral lesion that is removed for evaluation - Indicated when a lesion is located in an area that would be cosmetically or functionally impaired by surgery - Indicated whn the lesion is larger than 1 cm in all dimensions - Surgeon will remove a wedge of tissue from the lesion, along with some normal tissue to the used for comparison - Complete surgical removal of the lesion is not performed until a final diagnosis of the type of lesion is made |
|
|
Excisional Biopsy |
- Surgical procedure in which tissue is cut from a suspect oral lesion - Involves removal of the entire lesion plus some adjacent normal tissue - Ideal for small lesions when complete removal will not create an esthetic or functional problem Ex. small, nonhealing sore on the labial mucosa may be removed completely during biopsy |
|
|
Exfoliative Biopsy |
- Diagnostic procedure in which cells are scraped from a suspected oral lesion for analysis - Also known as, oral brush biopsy - Introduced as a noninvasive technique to recognize oral cancer - Able to penetrate and remove tissue from all three epithelial layers of the oral mucosa - Does not require anhesthesia and produces minimal to no bleeding or discomfort to the patient - Brush is pressed agaisnt the lesion in question and rotated; the cells gathered on the brush are then rotated onto the enclosed glass slide, fixed, and send to lab for analysis |
|
|
Biopsy Results |
- Pathology report indicates whether the lesion is malignant or benign - Nonmalignant tumors and cysts are removed if their size and location interfere with appearance and normal functions - If they do not interfere and do not pose a threat to the patient, removal may be postpoened - Informing the patient of a malignant tumor requires kindness, empathy, and a tactful explanation from the DDS - Cannot be done through the phone, must be in person who a close family member present |
|
|
Suture |
- Refers to the act of stiching - Rule: if a scalpel hsa been used, sutures are placed to control bleeding and promote healing - Therefore, when a scalpel is on the setup tray, suture equiment with be added |
|
|
Suture Placement |
- Suture needles are supplied already threaded and in a sterile pack - Suture material is available in absorable and nonabsorbale varieties |
|
|
Absorbably Suture |
Materials dissolve and become absorbed by the body's enzymes during the healing process Common types: 1. Plain catgut 2. Chromic Catgut 3. Polyglactin 910 (Vicryl) |
|
|
Plain Catgut |
Provides fastest healing for mucous membrane and subcutaneous tissue |
|
|
Chromic Catgut |
Which provides a slower healing process, allowing the internal tissues to heal first |
|
|
Polyglactin 910 (Vicryl) |
Synthetic absorbable material |
|
|
Nonabsorbably Suture Materials |
Require patient to return to office for removal usually 5 - 7 days after surgery Materials: 1. Slk 2. Polyester Fiber 3. Nylon |
|
|
Silk |
Its strength and easy application |
|
|
Polyester Fiber |
One of the strongest sutures |
|
|
Nylon |
Strength and elasticity |
|
|
Suture Technique |
Extraction performed will determine the suture technique used by the surgeon - Interrupted and horizontal mattress sutures are the most commonly placed sutures for a single tooth socket - Mattress suture and the figure-eight suture are used for suturing two or more papillae together |
|
|
Control of Bleeding |
Immediately after an extraction is performed, sterile 2x2-inch gauve is folded and placed over the socket to control bleeding and for clot to form and heal Instructions: - After leaving the office, keep the pack in place for 30 - 45 mins. Removing the pack too son could disturb clot formation and may increase bleeding - Do not disturb the flot with your tongue or by rinsing your mouth vigorously - If bleeding continues and does not stop, call office - Restrict strenuous work or physical activity for that day |
|
|
Common Analgesics for Posextraction Pain Mild Pain |
- Ibuprofen - Acetaminophen |
|
|
Common Analgesics for Posextraction Pain Moderate Pain Situtations |
Prescription - Acetaminophen with Codeine - Hydrocodone |
|
|
Control of Swelling |
Use cold packs for swelling Instructions: First 24 hrs, place a cold pack on a cycle of 20 mins on and 20 mins off - First 24 hrs, place a cold pack on a cycle of 20 mins on and 20 mins off - After the first 24 hrs, apply external heat to the area of the face to enhance circulation in the tissues and promote healing - After the first 24 hrs, apply external heat to the area of the face to enhance circulation in the tissues and promote healing - After the first 24 hrs, begin gently rinsing the oral cavity with warm saline solution (tsp salt to 8 oz warm water) every 2 hrs to promote healing - After the first 24 hrs, begin gently rinsing the oral cavity with warm saline solution (tsp salt to 8 oz warm water) every 2 hrs to promote healing |
|
|
Common Analgesics for Postextraction Pain Severe Pain Situations |
Prescription, oxycodone (Percocet) |
|
|
Postoperative Diet |
- Day of the surgery, instruct patient that he or she can drink liquid and eat soft foods such as Jell-O, pudding and broth), trying to eat on the other side of the mouth - Make sure not to eat anything too hot or too cold and do not drink anything through a straw - After 24 hrs, or soon as patient can chew comfortable, patient can begin to eat solid foods, chew in the opposide side of the surgical site - Important to avoid alcoholic beverages |
|
|
Alveolar Osteoitis |
- Pain and inflammation resulting from exposed bone associated with the disturbance of a blood clot after extraction of a tooth, also known as a dry socket - When the blood clot at the site of the tooth extraction has been dislodge or has dissolved before the wound has healed - The underlying bone and nerves are exposed resulting in pain, not only in the socket but also radiating to the side of the face - Can occur 2-4 days after removal of the tooth |
|
|
Factors that initiate Alveolar Osteitis |
- Not caring for the extraction site as instructed - Not following hpme care instructions - Smoking, sneezing, coughing, spitting, or drinking from a straw within 24 hrs - Women who take oral contraceptives (may be more susceptible) |
|
|
Treatment of dry socket |
1. Flushing out the socket 2. Medicated dressings 1. Flushing out the socket2. Medicated dressings3. Pain Medication4. Self-care 3. Pain Medication |
|
|
Flushing out the Socket |
The surgeon will use a sterile saline solution and flush the socket to remove any food particles or other debris that may contribute to pain or infection |
|
|
Medicated Dressings |
- A surgical dressing either as a paste or saturated gauze strips with medicated dressing includes an antibacterial and topical anesthetic is packed into the socket for up to 5 days providing immediate relief for the patient - Patient may need to have the dressing changed several times over a 2 week period |
|
|
Pain Medication |
The surgeon may prescribe a pain medication |
|
|
Self-Care |
A sterile disposable syringe will be provided with instructions on how to flush the socket with warm saline solution at home to promose healing and eliminate debris |
