Transcript Oral and maxillofacial surgery

something about Oral
maxillofacial Surgery
Reporter: Huang Hai- yun
questions
1）Talk about the risks and complications
involved in the removal of third molars.
2）What is the instruction after tooth
extraction?
3） Avoid all rinsing for 24 hours after
extraction. Why?
• Oral and maxillofacial surgery is surgery
to correct a wide spectrum of diseases,
injuries and defects in the head, neck, face,
jaws and the hard and soft tissues of the
oral and maxillofacial region. It is a
recognized international surgical specialty.
 In the U.S.A., Canada, Australia, and New
Zealand, oral and maxillofacial surgery is
one of the 9 specialties recognized by the
American Dental Association, Royal
College of Dentists of Canada, and Royal
Australasian College of Dental Surgeons,
training programs lead to the trainee
obtaining qualifications in both Medicine
and Dentistry.
• In other parts of the world oral and
maxillofacial surgery as a specialty exists
but under different forms as the work is
sometimes performed by a single or dual
qualified specialist depending on each
country's regulations and training
opportunities available.
• An oral and maxillofacial surgeon is a
regional specialist surgeon treating the
entire craniomaxillofacial complex:
anatomical area of the mouth, jaws, face,
skull, as well as associated structures.
• Maxillofacial surgeons are usually initially
qualified in dentistry and have undergone
further surgical training.
• The popularity of oral and maxillofacial
surgery as a career for persons whose first
degree was medicine, not dentistry, seems
to be increasing. Integrated programs are
becoming more available to medical
graduates allowing them to complete the
dental degree requirement in about 3
years in order for them to advance to
subsequently complete Oral and
Maxillofacial surgical training.
conditions require oral surgery
• Teeth extraction
• Dental implants
• Jaw-Related Problems
• Other Conditions
EXTRACTION
• One of the main goals of modern dentistry
is the prevention of tooth loss. All possible
measures should be taken to preserve and
maintain your teeth because the loss of a
single tooth can have a major impact upon
your dental health and appearance.
However, it is still sometimes necessary to
remove a tooth. Here are some of the
reasons a tooth may need to be extracted.
reasons
some of the reasons a tooth may need to be
extracted.
• Severe Decay
• Advanced periodontal disease
• Infection
• Orthodontic correction
• Malpositioned teeth
• Fractured teeth or roots
• Impacted teeth
Impacted Teeth
• Wisdom teeth : third molars
Complete Bony Impaction Partial Bony
Impaction
• Other teeth:cuspids
bicuspids
• Wisdom teeth : third molars
fails to emerge in proper alignment or fails to
fully emerge through the gum line
Damage
• can result in swelling, pain, and infection of the
gum tissue :pericoronitis.
• cause permanent damage to nearby teeth, gums,
and bone and can sometimes lead to the
formation of cysts or tumors
• Some dentists believe that wisdom teeth may
push the other teeth in the mouth forward
and cause crowding and misalignment of the
lower front teeth.
Indication
Extraction of third molars is generally
recommended:
• When wisdom teeth only partially erupt;
• When there is a chance that poorly aligned
wisdom teeth will damage adjacent teeth;
When a cyst (fluid-filled sac) forms,
destroying surrounding structures such as
bone tooth roots.
Risks and complications
• PAIN :treated with pain medication.
• INFECTION : Patients are usually placed on
prophylactic antibiotics to prevent infections from
developing.
• SWELLING :vary between patients. apply an
ice pack or a cold towel to the outside of your
face
• BLEEDING : controlled with the pressure of
POSTOPERATIVE
INSTRUCTIONS
1)You will experience pain and swelling. This is
usually normal after an operation of this kind.
2)Bite on a gauze pack for 15-20 minutes.
3）Avoid biting the lips/cheeks.
INSTRUCTIONS
• 4）Do not spit. Hard spitting, rather than
wiping the inside of the mouth, can easily
destroy the clot from forming.
• 5）Do not smoke. Chemicals in cigarettes
can react with chemicals in your mouth
and actually break down a clot. Try to
avoid smoking for 48 hours at least.
INSTRUCTIONS
• Don’t eat until the anesthesia (numbness)
has completely gone.
• Avoid warm food as it can result in
bleeding. Eat only soft foods.
• When eating, try to chew your food on the
opposite side of the mouth.
INSTRUCTIONS
 6）Avoid all rinsing for 24 hours after
extraction. This is to insure the formation
of a healing blood clot which is essential to
proper wound healing. Disturbance of this
clot can lead to increased bleeding or the
loss of the blood clot. If the clot is lost, a
painful condition called dry socket may
occur. You may use warm salt water or
mild antiseptic rinses after 24 hours only if
prescribed.
INSTRUCTIONS
7）Do not drink hot liquids like tea or coffee.
Cool liquids are good for you though, so
drink plenty of water.
8）cold fomentation for some patients to
reduce the inflammation and swelling.
INSTRUCTIONS
9）DO NOT SPIT OR SUCK THROUGH A
STRAW: This will promote bleeding and
may dislodge the blood clot causing a dry
socket.
10）If the pain has not receded in 48 hours,
or if you have bleeding or foul odors, or
you have a high fever,call your dentist
and tell them about these symptoms
Dental implant
• .
WHAT？
• The implants are tooth root substitutes
that are surgically anchored in place in the
jawbone and act to stabilize the artificial
teeth to which they are attached. Suitable
candidates for dental implants need to
have an adequate bone level and density,
Jaw-Related Problems
• Unequal jaw growth.
• Improve fit of dentures.
• Temporomandibular joint (TMJ) disorders.
Unequal jaw growth
• Orthognathic surgery
the upper and lower jaw fail to grow properly.
some of these problems – like improper teeth
alignment – can be corrected with braces and
other orthodontic appliances, more serious
problems require oral surgery to move all or part
of the upper jaw, lower jaw, or both into a new
position that is more balanced, functional, and
healthy.
Improve fit of dentures
• For first-time denture wearers, oral surgery can
be done to correct any irregularities of the jaws
prior to creating the dentures to ensure a better
fit.
• Alveoloplasy
• Excision of torus
• Labio-buccal sulcus extention
• Ridge augmentation
Temporomandibular joint (TMJ)
disorders.
• Dysfunction of the TMJ(TMD), the small joint in
front of the ear where the skull and lower jaw
meet, is a common source of headache and
facial pain. Most patients with TMJ disorders can
be successfully treated with a combination of
oral medications, physical therapy, and splints.
However, joint surgery is an option for advanced
cases and when the diagnosis indicates a
specific problem in the joint.
TMD symptoms
• Jaw pain or soreness that is more prevalent in
the morning or late afternoon
• Jaw pain when you chew, bite or yawn
• Clicking when opening and closing your jaw
• Difficulty opening and closing your mouth
• Locked or stiff jaw when you talk, yawn, or eat
TMD symptoms
• An earache without an infection
• Sensitive teeth when no dental problems
can be found
Other Conditions Treated By Oral
Surgery
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Facial injury repair.
Lesion removal and biopsy.
Cleft lip and cleft palate repair.
Facial infections.
Snoring/sleep apnea.
Facial injury repair
• Oral surgery is often used to fix fractured
jaws and broken facial bones.
• There are 2 types of fractures:
• open: The bone is exposed to air inside
the mouth or outside the facial skin
• closed: The bone is completely covered
by soft tissue.
steps
Three in the repair of most fractures.
• 1. Reduction of the fracture: Realigning the bony parts
in their original anatomic relationship.
• 2.Fixation of the fracture : Methods and materials are
used to hold the bony parts in their correct relationship
while healing occurs.
3.Healing and Rehabilitation: This is the time that is
allowed for healing and for physical therapy. Adequate
nutrition and rest, avoiding alcohol and, tobacco is very
important.
Lesion removal and biopsy
• .Oral surgeons can take a small sample of
abnormal growth or tissue and then send it
for laboratory testing for identification.
Some lesions can be managed medically
or can be removed by the oral surgeon.
• HEAD AND NECK SURGERY：tumor
Cleft lip and cleft palate repair
• Cleft lip and cleft palate result when all or
portions of the mouth and nasal cavity do
not grow together properly during fetal
development. Oral surgeons work as part
of a team of healthcare specialists to
correct these problems through a series of
treatments and surgical procedures over
many years.
Facial infections
• Pain and swelling in the face, neck or jaws may
indicate an infection. Infections in this area of the
body can sometimes develop into lifethreatening emergencies if not treated promptly
and effectively. An oral surgeon can assist in
diagnosing and treating this problem. Surgical
treatment, if needed, may include cutting into
and draining the infected area as well as
extracting any teeth that might be involved.
Snoring/sleep apnea
• When conservative methods fail to
alleviate this problem, surgery can be tried.
Surgical procedures involve removing the
soft tissues of the oropharynx (an area in
the back portion of the mouth) or the lower
jaw. Laser surgery is a newer treatment
option. Depending on the surgical
technique used, the laser is used to either
slowly scar the palate, which tightens it, or
to remove palate tissue.