Incisions and Flaps

Question 1

Definition of oral surgery

Answer 1

• Oral surgery is the specialty of dentistry which includes the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region

Question 2

Definition of oral surgery

Answer 2

• Oral surgery is the specialty of dentistry which includes the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region

Question 3

BASIC NECESSITIES FOR SURGERY

Answer 3

• VISIBILITY
• ASSISTANCE
It depends on:- >Adequate access >Adequate light >Clean surgical field

Question 4

ASEPSIS

Answer 4

• Sepsis - Breakdown of tissue by action of microbes and is usually accompanied by inflammation
• Antiseptic - Substance that can prevent multiplication of organism capable of causing infection. Anstiseptics are applied on living tissues while Disinfectant are applied on inanimate object.
• Sterility - freedom from viable forms of micro organisms
• Sanitization - reduction of number of viable organisms

• To minimise wound contamintaion by pathogens because during a surgery, dentist violates the epithelial surface which is the most important barrier against an infection
• During oral surgical procedures dentist, assistant and equipment become comtaminated with patients blood and saliva

Question 5

The basic methods used for sterilization of instruments are:

Answer 5

• Dry heat
• Moist heat (autoclave)
• Chemicals
• Ethyleneoxide

Question 6

TECHNIQUES OF INSTRUMENT STERLIZATION

Answer 6

1. Heat

-moist heat
*Boiling
*Pasteurization
*Steam (autoclave)

-dry heat
*Flaming
*Incineration
*Hot air oven
*Radiation methods

2. Chemical
   -ethylene oxide
3. Filteration
   -membrane filters
   -seitz filters
   -candle filters

Question 7

MAINTAINENCE OF STERILITY

Answer 7

•By using disposable materials
•Surgical field maintaenance

Question 8

PREPARATION OF PATIENT

Answer 8

• After the patient is seated in the dental chair, the assistant attends to disinfecting the area to be operated on.
• The skin around the mouth is first disinfected with gauze impregnated with antiseptic solution, and then the mucosa of the oral cavity is disinfected.
• The patient is then covered with sterile drapes.
• Three sterile drapes are required for this,approximately80×80cm

• The first sterile drape is placed on the upper part of the chair (back and headrest), where the patient lies.
• The second drape is folded in a triangle-shape and is placed on top of the first drape, where the patient will rest their head.
• The base of the triangle must be facing downwards, where the patient’s nape of the neck is, when the patient’s head is resting on the chair.
• The lateral corners of the triangular drape cover the head and are fastened with the aid of a towel clamp at the base of the nose.
• The third corner is lifted forward, over the scalp hair, and is also fastened at the base of the nose with the same towel clamp.

• The third drape is spread across the patient’s chest, up to the neck, and is fastened at the sides of the triangular drape with two towel clamps, leaving the area of the nose , mouth and inferior border of the mandible exposed

Question 9

PREPARATION OF SURGEON

Answer 9

• The preparation of the surgeon is necessary in all surgical procedures and includes the disinfection of hands and appropriate clothing.

Before this procedure though, the dentist must have put on:
- Shoe covers
- Cap covering the hair
- Surgical mask
- Face shield

• The disinfection procedure starts with cleaning the hands with soap.
• Scrubbing should be restricted to critically contaminated areas.
• For disinfection alcoholic solutions or alternatively disinfectant soaps are recommended.
• Depending on the detergent a total time of 3–5 min is recommended.
• First hands, arms and elbows, than hands and wrists and finally the
hands only are disinfected.
• Care should be taken so that no non-sterile areas above the elbows are touched during this procedure.

PREPARATION OF SURGEON
• Hand and arm preparation done by antiseptics with low toxicity like iodoform, chlorhexidine, and hexachlorophene.

Two techniques are used :
A. Clean technique- used in office based surgeries. Surgeon wears a clean
dress and over it long sleeved laboratory coat or a surgical scrub
B. Sterile technique- mostly in operating room. Purpose of it is to minimise the number or micro organism that can ener the wound site.

• After this procedure, the dentist wears the sterile gown, which is tied by the assistant , and then dons the gloves.
• The first glove is held by the right hand by the cuff and is placed on the left hand, while the second glove is held by its exterior surface by the gloved hand and is placed on the right

Question 10

SURGICAL INCISIONS AND FLAPS rules

Answer 10

• The incision must be carried out with a firm, continuous stroke, not interrupted strokes.
• During the incision, the scalpel should be in constant contact with bone.
• Repeated strokes at the same place, many times, impair wound healing.