Periodontal and Oral Surgery Procedures

Question 1

Periodontal examintion and charting

Answer 1

In Periodontal practice, the dental assistant will assist with Periodontal
charting and Periodontal
surgeries, and provide home care instructions to the patient. Assistant also can remove or replace Periodontal
dressing,remove suures etc.

A thorough periodontal examination includes a variety of specific elements. The examination’s findings are recorded on a patient’s chart.

Patients are referred to Periodontist by general dentist or dental hygienist for treatment of a Periodontal
condition. After the Periodontal
Treatment, the patient chary will return to the general dentist for routine dental care.

*Periodontal examinations includes:
-medical and dental histories
-Radiographic evaluations
- examination of teeth
- examination of oral tissues
- examination detection of change in gingival health or bleeding of support structures
- assessment of the level of the bone
-detection of Periodontal pockets.

• Periodontal charting included:
  -pocket readings
  -furcations
  -tooth mobility
  -exudata
  -gingival recession

Question 2

periodontal pockets and mobility

Answer 2

periodontal pockets results when the gingival sulcus becomes deeper than normal. normal 3mm or less. The periodontal probing measure how much epithelial attachment has been lost to disease. The greater depth the greater loss of epithelial attachment and bone, and the more serious the periodontal pockets Disease.

periodontal pockets are very difficult and sometime impossible for the patient to clean. The bacteria in the periodontal pockets will multiply and if left untreated, the disease will progress until the tooth is ultimately lost.

It’s normal for teeth to have a slightly amount of Mobility because of the cushioning effect of periodontal membranes. However, excessive mobility can be indiction of the periodontal mobility.

Mobility scale:
0= normal
1= slight mobility
2. moderate mobility
3. extreme mobility

Question 2

medical and dental histories

Answer 2

For example, a patients with medical and dental histories Disease often complain of bleeding gums, loose teeth or bad taste in mouth.

early signs of medical and dental histories disease are change in gingiva color, size, shape, texture.

systemic disease can decrease resistance of tissue to infection. Lowered resistance make medical and dental histories disease more sever and more difficult to treat.

-Plaque Biofilm: early gingivitis that is composed of bacteria.

-Tooth mobility: refers to a loss of bone structure that supports a tooth that cause mobility in the socket.

-Calculus: is a plaque biofilm that has a chance to harden.

-suppuration: also known as pus it is composed if tissue fluid polymorphonuclear leukocytes and dead cells. The sign of this exudate is positive sign of information in the pocket.

-Width of attached gingiva: is continuous with gingival margin and tight bound to the underlying periosteum. It prevents the free gingiva from being pulling away from the tooth.

-Gingival Apperarance: this is an early indicator of existing health conditions or oral diseases. charting of changes in consistency ,color, contour, and shape f gingival tissue is an important part of the charing.

-Furcation involvement: this the loss f interradicular bone between multi-rooted teeth.

-Occlusion: documentation of occlusion or how the maxillary and mandibular teeth teeth is an important part of the dental record. Excessive force or abnormalities can led to serious problem.

-Periodontal probing depths: six measurements are taken of each tooth; this included distobuccal, buccal, mediobuccal, distorlingual, lingual mand mesiolingual. Normal depth for sulcus is 3 mm. A pocket depth greater than 3 mm is considered a medical and dental histories pocket.

Recession: this is the result of apical migration of the epithelial attachment that is measured with periodontal probe.

Question 3

Radiographs

Answer 3

The examination should include evaluation of plaque biofil, calacus, gingival appearance, periodontal probing depth, tooth mobility , location and extent of furcations, mucogingival relationships, bleeding, gingival recession and occlusal analysis.

during the periodontal examination, radiology might to taken to further evaluate and interpret the status of the periodontium and overall periodontal health of the patient. These x-ray will assist in revealing vertical or horizontal bone loss.

Question 4

periodontal probes

Answer 4

periodontal probes: instruments used to locate and measure the depth of periodontal pockets. Six measurements are taken and recorded for each tooth. The periodontal probe is tapered to be fit into the gingival sulcus and has a blunt or rounded tip.

Question 5

periodontal explorers

Answer 5

periodontal therapy requires the use of specialized instruction to remove calculus, smooth root surfaces, measure periodontal pockets, and perform periodontal surgery.

Explores: instrument used to locate supragingival and subgingival calculus deposits and provide tactile information to the operator about the roughness or smoothest of the root surfaces.

Question 6

scalers

Answer 6

scalers: instruments with pointed ends that are used to remove superagingival calculus. They are pointed ends that are used to remove supergingival calculus.

-sickles scalers: used primarily to remove large deposits of supragingival calculus.

-Chisel scalers: used to remove supragingival calculus in the contact area of anterior teeth.

-Hoe scalers: used to remove heavly supragingival calculus. hoes are most effective when usedon buccal and lingual sufaces of the posterior teeth.

-File scalers: considered a pull instrument, file scalers are used to remove overhanging restorations, and crush and break down calculus prior to curette use.

Question 7

Curettes

Answer 7

Curettes have rounded ends that are used to remove subgingival calculus, smooth rough root surfaces (root planing), and remove the diseased soft-tissue lining of the periodontal pocket (soft-tissue curettage). They have two basic designs.

• Universal Curettes: Curettes are designed so that one instrument can be used on all tooth surfaces. There are two cutting edges, one on each side of the blade. Universal curettes resemble the spoon excavators used in restorative dentistry.
• Gracey Curettes: Gracey curettes have only one cutting edge and are area specific—that is, they are designed for use on specific tooth surfaces (mesial or distal). Treatment of the entire dentition requires the use of several curettes.

Question 8

Ulterasonic scaler

Answer 8

Ultrasonic Scaler: a spray of water at the tip prevents the buildup of heat.

The ultrasonic scaler rapidly removes calculus and reduces hand fatigue for the operator. The ultrasonic scaler works by converting very high frequency sound waves into mechanical energy in the form of very rapid vibrations. A spray of water at the tip prevents the buildup of heat and provides a continuous flushing of debris and bacteria from the base of the pocket.

Because of the spray of water at the tip, there is a large amount of potentially contaminated aerosol spray. It is highly desirable for the operator of an ultrasonic scaler to have the dental assistant help by using the high-volume evacuator to minimize aerosol contamination.

An ultrasonic scaler is suitable for a number of procedures, including:
* Removing supragingival calculus and difficult stains
* Removing subgingival calculus, attached plaque, and endotoxins from the root surface
* Cleaning furcation area
* Removing deposits before periodontal surgery
* Removing orthodontic cements; debonding.
* remove overhanging margins of restorations.

Question 9

Ultraspnic scaler precaution

Answer 9

special precaution should be used in certain situation. In some cases, the use of an ultrasonic scaler is not advised.

-Communicable disease: patient with known communicable disease that can be transmitted by aerosols, such as tuberculosis, poses a risk to the operator.

• Immuncompromise: a compromised patient is ope to infection.
• Respiratory problem: materials can be aspirated into the lungs of patient with respiratory problem.
• swallowing difficulty: problems with swallowing or a severe gag reflex make treatment hazardous.

-Cardiac pacemaker:
-Demineralized areas: ultrasonic vibrations can remove any aeea of remineralization.

-Exposed dentinal surfaces: tooth structures can be removed, resulting in tooth sensitivity.

-Restorative materials: some restorative materials such as porcelain amalgam, composite resins and laminate veneers can be damaged by ultrasonic vibrations

Titanium implant abutments: unless a special plastic sheath is used to cover the tip, the ultrasonic tool will damages titanium surfaces.

Question 10

Periodntal knives

Answer 10

There are two different types of the periodontal knives commonly used.

• Kirkland knife: is one of the most commonly used knives in periodobtal surgery. These instruments usually are double ended with kidney shaped blades.

-Orban knife: used to remove tissue from the interdental areas. These knives are shaped like spears and have cutting edges on both of their blades.

Question 11

Pocket markers

Answer 11

Pocket markers: an instrument similar in appearance to cotton pliers; however, one tip is smooth and straight ad other is sharp and bet at the angle.

Question 12

Periodontal instruments

Answer 12

Many instruments are used in the treatment of Periodontal disease

-Hemostate: an instrument that can be used with one had to grasp, clamp off blood vessels and retract tissue.

-Tissue forceps: an insturment used to retract or hold tissue during surgery. The design is similar to a hemostat.

• needle holders: a forceps with a shorter, straighter beak that has a notch down the center of the beak. The notch allow for handling oof suture needle.

-Soft tissue rongerurs: hinged pilers used to remove bony fragments and tissue tags and shape tissue.

• Periodontal scissors: an instrument with long blades used to remove tags or cut sutures.

-Periosteal elevators: an instrument with long tapered end and a rounded end used to retract soft tissue away from the bone.

Question 13

Dental prophylaxis

Answer 13

Commonly referred to a prophy or cleaning prophylaxis is the complete removal of calculus, soft deposits, plaque, and stains from all supragingival and unattached subgingival tooth surfaces. The dentist an dental hygienist are the only members of the dental health team who are licensed to perform this procedure.

prophylaxis is indicated for patients with healthy gingiva as a preventive measure and is most commonly performed during recall appointment. Dental prophylaxis is also the primary treatment for gingivitis.

Question 14

Scaling, Root Planing, and Gingival Curettage

Answer 14

Scaling and root planing are non surgical treatments for type Il and III cases. In some cases, gingival curettage, a non surgical technique, also is needed. These procedures are necessary for dental health because they help return the tissues to a healthy state. A local anesthetic is usually administered before the procedure Scalers are used to remove supragingival calculus from the tooth surface. Curettes are used to remove supragingival and subgingival calculus. Some areas on the root surface remain rough after calculus removal if the cementum has become necrotic; the surface also remains rough if the scaling has produced grooves and scratches in the cementum. Root planing is performed after scaling procedures to remove any remaining particles of calculus and necrotic cementum embedded in the root surface. After root planing, the surfaces of the root are smooth and glass like. Smooth root surfaces resist new calculus formation and are easier for the patient to keep clean. Some patients also require gingival curettage. Gingival curettage, also referred to as subgingival curettage, is the scraping of the gingival lining of a periodontal pocket. This is performed to remove necrotic tissue from the pocket wall.

Question 15

Antimicrobial and Antibiotic agents

Answer 15

Antimicrobial and antibioic gents are used to treat some forms of periodontal disease

-Tetracyline: is an antibotic that is paarticularly used for the treatment of periodontitis early onset periofontitis and rapidly destructive periodontitis. An important side affect of tetracycline is its interference with the effectiveness of birth control pills.

Penicllin: is less effective against periodontal Disease infections than other antibiotics because many periodontal pathogens are resistant to it.

• Fluoride mouth rinses have been shown to reduce bleeding by delaying bacterial growth in the periodontal pockets.

-Chlorhexidine: a twice daily of Chlorhexidine rinse is most effective means available for reducing plaque and gingivitis. Chlorhexidine can cause some temporary brown staining of the teeth, tongue and resin restorations.

Question 16

Overview of periofontal surgery

Answer 16

Periodontal surgery is indicated to control the progress of periodontal destruction and loss of attachment when nonsurgical treatment is not enough to arrest the disease process.

The primary advantage of periodontal surgery is that it allows access to the root surface for scaling and root planing. Periodontal surgery also results in better access to furcations and other areas that are very difficult to reach during traditional scaling and root planing. After surgery, patients find it easier to clean difficult areas.

The health status of the patient or age of the patient, as well as limitations of the procedures, might mean that periodontal surgery is not an option. From the patient’s point of view, the disadvantages of surgery include time, cost, aesthetics, and discomfort. If you develop a good rapport with patients, you will be in a unique position to discuss these concerns with the patient.

The amount of bone remaining around a tooth is an important consideration in the decision to perform periodontal surgery. When there is a large amount of bone around a tooth, the dentist might take a wait-and-see approach, postponing or avoiding periodontal surgery. When this approach is taken, it’s important for the patient to practice excellent home care and receive routine dental care.

If the amount of bone is already reduced, delaying the surgery decreases the chance of saving the tooth.

Question 17

Grafting techniques

Answer 17

Treatment of mucogingival defects might involve surgery.
There are many grafting techniques used to restore and repair gingival tissues.

-Free gingival graft: Tissue us taken from the hard palate and used to cover areas where is inadequate or insufficient attached gingiva. The graft contains surface epithelium and underlying connective tissue.

-Connective tissue graft: this treatment uses connective tissue harvested from the palate. The tissue is places under a small flap at the receptor dit. This graft results in a more natural color at the graft site.

-Allograft: this is a connective tissue graphy that involves a donor graph. The tissue is decellularized to extract living cells. WHile this procedure required less surgery for the patient, it does increase the incidence of rejection.

-Frenectomy: removal of frenum inclsing attachment to the underlying bone. A lingual frenectomy is utilized when the frenum is too close to tip of the tongue a condition referred to as “ankyloglossia” in a maxillary baial frenectomy, a triangular piece os tissue is removed along with the frenum. It is used when the diastema between teeth 8 and 9 is too large.

Question 18

Excisional periodontal surery

Answer 18

periodonal surgery involves incisional surgery or excisional surgery.

incisional surgery: also known as periodontal flap surgery or simple flap surgery, it is performed when excisional surgery is not indicated.

excisional periodonal surgery is used to remove excess tissues. it’s most rapid means of reducing periodntal pockets.

Gingivectomy and gingivoplastry are coomon types of excisional surgeries.

Gingivectomy: is the surgical removal of diseased gingival tissues. This procedure is performed when it is necessary to reduce the depth of the periodontal pocket and to remove fibrous gingival tissue. The surgical procedure involves making bleeding points with the use of pocket markers and removing the gingival tissues with periodontal knives and scissors. Recently, the use of dental laser equipment in gingivectomy has become popular. After the healing process, it’s easier for the patient to clean an area in which the pockets have been reduced.

Gingivoplasty: involves the surgical reshaping and contouring of the gingival tissues. The presence of deep periodontal pockets with fibrous tissue is the main indication for both gingivectomy and gingivoplasty. Both procedures are often performed simultaneously. During gingivoplasty, the gingivae are recontoured with the use of periodontal knives, rotary diamond burs, curettes, and surgical scissors. Gingival margins are thinned and given scalloped edges.

Question 19

Incisional periodontal surgery

Answer 19

three common types of Incisional periodontal surgery

• Osseous surgery: is performed to remove defects and to restore normal contours in the bone. Two types of bone surgeries are osterplasty and osterctomy. Each requirers surgical exposure of bone, followed by recanting with the use of a rotary diamond bur or a bone chisel.

-Osteoplasty: or additive surgery, bone is contoured and reshaped. In addition, bone might be added wither through bone grafting or placement of bone substitute materials. This procedure is useful in some patient with bone defects caused by periodontal disease.

-Ostectomy: or subtractive surgery, bone is removed. This procedure is neccessary when the patient has large exostoses. For example ostectomy is performed if a patient needs a denture and bony growth would interfere with the comfort and fit of the denture.

Question 20

Postsurgical Patient Instructions

Answer 20

After periodontal surgery, the periodontist will most likely prescribe an analgesic and possibly an antibiotic. Many periodontists recommend the use of an antibacterial rinse twice a day to help control plaque. A chlorhexidine mouthwash also might be used to freshen the mouth and inhibit plaque formation during the early stages of healing. Postoperative instructions should be given to the patient to ease discomfort and promote healing. A periodontal surgical dressing is much like a bandage over the surgical site. Periodontal dressings, also known as periopacks, are used to:
* Hold the flaps in place.
* Protect the newly forming tissues.
* Minimize postoperative pain, infection, and hemorrhage.
* Protect the surgical site from trauma during eating and drinking.
* Support mobile teeth during the healing process.

A variety of materials for periodontal dressings are on the market. The most commonly used materials are:
* Zinc oxide-eugenol (ZOE)
* Noneugenol

Question 21

Zoe dreassings

Answer 21

Zinc oxide eugenenol: dressings are supplied as a powder and a liquid are mixed before use. the materilas can be mixued ahead of time, wrapped in waxed paper, and frozen for future use.

Zoe has a slow time which allows doe a longer working time. Zoe sets to firm, heavy consistency and provides good support and protection for tissue and flaps.

patients might experience redness and buring pain in the area oof dressing.

Noneugenol dressing is most wide type of periodontal dressing. It’s supplies in two tubes: one of base material and the other of accelerator. It’s easy to mix and place, and has a smooth surface for patient comfort.

Question 22

Equipment and supplies for ZOE dressings

Answer 22

review the equipment and supplies here used to mix the zoe dressing. Note that noneugenoldressing has a rapid setting time if exposed to warm temp. It cannot be mixed in advance and stored.

-Paper mixing pad
- wooden tongue depressor
- noneugenol dressing
- paper cup filled with room temp water
-saline solution
-plastic type filling instrument

Question 23

Advantages of laster surgery

Answer 23

The advantages of laser surgery over conventional surgery are listed here:

• Laser incisons heal faster than incisions made with electrosurgery
• hemostasis
• thee surgical field is relatively dry
• the opportunity for bloodborne contamination is reduced
• there is less trauma to adjacent tissues
  -There is less postsurgical swelling, scarring, and pain
  -some procedures can be performed more quickly
  -patient who are afraid of surgery might accept this method.

Question 23

Lasers in periodontics

Answer 23

A laser beam is a highly concentrated beam of light. The power of this beam can be adjusted to enable it to cut cauterize tissue. the use of lasers s promising new technology is density. Research that might lead to more widespread uses of lasers in clinical dentistry continues.

Lasers can be used to perform procedures on soft tissues, such as

• removal of tumors and lesions
  -vaporization of excess tissues, as in gingivoplasty, gingectomy, and frenectomy

-removal of or reduction in hyperplastic tissues
-control of the bleeding or vascular lesions.

Question 24

laster safety

Answer 24

-Shielded eyeglasses: to protect the eyes the dental staff and the patient must were special shielded eyeglasses,

-Matte finished instruments: reflective surfaces on instruments, mirror and even polished restoration can reflect laster energy. The matte finish minimizes reflection.

-protection of nontarget tissues: Tissue not being treated with the laster. should be shield with the use id wet gauze packs.

-High volume evacuation: hhigh volume evacuation should be used to draw off the pulme (cloud) create when tissue vaporize. This plume should should be considered iinfections.

Question 25

Oral and maxillofacial surgery

Answer 25

Oral and maxillofacial surgeryL is specialty of dentistry involving the diagnosis and surgical treatment of disease , injuries and defects. It surgically treats and corrects injuries and diseases of the head, neck, and jaw. it can also include treatment of the hard and soft tissue of the oral area.

Question 25

oral surgery procedures

Answer 25

The oral maxillofacial surgeon (OMFS) has received an additional 4 to 6 years of training beyond the DDS/D<D degree. The surgeon might have also received a medical degree as part of the extensive training program.

AN oral surgeon performs a variety of procedures:

1. extraction of decayed teeth that cannot be restored
2. surgical removal of impacted teeth
3. extraction of nonvital teeth
4. preprosthetic surgery to smooth and contour the alveolar ridge.
5. removal of teeth for orthodontic treatment
6. removal of root fragments
   7.removal of cysts and tumors
7. biopsy
   9.treatment of fractures of the mandible or maxilla
8. surgery to alter the size or shape of facial bones
9. surgery of the temporomandiblular joint
10. reconstructive surgery
11. cleft-lip and cleft palate repairs
12. salivary gland surgery
13. surgical implant procedures

Question 26

Dental surgical assistant

Answer 26

Maxillofacial surgeries take place in a dental operatory, a surgical suite, or an operating room. Regardless of the location, surgical assistants are an integral part of the surgical team. The surgical assistant must have advanced knowledge and skills in:
* Patient assessment and monitoring
* Specialized instruments
* Surgical asepsis
* Surgical procedures
* Pain-control techniques The dental assistant assists the oral surgeon.

Question 27

Specialized surgical instruments

Answer 27

It is critical for the surgical assistant to have a working knowledge and understanding of surgical instruments.

Three instruments that are commonly used after the tooth has been removed from the socket are the rongeur, sugerical curette and bone file.

• Rongeur: Hinged instrument similar to a fingernail clipper. During a procedure, sharp edge must be kept with gauze squares.

-Surgical curette: This instrument is used to clean and scrape the interior of the tooth socket to remove diseased tissues. The double ended type is the most commonly used. It is a smaller. working end.

-Bone file:this is great instrument that us used in a push pull motion to smooth rough margins of the alveolus.

Question 28

Elevators and forceps

Answer 28

Elevators are used to apply leverage aginst the tooth to loosen it from the periodontal ligament and ease extraction. There are different types of elevators and each one is used for specific purpose for example:

• The periodteal elevator is used to eparate the periosteum from bone.

-The straight elevator is the most common elevator used to remove a tooth and it’s roots.

-Root-tip pick is an elevator used to remove fractured roots and root tips

Forceps have a handle, neck and beak. They are used to grasp the tooth with maximum contact on the facial-lingual aspects of the roots just below the cervix. They can be identified by shape or number and are designed as left and right pairs.

Question 29

Bastic surgical instruments

Answer 29

used in basic procedures:

-Dressing pliers: dressing pilers are tweezers with serrated, pointed backs used for picking up items

-scalpel: surgical knife used to make precise incisions into soft tissue

-hemostat: is used to grasp and hold things

• Needle holder: is ised to firmly grasp a suture needle.
• surgical scissors: used to trim soft tissue

-suture scissors: are used to cut suture materials.

-Retractors: used to hold or retract tissue during surgery.

Question 30

more basic surgical instruments

Answer 30

-Mouth propL known as bit-block, this instrument allows the patient to rest and relax the jaw muscles during surgery.

• Surgical aspirators: a narrow suction tip used to aspirate the socket
• chisel: single type used for remove bone

-Mallet: provide a source of pressure used on the chisel handle.

-surgical burs: surgical burs ae used to remove bone or to cut split the crown or root of teeth.

-suture needle and materials: used to close a wound or incision. The needle can be straight or curved and utures can be resorbable or non-resorbable.

Question 31

Surgical asepsis

Answer 31

because surgical procedures invade open tissue, the surgical team must follow procedures known as chain od asepsis.

Surgical asepsis is the absence of microorganisms in the surgical field. It is required to prevent infiltration of an open wound. The surgical team must be use a surgical scrub and sterile gloving.

Question 32

Preparing for surgery

Answer 32

Surgery assistant perform as number of important tasks during ,prior and after surgery.

-Preiminary preparation: The surgical assistant ensures that;
* All patient records and radiographs are in order
* Consent forms have been signed and are available
* Information requested from the patient’s physician has been received
* Laboratory cases have been checked
* Surgical setups have been prepared and sterilized
* Preoperative instructions for any premedication have been prepared.

-Preparing the treatment room:
The surgical assistant prepares the treatment room by:
* Placing protective barriers
* Keeping surgical instruments in their sterile wraps until they are to be used
* Having the appropriate pain-control medications set out and ready for administration
* Having the postoperative instructions ready to provide to the patient
* Placing the radiographs on a view box.

-Preparing the patient: The surgical assistant prepares the patient by:
* Updating the medical history and laboratory reports
* Confirming with the patient that any prescribed premedication was taken as directed
* Taking vital signs for a baseline
* Seating and draping the patient
* Positioning the chair

Question 33

oral surgery assistant’s role

Answer 33

During the surgery
-maintain the chain of asepsis
- transfer and receive instruments
-provide aspiration and retraction as needed
- maintain a clear operating filed with light
- monitor the patient’s head and mandible if necessary
- stread the patient’s head and mandible if necessary
-Observe the patient’s condition and anticipate the surgeron’s needs.

After the surgery
- Stay with the patient
- give verbal and written postoperative instructions
-schedule a postoperative visit
-update the patient’s treatments records
- return the patient’s recoreds to the business assistant
-break down and disinfect the treatment area.
-

Question 34

Extractions

Answer 34

Tooth extraction might be necessary in certain situations. Forceps extraction is the surgical removal of a tooth that is fully erupted and has a solid, intact crown that can be grasped firmly with the forceps.

Alveoloplasty is a multiple extraction procedure involving the contouring and smoothing of the alveolar crest of the surgical site. It is most commonly done when a partial or denture is being constructed. It can involve multiple extractions in different arches. The procedure is the same as a forceps extraction.

After a tooth is extracted, the surgeon might perform an alveolectomy. This procedure removes alveolar bone crest that might have remained after tooth extraction and prepares the alveolar bone for denture placement.

The removal of an impacted tooth is a complex extraction of a tooth that has not erupted. There are two types of impactions:
* Soft-tissue impaction in which the tooth is located under the gingival tissue
* Hard-tissue impaction in which the tooth is covered by tissue and bone

Question 34

Biopsy

Answer 34

Biopsy is the surgical removal and examination of lesions in the oral cavity

-Insisional Biopsy: is a procedure in which only part of the suspicious area is removed for examination and diagnoosis.

• exisional Biopsy: is a procedure in which the entire suspicious area is removed for examination and diagnosis.

-exfoliative Biopsy: is procedure in which cells are brushed or scraped from the durface for examination and diagnosis.

Question 35

Oral surgery procedures

Answer 35

• Arthrotomy: used to treat TMJ. The mandible is reconstructed and realignd

-Cleft lip, palate and tongue: result of failure of the median nasal process and one or both maxillary processes to fuse.

-cyst removal: common oral cysts are dentigerous, mucocele, radicular, and radicula. Cysts are fluid filled sacs.

-Drainage of facial infections: cellulitis or abscess the surgeon makes an incision into the infected area to drain the infected matter.

-Exodontia: is removal of a tooth. It is referred to as simple extraction.

-Exostosis: Refers to growth of new bone one boe that might be painful. The surgeon might remove this bone in preparation for dentures.

-Fractures: An open fracture requires osteomy and rigid flextion with pplate, pinm mesh or graphs.

-Frencectomy: is removal of frenum including attachment to the underlying bone.

Question 36

More oral surgery procedure

Answer 36

Genioplasty: contouring the bone of chin or cheek for restorative or cosmetic purpose.

-Gingivectomy and gingivoplasty: is periodotal surgical procedure that removes and reshapes loos diseased gingival tissue to get rid of pockets between the teeth and gum. Gingivoplasty is excisional periodontal surgery that reshapes and contours the gingiva.

-Implantology: is placing of dental implant. The oral surgeon might work in conjunction with the general dentist.

Oral pathology and tumors: refer to lesion of the intra and extraoral region of the mouth the tumors can be benign or malignant.

-periodntal flap surgery: tissues are sectioned or removed. this might be done to gain access tot he roots or clear tissue taht obstructs taht crown, crown,casing irritation or infection.

-Surgical endodontics: is the opening of the periodontium, inclusing ome alveolar bone to remove the root apex.

-surical orthodotics: to restore facial aesthetics and function to patient following trauma or result of a congenital or developmental condition .

Question 37

sutures

Answer 37

sutures : are the stitches places to control bleeding and promote healing. sutures can be absorbable or nonabsorbable.

of the absorbable sutures, plain catgut provides the fastest healing for mucous membranes and subcutaneous tissue. chrmic catgut proviides a much lower healing

Nonabsorbable sutures including silk, polyester fibers and nylon. silk is used for its strength and ease of use. Polyester fiber is one of the storngest strucres.Nylon is used for its strength and elasticity.

Question 38

Postoperative care

Answer 38

after surgery, Postoperative care is important to patient’s recover. Bleeding and swelling must be controlled.

Alveolitis: is a postoperative complication caused by nor more more of the following factors:

• Inadequate blood supply to the socket
• trauma to the socket
• infection within the socket
  -dislodgment of the colt from the socket

Cotronlling post-operative bleeding: To control postoperative bleeding, a 2-by-2-inch piece of gauze is folded and placed over the site. It will encourage clot formation and healing. Patients should:
* Keep gauze in place for 30 minutes.
* Call the dental office if bleeding does not stop.
* Avoid disturbing the clot with their tongue or by rinsing their mouth vigorously.
* Restrict strenuous work or physical activity that day.

Controlling post operative swelling: To control postoperative swelling, patients should:
* Use Ibuprofen before and after surgery.
* Place a cold pack in a cycle of 20 minutes on/20 minutes off during the first hours following
* Apply external heat to the area of the face in question to increase circulation in the tissues and to promote healing after the first 24 hours following surgery.
* Begin gently rinsing the oral cavity with warm saline solution after the first 24 hours following surgery.