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Synopsis of Oral and Maxillofacial Surgery (An Update Overview)
Pradip K Ghosh
ONE:
Sterilization and Disinfection
TWO:
Healing of Extracted Socket and Healing of Bone Following Fracture/Surgery
THREE:
Exodontics or Exodontia
FOUR:
Impaction
FIVE:
Common Precancerous Lesions and Oral Cancer
COMMON PRECANCEROUS LESIONS/CONDITIONS
Leukoplakia
Treatment Modalities of Leukoplakia (Figs 5.2 to 5.5)
Carcinoma in situ
Treatment Modalities CA in situ
Oral Submucous Fibrosis
Clinical Features
Clinical Classification of OSMF
Treatment Modalities of OSMF (Based on Modified Dictum of Prof Ravindra M Mathur)
Erosive Oral Lichen Planus
Epidemiology
Etiologic Factors
Treatment Modalities of Erosive Oral Lichen Planus
Querat's Erythroplakia
Treatment
Chronic Syphilitic Interstitial Glossitis
Treatment
Sideropenic Dysphagia (Plummer-Vinson Syndrome/Kelly Patterason Syndrome)
Treatment
Some Important Predisposing Factors for Precancerous Conditions
ORAL CANCER
Radiological Appearance of Oral Cancer
Types of Intraoral Malignancies
TRIAGE OF LESIONS
Carcinogenesis
Theories of Carcinogenesis
The Genetic Theory
The Multistep Theory
Immune Surveillance Theory
Monoclonal Hypothesis
TUMOR IMMUNOLOGY
Diagnostic Procedures
Etiopathological Observation of Oral Squamous Cell CA
Border's Classification
Classic Features of Malignant Ulcer
Treatment Modalities of Oral Cancer
Radical Neck Dissection
Clinical Staging of Cervical Lymph Nodes Metastasis by Anderson
Various Incisions Recommended for Radical Neck Dissection are Follows
Chemotherapy (Seldom Use Alone)
Irradiation (External or Interstitial)
Surgery with Radiation with Neck 4000 – 4500 r
Immunotherapy (Clinical trial)
Major Complication of Oral Cancer Treatment
SIX:
Biopsy
DEFINITION
Principles of Biopsy
Instruments for Biopsy
Incisional Biopsy
Excisional Biopsy
Aspiration Biopsy
Drill Biopsy
Punch Biopsy
Exfoliative Cytology
Fine Needle Aspiration Cytology
SEVEN:
TM Joint and Its Diseases
ANATOMICAL AND PHYSIOLOGICAL ASPECTS OF TM JOINT
Anatomical Consideration
Physiological Concept
Hypermobility
Subluxation
Clinical Classification
Treatment Modalities
Conservative Method
Surgical Methods
Injury to the TM Joint Causes Complications as Follows
Arthrosis
Arthritis
Rheumatic Arthritis
TMJDS/MPDS/Facial Arthomyalgia
Cardinal Signs
Diagnosis
Clinical Features
Treatment Procedure
Rowe's Proposed the Limited Mandibular Mobility into the following Categories
Trismus
Definition
*Modified Rowe's Classification of Trismus
Etiology of Pseudoankylosis
Etiology of Extracapsular Ankylosis
Etiology of Intracapsular Ankylosis
Universally-accepted Dictum or Protocols for the Management of TM Joint Ankylosis Recommended by Kaban, Perrot and Fisher 90
Aims and Objectives of Surgery as Summarized by Rowe
Surgical Modalities
Relapse may be Attributable to Three Factors
EIGHT:
Odontogenic and Non-odontogenic Cysts of Jaws
DEFINITION OF CYST
Modified Classification Recommended by Shear and Kramer
Simple Classification Recommended by Harris and Seward
Classification of Odontogenic Cyst Recommended by Charles A Waldron from Neville et al
Developmental
Inflammatory
An Analytical Observation
Growth and Development of Odontogenic Cyst
Cawson Summarized the Pathogenesis of Cyst Formation as Follows
Concept of Mode of Formation of Various Types of Developmental Odontogenic Cysts Cited from Lucas
Primordial Cyst (Keratocyst)
Clinical Features
Concepts of Recurrences
Radiological Features (Figs 8.2 and 8.3)
Pathogenesis (Fig. 8.4)
Investigation: Electorphoresis Study
Treatment
Dentigerous Cyst
Pathogenesis and Growth (Fig. 8.5)
Diagnosis and Investigation
Analytical Observation
Treatment
Dental Cyst (Radicular Cyst, Periapical Cyst) (Fig. 8.7)
Mechanism of Formation of a Dental Cyst
Treatment Method (Figs 8.8A to D)
Marsupialization or partsch operation (Fig. 8.9)
Residual Cyst
Treatment
Calcifying Epithelial Odontogenic Cyst (Fig. 8.10)
X-ray Findings
Pathogenesis
Histological Features (Fig. 8.11)
Treatment
Botryoid Odontogenic Cyst
Multiple Cystic Lesions of the Jaws
Basal Cells Naevus Syndrome or Gorlin and Goltz Syndrome
Non-odontogenic Fissural Cysts
Median Palatine Cyst
Median Alveolar Cyst
Globulomaxillary Cyst
Nasoalveolar or Nasolabial Cyst
Nasopalatine or Incisive Canal Cysts (Fig. 8.12)
Cyst of the Papilla Palatine
Median Mandibular Cyst
Non-odontogenic, Non-epithelium, Cysts- like Conditions, the Traumatic or Haemorrhagic Bone Cyst
Etiopathological Concepts
Soft Tissue Cysts of the Oral Cavity
Mucocele
Etiological Factors
Site
Treatment (Figs 8.14 and 8.15)
Ranula
Treatment
Aneurysmal Bone Cyst
Etiology
On Aspiration, Dark Venous Blood will come out from the Lesion
Treatment
Mandibular Salivary Gland Depression or Stafne's Idiopathic Bone Cavity
Clinical Features
Cysts Associated with the Maxillary Antrum
Surgical, Ciliated Cyst of the Maxilla
Etiopathogenesis
Clinical Features
Histopathology
Treatment includes Enucleations by Snawdon's Technique (Figs 8.17A and B)
NINE:
Role of Oral Surgeon in the Adjuvant Management for the Orthodontic Treatment
TEN:
Pain, PTN and Facial Palsy
DEFINITION OF PAIN
Concept of Basic Pain Physiology
Anatomy and Physiology of Pain
Pattern Theory
Components of Pain
Pain Perception
Pain Reaction
Pain Threshold
ELEVEN:
Diseases of Maxillary Antrum
ANATOMY AND PHYSIOLOGY OF MAXILLARY ANTRUM
Function
Importance of Surgical Anatomy of Maxillary Air Sinus
Radiology of Maxillary Sinus
Extraoral
Special Diagnostic Tests in Addition to the Radiological Methods
X-ray Shows the Haziness in OMV/Water's View Recommended by Water and Waldron
Treatment
Diagnosis and Management of the Displaced Root in the Maxillary Antrum (Figs 11.1 to 11.3)
Management
Postoperative Instruction and Advice
Advice
Recommended Surgical Technique by Ito and Hara
Buccal Fat Pad Transfer Surgical Procedure
Intranasal Antrostomy
Caldwell-Luc Approach
Treatment
TWELVE:
Surgical Endodontics
INTRODUCTION
Indications
Contraindications
Recommended Procedures
Steps of Surgical Procedures (Figs 12.1 to 12.5)
Obtained Local Anesthesia
Analytical Observation
Analytical Observation
THIRTEEN:
Odontogenic and Non-odontogenic Tumors
BENIGN ODONOTOGENIC AND NON-ODONTOGENIC TUMORS
Classification of Benign Odontogenic Tumor by Ivor RH Kramer, Jens J Pindborg and Mervyn Shear 1992
A. Odontogenic Epithelium Without Odontogenic Ectomesenchyme
B. Odontogenic Epithelium With Odontogenic Ectomesenchyme, With or Without Dental Hard Tissue Formation
C. Odontogenic Ectomesenchyme With or Without Included Odontogenic Epithelium
Classification of Odontogenic Tumor by Charls A. Waldron, 1992
A. Tumors of Odontogenic Epithelium
B. Mixed Odontogenic Tumors:
C. Tumors of Odontogenic Ectomesenchyme:
Analytical Observation
Classification of Benign Non-odontogenic Tumor of the Jaws by Ivor RH Kramer, Jens J Pindborg and Mervyn Shear 1992
Classification of Non-odontogenic Tumors and Fibro-osseous Lesions of the Jaw Bones
Odontogenic Tumors (Tumors Arising from Odontogenic Epithelium Without Odontogenic Ectomesenchyme)
Ameloblastoma
Clinical Features
Site
Age and Sex
Radiological Findings (Fig. 13.1)
Histopathological Features (Fig. 13.2)
Analytical Observation
Outline of Surgical Modalities of Jaw Tumors Including Ameloblastoma
Analytical Observation
Calcifying Epithelial Odontogenic Tumor (Pindborg Tumor): CEOT (Fig. 13.3)
Radiological Appearance
Histopathologically (Figs 13.4A and B)
Management
Squamous Odontogenic Tumor
Pathogenesis or Origin of Development
Radiological Appearance
Histopathology
Management
Clear Cell Odontogenic Tumor (CCOT)
Radiological Appearance
Histopathology
Management
Adenomatoid Odontogenic Tumor (AOT)
Pathogenesis/Origin
Radiological Appearance (Figs 13.5A and B)
Histopathology (Fig. 13.6)
Management
Odontoma
Histopathology
Management
Odontogenic Fibroma
Origin
Management
Odontogenic Myxoma
Radiological Appearance
Histopathology
Management
NON-ODONTOGENIC LESIONS OF THE JAWS
Ossifying Fibroma
Clinical Features
Radiological Appearance
Histopathology
Management or Treatment
Fibro-osseous Lesions of the Jaws
Classification of Fibro-osseous Lesion Modified from Charles A Waldron, 1993
Fibrous Dysplasia
Clinical and Radiological Features
Etiology: Idiopathic (Unknown)
Investigation
Histopathologically
Management/Treatment
Analytical Observation
Cemento-osseous Dysplasia
Periapical COD or Cemental Dysplasia or Cementomas
Focal COD
Florid COD
Treatment
FOURTEEN:
Some Soft Tissue Tumors and Central Oral Lesions or Tumors-like Growth
FIFTEEN:
Inflammation of Bone
SIXTEEN:
Various Common Sutures and Suture Technique
SEVENTEEN:
Clinical History and Examination in Oral Surgery and Some Dictum and Discipline
EIGHTEEN:
Orofacial Infection and Its Spread
KEY WORDS
Abscess
Infection
Inflammation
Discharging Sinus
Fistulae
Periapical (Dental) Abscess
Treatment
Periodontal Abscess
Treatment
Pericoronitis
Clinical Features
Treatment
Routes of Spread of Orofacial Infection
The Factors Influencing Spread
Local Factors
Spread of Infection
Fascial Spaces
Facial Cellulites
Treatment
Hilton Method
Treatment
Necrotizing Fasciitis
Cavernous Sinus Thrombosis
Treatment
Infection of Nonodontogenic Origin
Assessment of Infection
Treatment
Some Analytical Observations
Demands Intensive Immediate Antibiotic Therapy
NINETEEN:
Excerpts of Orthognathic Surgery
INTRODUCTION
Role of Orthodontics
Outline of Different Operative Techniques for Correction of Anterior Maxillary Segment
Line Diagram of Some Methods used to Treat Relative Mandibular Retrognathism and Maxillary Protrusion
ANALYTICAL OBSERVATION
ACKNOWLEDGMENTS
TWENTY:
Tidbits of Cryo and Laser Surgery Used in Oral Maxillofacial Surgery
CRYOSURGERY
Mechanism of Tissue Destruction Explained by Prof Poswillo
Dipstick Method
Spray Technique (Fig. 20.1)
Tissue Response (Fig. 20.2)
Indications and Contraindications of Cryosurgery
Contraindications
ANALYTICAL OBSERVATIONS
LASER SURGERY (Figs 20.3 to 20.5)
Development of Laser Technology
Laser types include
Advantages
Disadvantages
The Laser Surgical Environment
Q-switched Nd
Some Analytical Observations
TWENTY-ONE:
Hemorrhage and Shock
HEMORRHAGE
Hematoma
Hemolock (Feracrylum HCl)
Management
Shock
Hypovolemic Shock
Cardiogenic Shock
Septic Shock
Neurogenic Shock
Management of Vasovagal Shock
Prevention
Treatment
TWENTY-TWO:
Cleft Lip and Palate
TWENTY-THREE:
Dental Emergencies
TWENTY-FOUR:
AIDS and Oral Surgery
ACQUIRED IMMUNODEFICIENCY SYNDROME (AIDS)
Etiology
DENTAL IMPORTANCE AND CONSEQUENCES
Causes of Consequences
Group I
Group II
Group III
Laboratory Investigation
Erythematous and Pseudomembranous Candidosis
TWENTY-FIVE:
Maxillofacial Trauma and Management
INTRODUCTION
HEALING OF JAW FRACTURES
Factors which Delay Healing
Local
Systemic
Applied Surgical Anatomy
Clinical Features of the Maxillofacial Injuries
Etiology
Predisposing Factors
Presentation
Background
Medical History
General Assessment
Clinical Examination
Radiographic Investigations of Maxillofacial Injuries
Standard Projections
Maxillary Bones
Zygomatic/Malar Bones
Mandible
Frontal Bones
Other Projections Sometimes Used
Other Important X-rays
Principles of Management
Immediate Intervention
Treatment Priorities Includes the Above in Addition to
Treatment Require Urgently
TREATMENT THAT CAN WAIT: MAXILLOFACIAL TRAUMA
Treatment of Soft Tissue Injuries
GENERAL PRINCIPLES OF FRACTURE TREATMENT
Specific Injuries Requiring Specialist Attention
COMPLICATION OF MAXILLOFACIAL INJURIES
Problems Related to Healing of Fracture
COMPROMISED AIRWAY
Causes
Management of Compromised Airways
Infection
Causes of Fracture Site Infection
Dentoalveolar Injuries
Predisposing Factors
Classification
Dimitroulis Summarized the Injuries as
Classification of Mandibular Fracture on the Basis of Anatomical Consideration (Fig. 25.1)
LINDAHL, 1977 CLASSIFIED THE CONDYLAR FRACTURES (Fig. 25.3)
A. Fracture Level (Fig. 25.3)
B. Relation of Condyle to Mandible
C. Relation of Condyle to Glenoid Fossa of Temporal Bone
Clinical Features
Fracture Unilateral Condyle
Affected side
Opposite side
Clinical Features of Fracture Bilateral Condyle
Management
Conservative
Surgical Indications
Surgical Approaches
Clinical Features of Fracture Angle of the Mandible
Clinical Features of Body of the Mandible
Concept of the Reduction of the Fracture Fragment
Adaptational Technique of Fixation of Plate (Figs 25.6 and 25.7)
Compression Plating System
AO/ASIF Plating System
Compression Principles
Techniques
Material Used for Osteosynthesis
Advantages of Bone Plating
Fracture of Zygomatic Complex
The Function of Zygoma
Clinical Features of Zygomatic Fractures
Submento Vertex Method (Jug Handle View)
Surgical Approaches for the Management of Treating Zygoma Fracture
Percutaneous Approach
Method of Stabilizing Zygomatic Fractures
MID-FACE INJURY INCLUDING THE MIDDLE-THIRD FRACTURES OF THE FACIAL SKELETON
Planning of Surgical Treatment
External Skeletal Fixation
FRACTURE OF NASAL BONE AND NASOETHMOIDAL INJURIES
Reduction and Immobilization
Nasoethmoidal Injuries
Classification
Isolated Nasoethmoidal Injury
Combined Nasoethmoid Injury Plus Midface Fractures
Clinical Features
Outline of Treatment
Blowout Fractures
Clinical Features
Radiological Investigation
Outline of Treatment
Superior Orbital Fissure Syndrome
TWENTY-SIX:
Diseases of Salivary Gland
TWENTY-SEVEN:
Preprosthetic Surgery
ALVEOLAR SURGERY FOR RIDGE CORRECTION
Fraenectomy
THE SURGICAL TECHNIQUE OF FRAENECTOMY
ALVEOLAR SURGERY FOR RIDGE EXTENSION
Maxillary Procedures
Mandibular Procedures
Buccal Approach
Lingual Approach
Labiolingual Approach
ALVEOLAR SURGERY FOR RIDGE AUGMENTATION
Mandibular Augmentations
Maxillary Augmentation
Augmentation in Combination with Orthognathic Surgery
TWENTY-EIGHT:
Tidbits of Implants and the Role of Oral Surgeon
TWENTY-NINE:
Excerpts of Osteodistraction Technique
THIRTY:
Tissue Transplantation, Flap and Current Concept of Bone Grafting
TISSUE TRANSPLANTATION
Homogeneous Tooth Transplantation
Autogeneous Tooth Transplantation
Perspective of Biological Factors of Bone Graft
THIRTY-ONE:
Tidbits of Commonly Used Therapeutics in Oral Surgery
INDEX
TOC
Index
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