Textbook of Oral and Maxillofacial Surgery Neelima Anil Malik
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1Textbook of Oral and Maxillofacial Surgery2
3Textbook of Oral and Maxillofacial Surgery
Third Edition
Edited by Prof. Dr. Neelima Anil Malik BDS, MDS (Bom), FIAOS Principal, Professor and Head Department of Oral and Maxillofacial Surgery Krishna Institute of Medical Sciences Deemed University's School of Dental Sciences and Hospital Karad Dist. Satara, Maharashtra, India Former Dean Nair Hospital Dental College, Mumbai, Maharashtra, India Former Professor and Head and Professor Emeritus Department of Oral and Maxillofacial Surgery Nair Hospital Dental College (NHDC) Mumbai, Maharashtra, India Former Recognized Undergraduate and Postgraduate Teacher of University of Mumbai and Maharashtra University of Health Sciences Former Honorary Advisor and Consultant Armed Forces Medical College (Dental Faculty) Pune, Maharashtra, India First Lady President of Association of Oral and Maxillofacial Surgeons of India, 2003 Gold and Silver Medalist Nair Hospital Dental College (NHDC), Bombay University Recipient of Mumbai Mayor's Award, 2006 Recipient of Outstanding Teacher Award, 2011 Award given by Bitein—Premier Indian Dental Portal Foreword SG Damle
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This book has been published in good faith that the contents provided by the contributors contained herein are original, and is intended for educational purposes only. While every effort is made to ensure accuracy of information, the publisher and the editor specifically disclaim any damage, liability, or loss incurred, directly or indirectly, from the use or application of any of the contents of this work. If not specifically stated, all figures and tables are courtesy of the editor. Where appropriate, the readers should consult with a specialist or contact the manufacturer of the drug or device.
Textbook of Oral and Maxillofacial Surgery
First Edition: 2002
Reprint: 2005
Second Edition: 2008
Reprint: 2010
Third Edition: 2012
9789350259382
Printed at
5Dedicated to
Professor Dr M.S.N. Ginwalla
Pioneer of Oral and Maxillofacial Surgery (India)
LDSc (Bom 1938), DDS (McGill Canada,1940), FICD, FIAOS, FAMS, JP
Postgraduate Course (MSc) in Maxillofacial and Plastic Surgery
University of Toronto, Canada, 1942, under Dr F Risdon
Former Professor of Oral Surgery
Honorary Plastic Surgeon
Bai Yamunabai Laxman (BYL) Nair Charitable Hospital
Bombay, Maharashtra, India, 1945 to 1947
Honorary Plastic Surgeon
St George's and King Edward Memorial (KEM) Hospital
Bombay, Maharashtra, India, 1945 to 1955
Former Dean, Professor and Head and Professor Emeritus
Department of Maxillofacial, Plastic and Oral Surgery
Nair Hospital Dental College, Mumbai, Maharashtra, India
14-06-1963 to 13-06-1973 (Dean)
and
To all my esteemed teachers
with
Love and respect
and
To my husband Dr Anil Malik
and
To my daughter Dr Shambhvi Anil Malik6
7Contributors
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9
Dr SG Damle
Director
Medical Education and Public Health
Joint Municipal Commisioner (JMC)
Municipal Corporation of Greater Mumbai
Mumbai, Maharashtra, India
Foreword
It is my privilege to write a few words about the Textbook of Oral and Maxillofacial Surgery.
Textbook of Oral and Maxillofacial Surgery is well-orchestrated effort by the editor, Professor Dr (Mrs) Neelima Anil Malik, Head, Department of Oral and Maxillofacial Surgery, Nair Hospital Dental College (NHDC), Mumbai, Maharashtra, India. She is an academician par excellence. This, coupled with her skills and expertise in the field of oral and maxillofacial surgery, makes her an epitome for an ideal oral and maxillofacial surgeon and an eminent teacher.
The hallmark of the book is an extensive, pointwise coverage of the vast subject of oral and maxillofacial surgery in accordance with the syllabus of Dental Council of India and universities all over India. I am confident that the lucid well-illustrated book with easy language and concise tables will make an interesting and informative reading for undergraduate students.
The book has been authored by dedicated, outstanding, experienced clinicians and eminent teachers from India and will provide guidelines to safe and sound operative techniques suitable for the Indian subcontinent. The information provided in the book is the latest, taking into account the advances in science and technology in dentistry.
The editor deserves a hearty congratulation for all the efforts and hard work, she has undertaken. I am sure that the book will guide students into gaining an insight into the vast field of oral and maxillofacial surgery.
SG Damle
Dean, Nair Hospital Dental College (NHDC)
Mumbai, Maharashtra, India
Director, Medical Education and Public Health
Joint Municipal Commisioner (JMC)
Municipal Corporation of Greater Mumbai
Mumbai, Maharashtra, India
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11Preface to the Third Edition
My dear students and teachers,
It gives me an immense pleasure to connect with you all again, through this third edition of my Textbook of Oral and Maxillofacial Surgery.
This year, I have been voted as “Outstanding Teacher” (2011) by all my readers, well-wishers, all over the country, through The Premier Indian Dental Portal—Bitein. It always feels nice to be loved, appreciated and it encourages me more to contribute to the field of oral and maxillofacial surgery in my own humble way. Again ‘a big thank to everybody’.
I am presenting this updated third edition of my book to you all and wish that you will always support me by reading this textbook.
The highlight of this new edition is the updated knowledge and inclusion of new chapters dedicated to the new technology—Recent Advances in Oral and Maxillofacial Surgery, Cone Beam Computerized Tomography (CBCT), Lasers, Piezosurgery. An additional chapter is also added to implantology section. This would not have been possible without the unconditional support from my contributors for this edition—Professor Vidya Rattan, Professor Mushtaq I Parkar, Dr Shambhvi Anil Malik, Dr Prashant A Punde, Dr Nilesh Patil, Dr Mounesh Kumar and Dr Jayant Landge.
The new technology gives the power of precision in clinician's hands, but we have to keep in mind that it keeps transforming at faster pace. As professionals, we need to change, learn, evolve, grow and more importantly, do it almost overnight. Using the latest technology to the best of our advantage, is no longer a bonus—it is a requirement. The volume of information is overwhelming. The solution is to adopt a timeless methodology for how to separate the ‘wheat from the chaff’. We have tried to give comprehensive information of most of the updates in clinical practice. I hope its application in day-to-day clinical practice will benefit the patients.
I once again thank God almighty for his blessings in all my endeavors.
I also wish to convey my thanks to my earlier contributors, and of course, to M/s Jaypee Brothers Medical Publishers (P) Ltd, New Delhi, India, without their contribution, this third edition would not have been possible.
Recently, Shri Jitendar P Vij (Chairman and Managing Director), M/s Jaypee Brothers Medical Publishers (P) Ltd, New Delhi, India, has celebrated his successful 45 years of service in medical publishing.
During his journey, he has imparted knowledge to countless students, through his books, all over the world, and in turn, touched so many souls. My humble tribute to the passionate publisher Shri Jitendar P Vij. He has an amazing foresight in choosing his authors and he personally gives the much-needed support and encouragement.
My family members, my husband Dr Anil Malik, my daughter Dr Shambhvi Anil Malik, my friends and well- wishers have also contributed towards the success, by constant encouragement and support.
All the very best,
With warm regards,
Truly yours,
Love you all,
Neelima Anil Malik
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13Preface to the First Edition
This textbook is the natural outcome of having worked at one of the prime dental teaching institutes in India, where there is abundance of variety of clinical materials and excellent infrastructure, with my teachers, colleagues and good friends over the past twenty-seven years in various capacities. This text also represents many years of combined clinical research and experience at our institute.
The field of Oral and Maxillofacial Surgery has witnessed significant changes over the last two decades. These changes have improved our knowledge and understanding of the diagnosis and management of oral and maxillofacial surgical problems. The basic aim of this textbook is to incorporate this updated information and provide concise description of various oral and maxillofacial surgical procedures and current concepts and contemporary information.
The unique feature of this book is that it incorporates all of those various subjects, which are usually found in separate textbooks. We have taken efforts to present every chapter with updated text and to provide clear illustrations, wherever required.
The information given and the chapters mentioned in this book are based on the curriculum prescribed for undergraduate program for all universities in India.
We felt the need to incorporate the extensive section on anesthesiology, as this aspect is not covered adequately in currently available standard textbooks in the subject. For the first time in the history, the anesthesiology chapters are supplemented with color illustrations.
It has been observed that the current trend of the undergraduate students is not to refer to many textbooks, may be because of either the time factor or the lack of availability of books, etc. We, therefore, desired to accommodate maximum information in one single textbook (Local anesthesia is not included, as many good books are available).
The purpose of this book is to present as lucid and simple text as possible in the point format, without sacrificing the biological concepts.
Pains taking efforts are also made to create illustrations and to provide maximum clinical pictures in most of the chapters, which is an essential feature of the book.
The earlier publications by our predecessors and prominent workers in the field served as a valuable source of reference material for this book.
The book is basically intended for dental undergraduates, but would certainly be useful for postgraduates, general practitioners and teachers in the field.
I humbly request the teachers throughout the country to give suggestions, contributions for future additions.
As we begin with the first century of the new millennium, we hope that this textbook will provide the data and reference source to assist the clinician and others to face the oral and maxillofacial problems.
“Never must the physician say the disease is incurable. By that admission he denies God, our creator, he doubts Nature with her profuseness of hidden powers and mysteries.”
Paracelsus
I am very happy to present this textbook to the students all over the country, in the year, when I have been selected as “President Elect” of the Association of Oral and Maxillofacial Surgeons of India. I am grateful to all the members for giving me this opportunity to serve the fraternity.
Neelima Anil Malik
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15Acknowledgments
For the last many many years, I always dreamt of presenting a Textbook of Oral and Maxillofacial Surgery to the students all over the country.
First and foremost I have to thank “The Supreme Power—God” for giving me energy, inspiration and courage to complete this arduous task and to make my dream come true. Without “His” blessings nothing is possible.
I acknowledge my gratitude to Professor Dr SG Damle, Dean, Nair Hospital Dental College and Director, Medical Education and Public Health, Municipal Corporation of Greater Mumbai, Maharashtra, India. I am indebted to him for providing the facilities and opportunities, that made it possible to conduct the various clinical research and patient care, over the years, from which the clinical material for this text has been obtained. His constant encouragement and appreciation of the good work has always given us a boost.
My acknowledgments are also due to my all undergraduate teachers, who made the subject of oral and maxillofacial surgery so interesting, which inspired me to join the postgraduate studies in the subject.
I am indebted to my postgraduate teachers Professor Dr AP Chitre, Professor Dr KHC Kapadia and Professor Dr SK Dewan for their encouragement and guidance throughout my training program.
I would fail in my duty, if I do not mention late Dr Mrs Dhun Battiwala, who taught me my very first dental extraction. She and Dr AD'Costa supported me and helped me to continue my postgraduate studies along with the teaching job in the subject of oral and maxillofacial surgery, by exchanging their teaching posts with me. I am grateful to both of them.
A book of this magnitude was possible, only with cooperation of many individuals.
I would like to express my deep appreciation to all the contributors, whose untiring efforts have made this textbook possible.
My special thanks to the staff of the Anesthesiology Department of Topiwala Nair Medical College (TNMC) and Hospitals, Mumbai, Maharashtra, India, who have been always supportive for many many years and their contribution towards this book is also immense. Special credit goes to Professor Dr Mrs Divekar (Ex-Professor and Head of the Anesthesiology at TNMC) who developed the present ‘state-of-the-art‘ anesthesiology department at our institute. And later on, more advances were carried forward by Professor Dr Mrs Panchal—Previous Professor and Head of the Department of Anesthesiology at TNMC and Current Professor and Head of the Department, Professor Dr Mrs Kamdar. Their excellent techniques and constant support has always made our life easy and given us the opportunity for excellent patient care.
Professor Dr JN Khanna also deserves special mention, as I have had opportunity to work with him and to enrich my knowledge and skill and share the responsibility of the department of oral and maxillofacial surgery at Nair Hospital Dental College (NHDC), Mumbai, Maharashtra, India.
I acknowledge the unconditional assistance given to me in my day-to-day work, by my Associate Professor, Dr M Deshpande and Senior Lecturer, Dr P Solanki, and I also thank all teaching and nonteaching staff members of the department.
My special thanks to all my present and past postgraduate students for the stimulation and encouragement, I derived from their enthusiasm and interest in the field of Oral and Maxillofacial Surgery.
I am grateful and indebted to the following for their knowledge and assistance in specific areas:
Thank you all for your kind support and understanding.
I would like to thank Dr MI Parkar, our past student/resident and currently practicing Surgeon of oral and maxillofacial surgery, and teacher at Yerala Medical Trust's Dental College and Hospital at Navi Mumbai, Maharashtra, India, for his immense contribution towards the completion of this book.
Finally, my deep appreciation and love to my husband Dr Anil Malik for his personal sacrifice and constant support in permitting me to undertake and accomplish such a difficult endeavor and to my beloved daughter Dr Shambhvi Anil Malik for her motivation, inspiration and encouragement.
I am also grateful to Shri Jitendar P Vij (Chairman and Managing Director), Jaypee Brothers Medical Publishers (P) Ltd. New Delhi, India, who personally encouraged me to write the textbook.
On the occasion of releasing this third edition, I wish to thank profusely Shri Jitendar P Vij (Chairman and Managing Director), Mr Tarun Duneja (Director-Publishing) for publishing this book in excellent form. I thank the entire staff of Mumbai branch especially Mr CS Gawde (Branch Manager) and Mr Ramesh Krishnamachari (Commissioning Editor) for their cooperation and help.
I also wish to thank Mr KK Raman (Production Manager), Mr Sunil Kumar Dogra, Mr Manoj Pahuja,
Mr Dinesh Joshi, Ms Samina Khan and Mr Gyanendra Kumar, for giving competent technical support which has helped me to bring out this edition with added color and excellence.
Last but not least, I would like to mention that I am indebted to individuals (including patients) too numerous to mention separately.