Frequently Asked Questions: Oral Surgery Priya Verma Gupta, Vikram Shetty
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Oral and maxillofacial surgery
A surgical branch, to correct wide spectrum of diseases, injuries and defects in the head, neck, face, jaw regions and the hard and soft tissues of the oral and maxillofacial region. It deals with the art of diagnosis and treatment of various diseases, injuries and defects involving the orofacial region.
A process, which removes visible contamination but does not necessarily destroy microorganisms. It is a necessary prerequisite for effective disinfection or sterilization.
The avoidance of pathogenic organisms. It is the term used to describe methods, which prevent contamination of wounds and other sites, by ensuring that only sterile objects and fluids come into contact with them, and that the risk of airborne contamination is minimized.
Aseptic technique
It aims at excluding all microorganisms. Surgical technique is aseptic when sterile instruments and clothing and “no touch technique” are employed. It is the term used to2 describe methods which prevent contamination of wounds and other sites by ensuring that only sterile objects and fluids come into contact with them, and that the risks of airborne contamination are minimized.
The procedure or application of an antiseptic solution or an agent, which inhibits the growth of microorganisms, while remaining in contact with them, but does not necessarily imply sterility. The examples are scrubbing up and preparation of operative sites.
A chemical applied to living tissues, such as skin or mucous membrane, to reduce the number of microorganisms present by inhibition of their activity or by their destruction.
A process, which reduces the number of viable pathogenic microorganisms to an acceptable level but may not inactivate some viruses and bacterial endospores.
A chemical substance, which causes disinfection. It is used on nonvital objects to kill surface vegetative pathogenic organisms but not necessarily spore forms or viruses.
Critical Instruments
Instruments which penetrate mucous membrane or contact bone, the bloodstream or other normally sterile internal tissues, e.g., surgical instruments, scalpel, blades, surgical dental burs, needles, periodontal scalers, etc.
Semicritical Instruments
Instruments which contact mucous membrane but do not penetrate the soft tissues, e.g., mouth mirrors, dental handpieces, etc.
Noncritical Instruments
3Instruments, which contact intact skin. For example, X-ray heads, face bows, pulse oximeter, blood pressure cuff, etc.
The use of a physical or chemical procedure to destroy all forms of microorganisms including bacteria, spores, fungi and viruses. The term sterilization can only be applied to instruments, and not to skin, where only antisepsis can be achieved.
Infection is the deposition of organisms in the tissues and their growth resulting in a host reaction.
It is defined as an unpleasant sensational experience initiated by noxious stimulus and transmitted over a specialized neural network to central nervous system (CNS), where it is interpreted as unpleasant pain sensation.
Local Anesthesia
It is defined as transient reversible loss of sensation in a circumscribed area of the body caused by either a depression of excitation in nerve endings, or an inhibition of conduction process in the peripheral nerves, without loss of consciousness.
Anesthesia Machine
An equipment, by which the operator can deliver a desired concentration of a mixture of anesthetic agents (gases as well as liquids) in an inhalational (gaseous) form with oxygen and/or air, which serves as a vehicle to carry this mixture to its outlet.
Breathing System (Circuit)
4An assembly of equipment that not only carries anesthetic mixture from the outlet anesthesia machine to the patient, but also allows to monitor and control patient's breathing.
Pulse Oximeter
A non invasive equipment that allows to monitor continuously the oxygen saturation of the patient and also the heart rate.
An equipment that continuously records the carbon dioxide tension (in mm Hg or %) of the expired gas mixture (only numerical values as in capnometer or numerical value with graphical recording as in capnograph).
It is a branch of dentistry that deals with the extraction/removal of teeth. Howe had described an ideal extraction as the painless removal of the whole tooth/root with minimum trauma to the investing tissues (hard and soft), so that the wound heals uneventfully. Removal of a tooth does not require large amount of force, but fine and controlled force, so that the tooth is gently lifted from alveolar process and not pulled out.
Intra-alveolar extraction/traditional/conventional extrac-tion
Removal of a tooth/root by using specially designed dental forceps and elevators. It is also known as closed method of extraction. This method cannot be used in root deformities, hypercementosis, grossly decayed crown/root, brittle tooth/root, endodontically treated tooth/root. The procedure is also termed as simple extraction.5
Transalveolar extraction
A type of extraction which is carried out by planning surgical flap technique with alveolar bone removal and tooth sectioning of a tooth/root. It is known as open method for extraction or complex/complicated extraction procedure.
Impacted teeth
According to World Health Organization (WHO), an impacted tooth is the one that is unable to fully erupt in its normal functional occlusion/location by its expected age of eruption, because it is blocked by overlying soft tissue or bone or another tooth. Fully impacted tooth is completely encased in the jaw bone. Partially impacted tooth is the one, which is not completely encased in the jaw bone and has communication in the oral cavity.
Unerupted tooth
It is a tooth that is in the process of eruption and is likely to erupt, based on clinical and radiographic findings.
Malposed tooth
A tooth unerupted or erupted, which is in an abnormal position in the maxillary or in the mandibular dental arch.
Ankylosed tooth
Normal periodontal ligament between cementum and alveolar bone is absent and the tooth is fused to alveolar bone (associated with genetics and systemic factors).
Ectopic eruption
When the tooth is erupted away from its normal location and may be erupted in the position of another tooth or malposed in an abnormal location. Ectopic teeth are commonly seen in the palate and maxillary sinus, but6 cases also have been reported at unusual sites, such as the mandibular condyle, coronoid process, orbit and nasal cavity. Probable causes are trauma, pathology or congenital factors and genetics.
Transmigration of a tooth
Movement of a tooth from normal position to another abnormal location.
Supernumerary tooth
It is an extra tooth in addition to the normal permanent or deciduous teeth series.
Prenatal teeth
Extra teeth seen in infants.
It is a condition of having supernumerary teeth, which appear in addition to regular number of teeth. They appear in any area of the dental arch and can affect any dental organ.
Teeth that occur between or just posterior to the central incisors.
Teeth that erupt buccally or palatally to molars.
Teeth that are situated distal to the third molars.
It is the alternative surgical option, suggested for impacted mandibular third molars, which are in significantly close proximity to IAN. This method avoids injury to IAN.
Surgical endodontics
7The removal of pathologic tissues, other than the contents of root canal to retain a tooth, with pulpal/periapical involvement.
It is a Greek terminology meaning stiff joint orthe joint which cannot move. In temporomandibular joint (TMJ) ankylosis, it is basically stiffening (immobility) or pathological intracapsular fusion/union (either of fibrous tissue adhesion or bony deposition) between the head of the condyle and glenoid fossa articular area.
Internal derangement (ID)
It is a disruption of the internal aspects of the TMJ, in which an abnormal relationship exists between the disk and the condyle, fossa and articular eminence.
It is the excision of the condyle. This procedure had mixed results and multiple complications, particularly an open bite, malocclusion and deviation of the mandible on opening.
It may be performed to increase an access to the joint space for reconstruction of the disk, as well as to diminish the obstacle in the pathway of translocation.
Hemimandibular hyperplasia
This condition is characterized by a three-dimensional enlargement of one side of the mandible. Thus, there is enlargement of the condyle, the condylar neck, the ascending ramus and the body. The abnormal growth terminates precisely at the symphysis, giving rise to a sharp8 step in the mandible at that site and justifying the term hemimandibular hyperplasia.
Orthodontic camouflage
It is a biologically acceptable dental compensations, that has been built in, to mask the skeletal malocclusion, brought about by means of orthodontic treatment, in borderline skeletal deformities.
Orthognathic surgery
The art and science of diagnosis, treatment planning and execution of treatment by combining orthodontics and oral and maxillofacial surgery to correct musculoskeletal, dento-osseous and soft tissue deformities of the jaws and associated structures. In the severe skeletal deformities, orthodontics alone may compromise esthetics and stability and surgery alone, may compromise function and stability.
Distraction osteogenesis (DO)
The technique of bone lengthening in which osteotomized bone is moved apart and there is neo bone regeneration between the two separated bony ends.
A relatively common complication following fractures of the zygomatic complex. It is a blurred, double vision experienced by the patient.
Monocular diplopia
Double vision through one eye, with the other closed, requires the immediate attention of an ophthalmologist, as it indicates a detached lens or other traumatic injury of the globe.
Binocular diplopia
When looking through both eyes simultaneously, double vision is experienced by the patient. It is a common9 complaint and occurs in approximately 10–40% of zygomatic injuries.
It is the inward sinking of the eye. It is a troublesome sequel to the fractures of the zygomatic complex.
Comminuted fracture
A fracture in which the bone is splintered or crushed into multiple pieces. These types are generally due to greater degree of violence or high velocity impact. Gunshot wounds, where missiles are traveling at a high velocity can produce these fractures.
Complicated or complex fracture
Fractures associated with the damage to the important vital structures complicating the treatment as well as prognosis. Example–fractures with injury to the inferior alveolar vessels or nerves, facial nerve or its branches, facial vessels, condylar fractures with associated injuries to middle cranial fossa, etc.
Impacted fracture
It is rarely seen in mandibular fractures and more commonly seen in maxilla. This is a fracture in which one fragment is firmly driven into the other fragment and clinical movement is not appreciable.
Greenstick fracture
A fracture in which one cortex of the bone is broken with the other cortex being bent. It is an incomplete fracture seen in young children because of inherent resilience of the growing bone.
Pathological fracture
Spontaneous fracture of the mandible occurring from mild injury or as a result of a normal degree of muscular10 contraction. This is because of weakness caused due to the pre-existing bone pathological processes.
A cyst is a pathologic cavity or sac within the hard or soft tissues that may contain fluid, semifluid/semisolid or gas and not always lined by epithelium.
Tumor or neoplasm
An abnormal new, uncoordinated growth in the body, which results from excessive, autonomous, purposeless proliferation of cells, which continues, even after cessation of stimuli. Tumors are broadly divided into two groups–benign and malignant, depending upon their behavior pattern and cellular structure.
Odontogenic sinusitis
It is the inflammation of mucosa of any of the paranasal sinuses. Inflammation of either all of the paranasal air sinuses or most them simultaneously, is known as pansinusitis.
Acute maxillary sinusitis
Acute maxillary sinusitis may be suppurative or nonsuppurative (Catarrhal) inflammation of the antral mucosa.
Chronic maxillary sinusitis
Chronic maxillary sinusitis may be due to a persistent dental focus, chronic rhinitis, chronic infection in the frontal or ethmoidal sinuses, allergic conditions, etc.
Osteomyelitis (OML)
It is an inflammation of medullary portion of bone, bone marrow or cancellous bone.
Trigeminal neuralgia (TN)
11It is defined as sudden, usually unilateral, severe, brief, stabbing, lancinating, paroxysmal, recurring pain in the distribution of one or more branches of 5th cranial nerve.
Oral submucous fibrosis
An insidious, chronic mucosal condition affecting any part of oral cavity and sometimes pharynx, associated with fibroelastic transformation of juxtaepithelial connective tissue layer and epithelial atrophy leading to progressive stiffness of the oral mucosa causing trismus and inability to eat.
Bright red velvety plaque or patch that cannot be characterized clinically or pathologically as any other disease.
Orofacial clefts
They are congenital deformities, which manifest at birth. Any disturbance during the embryological formation and development and growth of orofacial region will result in the formation of orofacial clefts.12