Oral Surgery

1
Oral Surgery

• 02 / 08 / 08 Lecture 5

2
Causes of Subperiosteal Infections

• Bone debris
• Bacterial byproducts
• Metal filings
• All of the above

3
Pt presents w/impacted nasopalatine cyst. What
incision?

• Envelope flap.
• If you dont have enough access add more teeth to
  the flap

4
Nerves / Neurovascular bundles that you are
allowed to cut

• Long buccal
• Nasopalatine
• Just make sure that you are doing dentistry when
  you cut them dont cut them when you are
  gardening or grocery shopping because you might
  get sued. Youve been warned.

5
Easiest instrument to reflect a flap

• Molt curette

6
Sling suture good for

• Papilla approximation

7
Torri

• Gravity is our enemy when removing torri because
  gravity will pull down our flap so, what is
  done?
• Plastic stent for palate
• 7-10days
• Lab fabricated
• Leave baseplate thickness, please, for swelling
• If pt has no teeth?
• Drill holes in stent and suture it to palate!

8
Sinus anatomy clues

• When you see the sinus go off in its own
  direction, independent of the rooth, youre
  looking at overlapping structures low risk.
• If you see the sinus follow the tooth anatomy
  bad news be careful.

9
Most frequent perf of sinus?

• Caused by6 palatal root of maxillary first molars.

10
When is it ALWAYS surgical?

• Lone-standing molars in older patients are always
  surgical.
• There are other cases as well, discussed elseware.

11
Root morphology

• Thirds have greatest variability
• For thirds removal
• Want 1/3 of root to be formed (minimum)

12
Hypercementosis

• Something is going to break schedule four
  appointments for the extraction get Starbucks
• Just like Britney Spears

http//www.youtube.com/watch?vPDP2R97HVU0
13
For sinus perforations

• Prescribe
• Antibiotics
• Generally, amox 500tid for 7d
• Some may prescribe augmentin
• Decongestants
• Home care instructions

14
Removing a tooth is like removing what?

• Pole from a hole!
• Expansions of the bony socket is key
• Dilate the plate by emphasizing the movement
  where the bone is thinnest
• Generally the buccal

15
Pinch-grasp technique

• One is on the forcep, the other is on the buccal
  and lingal plate to help you feel the bone when
  it breaks

16
Thick / Thin

• The palatal bone is the thickest, the thinnest is
  over the cuspids