oral_surgery.docx - MY TOOTHY by linzhengnd


									                                    Oral Surgery
We already have been exposed to different topics in dentistry probably the one which
will connect you mainly to medicine is surgery ,because you will be dealing with patients
with blood.. and you have to take good care with all of this to be prepared to any
surgical procedure.

We have two different terms, oral surgery and Maxillofacial Surgery :

Oral surgery is that aspect of surgery which you deal only with the oral cavity dental
extractions so whether it’s simple or surgical extractions of teeth you will be dealing
with some of oral infections…Etc

While the Maxillofacial Surgery is applied to maxillo from maxilla,facial from the face
where you will be dealing from the frontal bone to the mandible,and also its are
involved with the stages of cancer and its diagnosis.

So Maxillofacial Surgery are usually occupied in hospitals and they will be dealing with
patients under general anesthesia doing different kind of things.

“ there is a patient behind every tooth “ what does that mean ?

that means we are dealing with a patient with medical underlying , Oral problems and
disease (for example Diabetes) ,so you will have to know how to deal with this
hypertensive patient and be promised in our attitude.

Scope of Oral and Maxillofacial Surgery

1- Odontogenic infections
Odontogenic infection means inflammatory process caused by micro organisms, occurs
in the dental origin either the tooth , gum or the bone.

we can classify the causes to Bacterial viral or fungal

We can classify the infections to acute which means rapid, or chronic which is long
period of time .

When you have a patient with an acute infection whether its related to the oral cavity or
related to any part of your body there are clinical pictures :

General picture: fever , tonsillitis ‫, التهاب لوز‬no good appetite for eating .
Local picture : or what do we see in the mouth ,it depends on the type of the infection,
mostly like swelling in the mouth or white spots adjacent to the tooth or to the area of
the infection .

Treatment: by first removing the abscess (if there any) by incision or by extracting the
tooth, or remove the draining ,second give antibiotics, then remove the original cause
and fill up

if you don’t treat the infection in the appropriate time or way it might go to the skin
(leave ugly scar) and things will become worse

Infections sometimes can be detected by radio , refer to slide 10

2-Cysts of the jaw
Cysts is a pathological cavity within the bone ,filled with fluid or semi fluid material
(yellow like) its an abnormal present it should be not be there.

The mandible is a solid bone . When you start having a cysts it means the bone is
emptied, if you leave it for a long time (and usually you don’t know about it) the bone
will continue to be emptied and the bone will eventually fracture .

Cyst wall is an epithelium tissue and appears as a puffiness in the face .

How can we indicate it? Mainly on x rays as a radio lucent Area cavity in the bone

Treatment: We have to remove it by surgery.

Refer to slides .

3-Orthognathic Surgery
What is orthognathic surgery? Surgeries used to correct the abnormal relationship
between the maxilla and the mandible


When the jaw is advanced more then the other ( forward or backward)

When there is no occlusal (the patient cant eat)

Anterior open bite (you cant close your mouth)
So its needs are cosmetics and functional

Treatment: major surgery cutting the jaw and reposition it ‫بنحطه بمكان تاني‬

If not treated you will have psychological effects, it will affect the joint that is Tmj is an
articulation between the mandible and the base of the skull (you open and close your
jaw through this joint )

Its important for mastication and speech

What might go wrong or what is the disorders?

Falling on the teeth and not knowing that a fracture happened ,and as you grow older it
will cause the joint to fuse with the base of the skull, and not being able to open your
mouth beside 2 or 3 mls, and then you will have to take a rib from the chest (slide 36-
37) and grab it to the joint.

responsible for closing and opening the mouth in a certain way

4-TMJ ( Tempo mandibular joint )
 5-Maxillofacial trauma

Trauma is a fracture done ( discontinuity in the bone )which is pathology ,its either
affecting the mandible on one side or both sides ,unilateral or bilateral ,the mandible
with the maxilla in the zygoma or around the orbit of the eye

Mainly occurs in young generations caused by fights or the pressure done to the tooth
because of stress, and mostly car accidents

The bone is composed of the outer part which is the compact (extremely hard), and the
inner part which is the cancellous bone (sponge like) and the fracture has to go to both.

How does it appear? Usually under swelling and shows in x-rays.

Treatment : reduction and fixation

 (reduction means : to put the fracture segment to its origional and functional place, and
for how long depends on the fracture type and patient )
6-Tumors and oral cancer
 Tumors is abnormal, its growing cannot be controlled, and its either benign or
malignant, if malignant its highly invasive to the adjacent tissue or it can send metastasis
(messengers) to the either localize lymph nod ,or even to distal parts of the body (e.g.:
a female with breast cancer might send a messenger to the liver so the liver cancer is
secondary but the original was the breast )

Its usually presented as swelling or ulcer ( discontinuity in the epithelium ‫ )قرحه‬or a
white or a red region .(slides 51-56)

Oral cancer usually give distal messenger but it can also be regional specially lymph nod
(when you operate in a tongue for example with a cancer you have to open on the neck
remove all the lymph nods ).

The highly potential causes for oral cancer are smoking and alcohols

Treatment: should be diagnosed and after, we should know if its metastasis to other
sides of the body or if its localized in the mouth and according to that we will be able to
put the treatment .

Cancer of the oral cavity is not pleasant, actually a nightmare because there is the
tongue, throat, jaw and teeth , it will be hard to swallow, or if you are having a radio
therapy it affects the salivary glands....

Early diagnosis is a major thing because if you detect the cancer whether its oral or in
any part of the body there is a 70% in curing. (slides 59-62)

If you don’t treat it will send metastasis to liver or any other part of the liver and usually
they don’t get treated they will be left to die in dignity.(slides 64-66)


             SENDOS AL JALAM

Good Luck to you all (specially fara7,rand and du3a2 and most of all Diana )

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