Oral Surgery for the Geriatric Patient Module

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					        Oral Surgical Procedure for the Older Adult
                                    Case Study
An elderly man in his seventies has multiple complaints of dental pain
and difficulty chewing food. What should be done to help this
individual? How can we improve his dentition in an affordable
manner?22

Answer:
     The extensive dental decay and severe periodontal disease requires all teeth to
      be removed.
     A full mouth extraction of all the remaining dentition is performed.
     Also required is alveoplasty or bone recontouring prior to oral rehabilitation with
      dentures.
     Six weeks postoperatively, the bone and gums have healed very well.
     The patient is ready for denture prosthesis fabrication.
     Clinical and radiographic examination reveals adequate bone available to
      support a maxillary denture.
     The mandible has severe resorption and lacks enough bone to support a stable
      and retentive lower denture.
     Two dental implants are placed in the mandible.
     Osseointegration of the implants has taken approximately four months.
     A very stable and retentive overdenture can now be fabricated.
     A cost effective maxillary denture and mandibular overdenture are made and
      thus, greatly improving the quality of life for this individual.




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         Oral Surgical Procedure for the Older Adult
                              Glossary of Terms

AUTOGENOUS BONE GRAFT: Harvesting bone from one part of the body and
transplanting to another part of the same person

DENTAL IMPLANT: Titanium screw like device implanted in the jawbones upon which
a crown or denture may be attached to replace missing teeth

DISTRACTION OSTEOGENESIS: Surgical procedure to slowly and physiologically
lengthen bone

GERIATRICS: Branch of medicine dealing with the diseases and problems of aging

ORAL & MAXILLOFACIAL SURGERY: Specialty of dentistry dealing with surgical
procedures involving the oral and facial regions

OSSEOINTEGRATION: Healing of bone around a dental implant

OSTEORADIONECROSIS: Bone death due to excess exposure to radiation

PERIODONTITIS: Inflammation of the gingival tissue resulting in alveolar bone loss and
eventually tooth loss

PROSTHODONTICS: Specialty of dentistry dealing with the replacement of teeth with
bridges or dentures

SINUS LIFT: Elevation of the Schneiderian membrane lining the maxillary sinus to
place dental impla Autogenus




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       Oral Surgical Procedure for the Older Adult
                                    References

 1. AAOMS Surgical Update. Dental Management of the Geriatric Patient.
    January 7, 1995.

 2. U.S. is getting old fast. USA Today. April 21, 2005.

 3. Neville Bl. Oral and Maxillofacial Pathology. 2nd Ed. Philadelphia: W. B.
    Saunders Publishing; 2002.

 4. AAOMS Surgical Update. Dental Management of the Geriatric Patient.
    January 7, 2002; Vol. 15.

 5. Krames Patient Education Pamphlet. Understanding Dental Implants. 2003.

 6. Marx R, Stern D. Oral and Maxillofacial Pathology. Chicago: Quintessence
    Publishing Co. Inc; 2003.

 7. Branemark P. Tissue Integrated Prosthesis. Chicago: Quintessence Publishing
    Co. Inc; 1985.

 8. Parel S. Osseointegration and facial prosthetics. Int J Oral Maxillofac Implants.
    1986;1:27.

 9. Parel M. Tactical Pereodonics and Esthetic Dentistry. Vol. 10. 1998;213.

10. Peterson L. Contemporary Oral and Maxillofacial Surgery. 4th ed. St. Louis:
    Mosby, Inc; 2003.

11. Kinsel R, Turbow M. The use of trephine biopsy needle to obtain autogenous
    corticocancellous bone from the iliac crest. Int J Oral Maxillofac Implants.
    2004;19:438.

12. Kosmidous L. Use of percutaneous implants for the prosthetic rehabilitation of
    orbit defects in irradiated cancer patients. Int J Oral Maxillofacial Implants.
    1998;13:121.

13. Misch C. Comparison of intraoral donor graft sites for onlay grafting prior to
    implant placement. Int J Oral Maxillofacial Implants. 1997;12:767.

14. Widmark G. Rehabilitation of patients with severely resorbed maxillae by
    implants with or without bone grafts. Int J Oral Maxillofacial Implants.
    1998;13:474.

15. Assael L. Atlas of the Oral and Maxillofacial Surgery Clinics of North America.
    Philadelphia: W.B. Saunders Co. 1994;2:2.


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       Oral Surgical Procedure for the Older Adult

16. Kainulainen V. Safety of zygomatic bone harvesting: A prospective study of 32
    consecutive patients with simultaneous zygomatic bone grafting and one-stage
    implant placement. Int J Oral Maxillofac Implants. 2005;20:245.

17. Hernandez-Alfaro F. Minimally invasive tibial bone harvesting under intravenous
    sedation. J Oral Maxillofac Surg. 2005;62:464.

18.   Blomqvist J. Retrospective analysis of 1-stage maxillary sinus augmentation
      with endosseous implants. Int J Oral Maxillofac Implants. 1996;11:512.

19.   Wheeler S. Six-year clinical and histologic study of sinus lift grafts. Int J Oral
      Maxillofac Implants. 1996;11:26.

20.   Alveolar Distraction Osteogenesis, AAOMS Surgical Updates. January 7, 2005.
      Vol. 19.

21.   Block M, Barughman D. Reconstruction of severe anterior maxillary defects
      using distraction osteogenesis, bone grafts, and implants. J Oral Maxillo Fac
      Surg. 2005;63:291.

22.   Misch C. Immediate loading of definitive implants in the edentulous mandible
      using a fixed provisional prosthesis: The denture conversion technique. J Oral
      Maxillofac Surg. 2004;62:106.




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     Oral Surgical Procedure for the Older Adult
         SOUTH CAROLINA GERIATRIC EDUCATION CENTER
           EVALUATION FORM FOR GERIATRIC MODULES

        PLEASE COMPLETE AND RETURN TO THE PRESENTER

 MODULE TITLE: _____________________________________________________

TRAINING DATE: ______________________          LOCATION____________________

1.   How well organized was the training?
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3.   How helpful will this training be to you in your work?
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6.   What did you like about this training?

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7.   What did you NOT like about this training?




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