Contemporary Oral and Maxillofacial Surgery

Front Cover......Page 1
Inside Front Cover......Page 2
Contemporary Oral and Maxillofacial Surgery......Page 3
Copyright Page......Page 6
Dedication......Page 7
Contributors......Page 8
New to This Edition......Page 10
Acknowledgments......Page 11
Table Of Contents......Page 13
I Principles of Surgery......Page 15
Medical History......Page 16
Medical History......Page 17
Physical Examination......Page 20
Angina Pectoris......Page 22
Myocardial Infarction......Page 23
Congestive Heart Failure (Hypertrophic Cardiomyopathy)......Page 24
Asthma......Page 25
Renal Transplantation and Transplantation of Other Organs......Page 26
Diabetes Mellitus......Page 27
Hereditary Coagulopathies......Page 29
Therapeutic Anticoagulation......Page 30
Pregnancy......Page 31
Postpartum......Page 33
Prevention......Page 34
Emergency Supplies and Equipment......Page 35
Hypersensitivity Reactions......Page 36
Chest Discomfort......Page 39
Respiratory Difficulty......Page 40
Hyperventilation......Page 41
Foreign Body Aspiration......Page 42
Gastric Contents Aspiration......Page 43
Vasovagal Syncope......Page 44
Orthostatic Hypotension......Page 45
Seizure......Page 46
Local Anesthetic Toxicity......Page 47
Diabetes Mellitus......Page 48
Thyroid Dysfunction......Page 49
Adrenal Insufficiency......Page 50
Cerebrovascular Compromise......Page 51
Basic Necessities for Surgery......Page 52
Incisions......Page 53
Hemostasis......Page 54
Means of Promoting Wound Hemostasis......Page 55
Dead Space Management......Page 56
Patient General Health and Wound Healing......Page 57
Epithelialization......Page 58
Inflammatory Stage......Page 59
Remodeling Stage......Page 60
Necrotic Tissue......Page 61
Bone Healing......Page 62
Implant Osseointegration......Page 63
Nerve Healing......Page 66
Nerve Repair......Page 67
Upper Respiratory Tract Flora......Page 70
Hepatitis Viruses......Page 71
Terminology......Page 72
Moist Heat......Page 73
Techniques of Instrument Disinfection......Page 75
Hand and Arm Preparation......Page 77
Sharps Management......Page 78
Mechanism of Action......Page 82
Toxic Reactions......Page 83
Relevant Anatomy......Page 84
Technique for Administering Local Anesthesia for Oral Surgery......Page 85
Mandibular Injections......Page 87
Periodontal Ligament Injection......Page 90
Oral Sedation......Page 91
General Protocol for Using Nitrous Oxide......Page 92
References......Page 95
II Principles of Exodontia......Page 96
Incising Tissue......Page 97
Retracting Soft Tissue......Page 99
Controlling Hemorrhage......Page 101
Burr and Handpiece......Page 102
Suture Needle......Page 103
Scissors......Page 104
Removing Fluids......Page 105
Holding Towels and Drapes in Position......Page 106
Extracting Teeth......Page 107
Types of Elevators......Page 108
Periotomes......Page 109
Forceps Components......Page 110
Maxillary Forceps......Page 112
Mandibular Forceps......Page 113
Instrument Tray Systems......Page 115
Presurgical Medical Assessment......Page 120
Teeth Involved in Jaw Fractures......Page 121
Condition of the Crown......Page 122
Radiographic Examination of the Tooth for Removal......Page 123
Configuration of Roots......Page 124
Patient and Surgeon Preparation......Page 126
Chair Position for Extractions......Page 127
Mechanical Principles Involved in Tooth Extraction......Page 130
Principles of Elevator and Forceps Use......Page 133
Procedure for Closed Extraction......Page 135
Role of the Opposite Hand......Page 137
Incisors......Page 138
Canines......Page 139
First Premolar......Page 140
Molars......Page 141
Anterior Teeth......Page 142
Molars......Page 144
Modifications for Extraction of Primary Teeth......Page 145
Postextraction Tooth Socket Care......Page 146
Design Parameters for Soft Tissue Flaps......Page 149
Developing a Mucoperiosteal Flap......Page 151
Principles of Suturing......Page 153
Principles and Techniques for Open Extractions......Page 158
Indications for Open Extraction......Page 159
Technique for Open Extraction of a Single-Rooted Tooth......Page 161
Technique for Open Extraction of Multirooted Teeth......Page 163
Removal of Root Fragments and Tips......Page 167
Justification for Leaving Root Fragments......Page 170
Technique for Multiple Extractions......Page 171
Chapter Outline......Page 174
Prevention of Periodontal Disease......Page 175
Prevention of Pericoronitis......Page 176
Prevention of Root Resorption......Page 177
Prevention of Jaw Fractures......Page 178
Extremes of Age......Page 180
Classification Systems for Mandibular Third Molar Impactions......Page 181
Angulation......Page 182
Relationship to Anterior Border of Ramus......Page 183
Relationship to the Occlusal Plane......Page 184
Root Morphology......Page 185
Nature of Overlying Tissue......Page 187
Classification Systems for Maxillary Third Molar Impactions......Page 189
Removal of Other Impacted Teeth......Page 190
Surgical Procedure......Page 191
Step 2: Removal of Overlying Bone......Page 192
Step 3: Sectioning the Tooth......Page 194
Step 5: Preparing for Wound Closure......Page 196
Perioperative Patient Management......Page 197
Bibliography......Page 198
Hemorrhage......Page 199
Pain and Discomfort......Page 200
Edema......Page 202
Operative Note......Page 203
Tear of a Mucosal Flap......Page 204
Abrasion or Burn......Page 205
Root Displacement......Page 206
Extraction of the Wrong Tooth......Page 207
Fracture or Dislodgment of an Adjacent Restoration......Page 208
Fracture of the Alveolar Process......Page 209
Injury to Regional Nerves......Page 211
Oroantral Communications......Page 212
Postoperative Bleeding......Page 213
Wound Dehiscence......Page 215
Dry Socket......Page 216
Infection......Page 217
Legal Concepts Influencing Liability......Page 218
Patient Information and Office Communication......Page 219
Informed Consent......Page 220
Electronic Records......Page 221
Patient Abandonment......Page 222
Common Areas of Dental Litigation......Page 223
When a Patient Threatens to Sue......Page 224
Telemedicine and the Internet......Page 225
Risk Analysis and Management......Page 226
Americans With Disabilities Act......Page 227
References......Page 228
Bibliography......Page 229
III Preprosthetic and Implant Surgery......Page 230
Objectives of Preprosthetic Surgery......Page 231
Evaluation of Supporting Bony Tissue......Page 233
Evaluation of Supporting Soft Tissue......Page 234
Simple Alveoloplasty Associated With Removal of Multiple Teeth......Page 235
Intraseptal Alveoloplasty......Page 236
Buccal Exostosis and Excessive Undercuts......Page 237
Mylohyoid Ridge Reduction......Page 239
Genial Tubercle Reduction......Page 240
Maxillary Tori......Page 241
Soft Tissue Abnormalities......Page 244
Mandibular Retromolar Pad Reduction......Page 245
Inflammatory Fibrous Hyperplasia......Page 247
Labial Frenectomy......Page 249
Lingual Frenectomy......Page 253
Immediate Dentures......Page 254
Overdenture Surgery......Page 256
Soft Tissue Surgery for Ridge Extension of the Mandible......Page 257
Vestibule and Floor-of-Mouth Extension Procedures......Page 258
Submucosal Vestibuloplasty......Page 260
Segmental Alveolar Surgery in the Partially Edentulous Patient......Page 261
Correction of Skeletal Abnormalities in the Totally Edentulous Patient......Page 262
References......Page 264
Introduction to the Multidisciplinary Approach......Page 265
Hard Tissue Interface......Page 266
Biomechanical Considerations......Page 267
Medical History and Medical Risk Assessment......Page 269
Diagnostic Casts and Photographs......Page 270
Prosthetic Considerations in Implant Treatment Planning......Page 271
Surgical Treatment Planning Considerations......Page 275
Surgical Preparation......Page 276
Implant Site Exposure......Page 277
Preparing the Osteotomy......Page 279
Uncovering......Page 280
Implant Body or Fixture......Page 284
Implant Analog or Replica......Page 285
Prosthesis Retaining Screw......Page 286
Options for the Edentulous Patient......Page 288
Prosthetic Complications......Page 290
Bibliography......Page 294
Immediate Postextraction Placement of Implants......Page 295
Bone Grafting and Graft Substitutes......Page 297
Bone Morphogenetic Proteins......Page 298
Sinus Lift......Page 299
Zygomatic Implants......Page 308
Complex Cases......Page 311
Bibliography......Page 330
IV Infections......Page 331
Microbiology of Odontogenic Infections......Page 332
Pathophysiology of Odontogenic Infections......Page 333
Complete History......Page 335
Physical Examination......Page 336
Laboratory Studies......Page 337
Location and Severity......Page 338
Principle 4: Treat Infections Surgically......Page 340
Surgical Technique......Page 341
Determine the Need for Antibiotic Administration......Page 343
Use a Bactericidal Antibiotic Whenever Possible......Page 344
General Dentist’s Role in the Management of Odontogenic Infections......Page 345
Prophylaxis Against Infective Endocarditis......Page 346
Prophylaxis Against Prosthetic Joint Infection......Page 347
Acknowledgments......Page 348
Anatomy......Page 349
Microbiology and Antibiotic Management......Page 353
Medical Comorbidities......Page 356
Infections Arising From Maxillary Teeth......Page 357
Infections Arising From Mandibular Teeth......Page 359
Airway Management......Page 362
Surgical Management......Page 363
Cavernous Sinus Thrombosis......Page 366
Osteomyelitis......Page 367
Acute Suppurative Osteomyelitis......Page 369
Actinomycosis......Page 371
Candidiasis......Page 372
Acknowledgments......Page 377
Chapter Outline......Page 378
Periapical Surgery......Page 379
Anatomic Problems......Page 381
Horizontal Root Fracture......Page 382
Contraindications (or Cautions)......Page 383
Anatomic Considerations......Page 385
Antibiotics......Page 386
Submarginal Incision......Page 387
Anesthesia......Page 388
Periapical Exposure......Page 390
Root End Resection......Page 391
Root End Preparation and Restoration......Page 392
Root End–Filling Materials......Page 393
Corrective Surgery......Page 394
Location of Perforation......Page 395
Surgical Approach......Page 396
Surgical Procedure......Page 397
Healing......Page 398
Recall......Page 399
Surgical Microscope......Page 400
Bone Augmentation......Page 401
Bibliography......Page 402
Dental Management of Patients Undergoing Radiotherapy to the Head and Neck......Page 404
Treatment of Xerostomia......Page 405
Evaluation of the Dentition Before Radiotherapy......Page 406
Radiation Dose......Page 407
Preparation of Dentition for Radiotherapy and Maintenance After Irradiation......Page 408
Tooth Extraction After Radiotherapy......Page 409
Use of Dental Implants in Irradiated Patients......Page 410
Effects on Oral Microbiology......Page 411
General Dental Management......Page 413
Bisphosphonates......Page 417
Clinical Signs and Symptoms of MRONJ......Page 418
Dental Care for Patients Taking Antiresorptive Medications......Page 419
Dental Care for Patients With MRONJ......Page 420
References......Page 421
Clinical Examination of the Maxillary Sinus......Page 424
Radiographic Examination of the Maxillary Sinus......Page 425
Nonodontogenic Infections of the Maxillary Sinus......Page 427
Treatment of Maxillary Sinusitis......Page 429
Antral Pseudocysts......Page 430
Oroantral Communications: Immediate Treatment......Page 431
Oroantral Fistulae: Delayed Treatment......Page 433
References......Page 436
Embryology, Anatomy, and Physiology......Page 437
History and Clinical Examination......Page 441
Sialography......Page 442
Computed Tomography, Magnetic Resonance Imaging, Ultrasonography, and Positron Emission Tomography......Page 444
Salivary Scintigraphy (Radioactive Isotope Scanning)......Page 446
Fine-Needle Aspiration Biopsy......Page 448
Obstructive Salivary Gland Disease: Sialolithiasis......Page 449
Mucocele......Page 453
Salivary Gland Infections......Page 454
Sjögren Syndrome......Page 457
Traumatic Salivary Gland Injuries......Page 458
Benign Salivary Gland Tumors......Page 459
Malignant Salivary Gland Tumors......Page 460
V Management of Oral Pathologic Lesions......Page 464
Health History......Page 465
History of the Specific Lesion......Page 466
Clinical Examination......Page 467
Diagnostic Adjuncts......Page 470
Light-Based Adjuncts......Page 472
Laboratory Investigation......Page 473
Basic Tenets of Follow-up and Referral......Page 474
General Principles of Biopsy......Page 475
Soft Tissue Biopsy Techniques and Surgical Principles......Page 476
Wound Closure......Page 479
Handling of Tissues; Specimen Care......Page 481
Submission of Specimens......Page 482
Biopsy Submission Data Form......Page 483
Osseous Window......Page 485
Specimen Management......Page 487
References......Page 489
Eradication of Pathologic Condition......Page 491
Surgical Management of Cysts and Cystlike Lesions of the Jaws......Page 492
Technique......Page 493
Indications......Page 497
Advantages......Page 498
Indications......Page 499
Technique......Page 500
Advantages......Page 501
Principles of Surgical Management of Jaw Tumors......Page 502
Jaw Tumors Treated With Enucleation, Curettage, or Both......Page 503
Radiotherapy......Page 504
Surgical Management of Benign Lesions in Oral Soft Tissues......Page 507
Reconstruction of Jaw After Removal of Oral Tumors......Page 508
References......Page 509
VI Oral and Maxillofacial Trauma......Page 511
Contusion......Page 512
Laceration......Page 513
Closure of Wound......Page 514
History......Page 515
Clinical Examination......Page 516
Radiographic Examination......Page 517
Treatment of Dentoalveolar Injuries......Page 519
Crown Fracture......Page 520
Crown-Root Fracture......Page 521
Avulsion......Page 522
Alveolar Fractures......Page 527
Treatment of Pulp......Page 530
References......Page 532
History and Physical Examination......Page 533
Midface Fractures......Page 537
Treatment of Facial Fractures......Page 541
Mandibular Fractures......Page 543
Midface Fractures......Page 551
Lacerations......Page 556
References......Page 558
VII Dentofacial Deformities......Page 560
General Principles of Facial Growth......Page 561
Genetic and Environmental Influences......Page 562
Evaluation of Patients With Dentofacial Deformity......Page 563
Periodontal Considerations......Page 564
Restorative Considerations......Page 565
Treatment Timing......Page 566
Three-Dimensional Computerized Surgical Planning......Page 567
Mandibular Excess......Page 569
Maxillary Excess......Page 577
Orthognathic Surgery for Obstructive Sleep Apnea......Page 580
Distraction Osteogenesis......Page 598
Perioperative Care of the Orthognathic Surgical Patient......Page 599
Postsurgical Restorative and Prosthetic Considerations......Page 604
References......Page 605
Physiology of Aging......Page 607
Lower Face and Neck......Page 609
Face and Midface......Page 610
Eyelids......Page 611
Rhinoplasty......Page 614
Laser Resurfacing......Page 618
Conclusion......Page 620
References......Page 621
Chapter Outline......Page 622
Embryology......Page 623
Causative Factors......Page 624
Dental Problems......Page 625
Malocclusion......Page 627
Feeding......Page 628
Speech Difficulties......Page 629
Cheilorrhaphy......Page 630
Objectives......Page 631
Hard Palate Closure......Page 632
Alveolar Cleft Grafts......Page 633
Correction of Maxillomandibular Disharmonies......Page 635
Secondary Surgical Procedures......Page 637
References......Page 641
Two-Phase Theory of Osteogenesis......Page 642
Autogenous Grafts......Page 643
Allogeneic Grafts......Page 645
Disadvantages......Page 646
Hard Tissue Defect......Page 647
Soft Tissue Defect......Page 648
Goals and Principles of Mandibular Reconstruction......Page 650
Surgical Principles of Maxillofacial Bone-Grafting Procedures......Page 651
Prosthetic Reconstruction of the Midface......Page 654
References......Page 655
VIII Temporomandibular and Other Facial Pain Disorders......Page 656
Classification of Orofacial Pains......Page 657
Neuropathic Facial Pains......Page 658
Odontalgia Resulting From Deafferentation (Atypical Odontalgia)......Page 659
Postherpetic Neuralgia......Page 660
Migraine......Page 661
Cluster Headache......Page 662
Evaluation of Patient With Orofacial Pain......Page 663
Interview......Page 666
Examination......Page 667
Panoramic Radiography......Page 668
Psychological Evaluation......Page 669
Myofascial Pain......Page 670
Anterior Disk Displacement Without Reduction......Page 671
Systemic Arthritic Conditions......Page 672
Chronic Recurrent Dislocation......Page 673
Intracapsular Ankylosis......Page 674
Reversible Treatment......Page 675
Medication......Page 676
Physical Therapy......Page 677
Autorepositioning Splints......Page 678
Muscular Deprogrammers......Page 679
Arthrocentesis......Page 680
Disk Repair or Removal......Page 681
Modified Condylotomy......Page 682
Total Joint Replacement......Page 684
Combined Orthognathic Surgery and Alloplastic Temporomandibular Joint Reconstruction......Page 688
Temporomandibular Joint Reconstruction in the Growing Patient......Page 691
References......Page 693
Appendix 1 Operative Note (Office Record) Component Parts......Page 695
Schedule V: Controlled Substances......Page 696
Appendix 3 Examples of Useful Prescriptions......Page 697
Appendix 4 Consent for Extractions and Anesthesia......Page 698
Tetracyclines......Page 699
Antifungal Drugs......Page 700
A......Page 701
B......Page 702
C......Page 703
D......Page 704
E......Page 705
F......Page 707
H......Page 708
I......Page 709
M......Page 711
N......Page 713
O......Page 714
P......Page 715
R......Page 717
S......Page 718
T......Page 720
W......Page 721
Z......Page 722