BOOK
Contemporary Oral and Maxillofacial Surgery - E-Book
James R. Hupp | Myron R. Tucker | Edward Ellis
(2013)
Additional Information
Book Details
Abstract
A comprehensive guide to oral surgery procedures, Contemporary Oral and Maxillofacial Surgery, 6th Edition enhances your skills in evaluation, diagnosis, and patient management. Full-color photographs and drawings show how to perform basic surgical techniques, and an overview of more advanced surgical procedures includes guidelines on when to refer patients to specialists and how to provide supportive postoperative care. This edition also includes the latest developments in dental implants, instrumentation, and current technology. Written by well-known OMS educators James R. Hupp, Myron R. Tucker, and Edward Ellis III, this book is a valuable reference for any dental office.
- Complex Exodontia chapter describes techniques for surgical tooth extraction, including the principles of flap design, development, management, and suturing, as well as open extraction of single- and multi-rooted teeth, multiple extractions, and concomitant alveoloplasty.
- Management of Medical Emergencies chapter helps you prepare for, prevent, and manage the most common emergencies that may occur in the dental office setting.
- Management of Facial Fractures chapter outlines the fundamental principles for evaluation and treatment of the patient with facial trauma.
- Infection Control chapter describes proper cleaning and sterilization of office environment, working surfaces, armamentarium, and personnel to help you prevent the injuries and illnesses that result from improper sterilizing and disinfecting.
- Convenient appendices offer quick access to resources such as current price lists for key instruments, office record tips, sample drug schedules, examples of prescriptions, and consent forms.
- UPDATED content on implants, new instruments, and the latest technology help you treat your patients more effectively.
- UPDATED Implant Treatment information is divided into two new chapters, one on basic concepts and techniques for clinical situations where adequate bone and soft tissue exists and implants can be placed into a well-healed area of bone, and another chapter on more complex concepts focusing on cases that require immediate implant placement and cases where bone and soft tissue augmentation may be required.
- UPDATED Facial Cosmetic Surgery chapter is organized by nonsurgical and surgical procedures, covering popular procedures such as dermal fillers, botox, facial resurfacing, browlift and forehead procedures, blepharoplasty, rhinoplasty, and rhytidectomy.
- UPDATED Medicolegal Considerations chapter reviews concepts of liability, risk management, methods of risk reduction, and actions that should be taken if a malpractice suit is filed against the dentist or a dentist’s employee.
- UPDATED Correction of Dentofacial Deformities chapter includes new information on conventional treatment planning, image prediction, and 3D virtual computerized surgical planning.
- UPDATED Surgical Reconstruction of Defects of the Jaws chapter includes new information on Bone Morphogenetic Proteins (BMPs).
Table of Contents
| Section Title | Page | Action | Price |
|---|---|---|---|
| Front Cover | cover | ||
| Inside Front Cover | ifc1 | ||
| Contemporary Oral and Maxillofacial Surgery, 6/e | i | ||
| Copyright Page | iv | ||
| Dedication | v | ||
| Contributors | vii | ||
| Preface | ix | ||
| New to this Edition | ix | ||
| Acknowledgments | xi | ||
| Table Of Contents | xiii | ||
| I Principles of Surgery | 1 | ||
| 1 Preoperative Health Status Evaluation | 2 | ||
| Chapter Outline | 2 | ||
| Medical History | 2 | ||
| Biographic Data | 3 | ||
| Chief Complaint | 3 | ||
| History of Chief Complaint | 3 | ||
| Medical History | 3 | ||
| Review of Systems | 6 | ||
| Physical Examination | 6 | ||
| Management of Patients with Compromising Medical Conditions | 8 | ||
| Cardiovascular Problems | 8 | ||
| Ischemic heart disease | 8 | ||
| Angina pectoris. | 8 | ||
| Myocardial infarction. | 9 | ||
| Cerebrovascular accident (stroke). | 10 | ||
| Dysrhythmias. | 10 | ||
| Heart abnormalities that predispose to infective endocarditis. | 10 | ||
| Congestive heart failure (hypertrophic cardiomyopathy). | 10 | ||
| Pulmonary Problems | 11 | ||
| Asthma. | 11 | ||
| Chronic obstructive pulmonary disease. | 11 | ||
| Renal Problems | 11 | ||
| Renal failure. | 11 | ||
| Renal transplantation and transplantation of other organs. | 12 | ||
| Hypertension. | 12 | ||
| Hepatic Disorders | 12 | ||
| Endocrine Disorders | 13 | ||
| Diabetes mellitus. | 13 | ||
| Adrenal insufficiency. | 14 | ||
| Hyperthyroidism. | 14 | ||
| Hypothyroidism. | 14 | ||
| Hematologic Problems | 15 | ||
| Hereditary coagulopathies. | 15 | ||
| Therapeutic anticoagulation. | 15 | ||
| Neurologic Disorders | 16 | ||
| Seizure disorders. | 16 | ||
| Ethanolism (alcoholism). | 16 | ||
| Management of Patients during and after Pregnancy | 16 | ||
| Pregnancy | 16 | ||
| Postpartum | 18 | ||
| 2 Prevention and Management of Medical Emergencies | 19 | ||
| Chapter Outline | 19 | ||
| Prevention | 19 | ||
| Preparation | 20 | ||
| Continuing Education | 20 | ||
| Office Staff Training | 20 | ||
| Access to Help | 20 | ||
| Emergency Supplies and Equipment | 21 | ||
| Medical Emergencies | 22 | ||
| Hypersensitivity Reactions | 22 | ||
| Chest Discomfort | 24 | ||
| Respiratory Difficulty | 26 | ||
| Asthma. | 26 | ||
| Hyperventilation. | 26 | ||
| Chronic obstructive pulmonary disease. | 27 | ||
| Foreign body aspiration. | 27 | ||
| Gastric contents aspiration. | 28 | ||
| Altered Consciousness | 29 | ||
| Vasovagal syncope. | 29 | ||
| Orthostatic hypotension. | 30 | ||
| Seizure. | 30 | ||
| Local anesthetic toxicity. | 32 | ||
| Diabetes mellitus. | 33 | ||
| Thyroid dysfunction. | 34 | ||
| Adrenal insufficiency. | 35 | ||
| Cerebrovascular compromise. | 36 | ||
| 3 Principles of Surgery | 37 | ||
| Chapter Outline | 37 | ||
| Developing a Surgical Diagnosis | 37 | ||
| Basic Necessities for Surgery | 37 | ||
| Aseptic Technique | 38 | ||
| Incisions | 38 | ||
| Flap Design | 38 | ||
| Prevention of Flap Necrosis | 38 | ||
| Prevention of Flap Dehiscence | 39 | ||
| Prevention of Flap Tearing | 39 | ||
| Tissue Handling | 39 | ||
| Hemostasis | 40 | ||
| Means of Promoting Wound Hemostasis | 40 | ||
| Dead Space Management | 41 | ||
| Decontamination and Débridement | 41 | ||
| Edema Control | 41 | ||
| Patient General Health and Wound Healing | 42 | ||
| 4 Wound Repair | 43 | ||
| Chapter Outline | 43 | ||
| Causes of Tissue Damage | 43 | ||
| Wound Repair | 43 | ||
| Epithelialization | 43 | ||
| Stages of Wound Healing | 44 | ||
| Inflammatory stage. | 44 | ||
| Fibroplastic stage. | 45 | ||
| Remodeling stage. | 45 | ||
| Surgical Significance of Wound Healing Concepts | 46 | ||
| Factors That Impair Wound Healing | 46 | ||
| Foreign material. | 46 | ||
| Necrotic tissue. | 46 | ||
| Ischemia. | 46 | ||
| Tension. | 47 | ||
| Healing by Primary, Secondary, and Tertiary Intention | 47 | ||
| Healing of Extraction Sockets | 47 | ||
| Bone Healing | 47 | ||
| Implant Osseointegration | 48 | ||
| Facial Neuropathology of Traumatic Origin | 50 | ||
| Classification. | 50 | ||
| Nerve healing. | 52 | ||
| 5 Infection Control in Surgical Practice | 54 | ||
| Chapter Outline | 54 | ||
| Communicable Pathogenic Organisms | 54 | ||
| Bacteria | 54 | ||
| Upper respiratory tract flora. | 54 | ||
| Maxillofacial skin flora. | 55 | ||
| Nonmaxillofacial flora. | 55 | ||
| Viral Organisms | 55 | ||
| Hepatitis viruses. | 55 | ||
| Human immunodeficiency virus. | 56 | ||
| Mycobacterial Organisms | 56 | ||
| Aseptic Techniques | 56 | ||
| Terminology | 56 | ||
| Concepts | 57 | ||
| Techniques of Instrument Sterilization | 57 | ||
| Sterilization with Heat | 57 | ||
| Dry heat. | 57 | ||
| Moist heat. | 57 | ||
| Sterilization with Gas | 59 | ||
| Techniques of Instrument Disinfection | 59 | ||
| Maintenance of Sterility | 59 | ||
| Disposable materials. | 59 | ||
| Surgical field maintenance. | 61 | ||
| Operatory Disinfection | 61 | ||
| Surgical Staff Preparation | 61 | ||
| Hand and arm preparation. | 61 | ||
| Clean technique. | 64 | ||
| Sterile technique. | 64 | ||
| Postsurgical Asepsis | 64 | ||
| Wounds management. | 64 | ||
| Sharps management. | 64 | ||
| II Principles of Exodontia | 65 | ||
| 6 Instrumentation for Basic Oral Surgery | 66 | ||
| Chapter Outline | 66 | ||
| Incising Tissue | 66 | ||
| Elevating the Mucoperiosteum | 68 | ||
| Retracting Soft Tissue | 68 | ||
| Grasping Soft Tissue | 69 | ||
| Controlling Hemorrhages | 70 | ||
| Removing Bone | 70 | ||
| Rongeurs | 70 | ||
| Bur and Handpiece | 71 | ||
| Mallet and Chisel | 71 | ||
| Bone File | 71 | ||
| Removing Soft Tissue From Bony Cavities | 72 | ||
| Suturing Soft Tissue | 72 | ||
| Needle Holder | 72 | ||
| Suture Needle | 72 | ||
| Suture Material | 73 | ||
| Scissors | 74 | ||
| Holding the Mouth Open | 74 | ||
| Suctioning | 75 | ||
| Holding Towels and Drapes in Position | 76 | ||
| Irrigating | 76 | ||
| Extracting Teeth | 76 | ||
| Dental Elevators | 76 | ||
| Types of Elevators | 77 | ||
| Periotomes | 78 | ||
| Extraction Forceps | 78 | ||
| Forceps components. | 78 | ||
| Maxillary forceps. | 80 | ||
| Mandibular forceps. | 80 | ||
| Instrument Tray Systems | 83 | ||
| 7 Principles of Routine Exodontia | 88 | ||
| Chapter Outline | 88 | ||
| Presurgical Medical Assessment | 89 | ||
| Pain and Anxiety Control | 89 | ||
| Local Anesthesia | 89 | ||
| Sedation | 90 | ||
| Indications for Removal of Teeth | 91 | ||
| Caries | 91 | ||
| Pulpal Necrosis | 91 | ||
| Periodontal Disease | 91 | ||
| Orthodontic Reasons | 91 | ||
| Malposed Teeth | 91 | ||
| Cracked Teeth | 91 | ||
| Impacted Teeth | 91 | ||
| Supernumerary Teeth | 91 | ||
| Teeth Associated with Pathologic Lesions | 91 | ||
| Radiation Therapy | 91 | ||
| Teeth Involved in Jaw Fractures | 91 | ||
| Financial Issues | 91 | ||
| Contraindications for Removal of Teeth | 91 | ||
| Systemic Contraindications | 92 | ||
| Local Contraindications | 92 | ||
| Clinical Evaluation of Teeth for Removal | 92 | ||
| Access to the Tooth | 92 | ||
| Mobility of the Tooth | 92 | ||
| Condition of the Crown | 93 | ||
| Radiographic Examination of the Tooth for Removal | 93 | ||
| Relationship to Vital Structures | 94 | ||
| Configuration of Roots | 94 | ||
| Condition of Surrounding Bone | 96 | ||
| Patient and Surgeon Preparation | 96 | ||
| Chair Position for Extractions | 98 | ||
| Mechanical Principles Involved in Tooth Extraction | 100 | ||
| Principles of Elevator and Forceps Use | 102 | ||
| Procedure for Closed Extraction | 105 | ||
| Role of the Opposite Hand | 107 | ||
| Role of the Assistant during Extraction | 108 | ||
| Specific Techniques for the Removal of Each Tooth | 108 | ||
| Maxillary Teeth | 108 | ||
| Incisors. | 109 | ||
| Canines. | 110 | ||
| First premolar. | 110 | ||
| Second premolar. | 111 | ||
| Molars. | 111 | ||
| Mandibular Teeth | 112 | ||
| Anterior teeth. | 112 | ||
| Premolars. | 112 | ||
| Molars. | 115 | ||
| Modifications for Extraction of Primary Teeth | 116 | ||
| Postextraction Tooth Socket Care | 116 | ||
| 8 Principles of More Complex Exodontia | 119 | ||
| Chapter Outline | 119 | ||
| Principles of Flap Design, Development, and Management | 119 | ||
| Design Parameters for Soft Tissue Flaps | 119 | ||
| Types of Mucoperiosteal Flaps | 121 | ||
| Developing a Mucoperiosteal Flap | 121 | ||
| Principles of Suturing | 123 | ||
| Principles and Techniques for Open Extractions | 128 | ||
| Indications for Open Extraction | 128 | ||
| Technique for Open Extraction of Single-Rooted Tooth | 130 | ||
| Technique for Open Extraction of Multirooted Teeth | 132 | ||
| Removal of Root Fragments and Tips | 137 | ||
| Justification for Leaving Root Fragments | 138 | ||
| Multiple Extractions | 139 | ||
| Treatment Planning | 139 | ||
| Extraction Sequencing | 139 | ||
| Technique for Multiple Extractions | 140 | ||
| 9 Principles of Management of Impacted Teeth | 143 | ||
| Chapter Outline | 143 | ||
| Indications for Removal of Impacted Teeth | 144 | ||
| Prevention of Periodontal Disease | 144 | ||
| Prevention of Dental Caries | 144 | ||
| Prevention of Pericoronitis | 144 | ||
| Prevention of Root Resorption | 146 | ||
| Impacted Teeth under a Dental Prosthesis | 146 | ||
| Prevention of Odontogenic Cysts and Tumors | 146 | ||
| Treatment of Pain of Unexplained Origin | 147 | ||
| Prevention of Jaw Fractures | 147 | ||
| Facilitation of Orthodontic Treatment | 147 | ||
| Optimal Periodontal Healing | 147 | ||
| Contraindications for Removal of Impacted Teeth | 149 | ||
| Extremes of Age | 149 | ||
| Compromised Medical Status | 149 | ||
| Probable Excessive Damage to Adjacent Structures | 150 | ||
| Summary | 150 | ||
| Classification Systems for Mandibular Third Molar Impactions | 150 | ||
| Angulation | 150 | ||
| Relationship to Anterior Border of Ramus | 152 | ||
| Relationship to the Occlusal Plane | 153 | ||
| Summary | 153 | ||
| Root Morphology | 153 | ||
| Size of the Follicular Sac | 155 | ||
| Density of Surrounding Bone | 155 | ||
| Contact with Mandibular Second Molar | 156 | ||
| Relationship to Inferior Alveolar Nerve | 156 | ||
| Nature of Overlying Tissue | 156 | ||
| Classification Systems for Maxillary Third Molar Impactions | 158 | ||
| Removal of Other Impacted Teeth | 159 | ||
| Surgical Procedure | 159 | ||
| Step 1: Reflecting Adequate Flaps for Accessibility | 160 | ||
| Step 2: Removal of Overlying Bone | 161 | ||
| Step 3: Sectioning the Tooth | 162 | ||
| Step 4: Delivery of the Sectioned Tooth with Elevator | 164 | ||
| Step 5: Preparing for Wound Closure | 165 | ||
| Perioperative Patient Management | 165 | ||
| References | 166 | ||
| Bibliography | 167 | ||
| 10 Postoperative Patient Management | 168 | ||
| Chapter Outline | 168 | ||
| Control of Postoperative Hemorrhage | 168 | ||
| Control of Postoperative Sequelae | 169 | ||
| Pain and Discomfort | 169 | ||
| Diet | 171 | ||
| Oral Hygiene | 171 | ||
| Edema | 171 | ||
| Prevention and Recognition of Infection | 171 | ||
| Trismus | 172 | ||
| Ecchymosis | 172 | ||
| Postoperative Follow-Up | 172 | ||
| Operative Note | 172 | ||
| 11 Prevention and Management of Extraction Complications | 174 | ||
| Chapter Outline | 174 | ||
| Prevention of Complications | 174 | ||
| Soft Tissue Injuries | 175 | ||
| Tear of a Mucosal Flap | 175 | ||
| Puncture Wound | 175 | ||
| Stretch or Abrasion | 175 | ||
| Problems with a Tooth Being Extracted | 176 | ||
| Root Fracture | 176 | ||
| Root Displacement | 176 | ||
| Tooth Lost into the Pharynx | 177 | ||
| Injuries to Adjacent Teeth | 178 | ||
| Fracture or Dislodgment of an Adjacent Restoration | 178 | ||
| Luxation of an Adjacent Tooth | 178 | ||
| Extraction of the Wrong Tooth | 179 | ||
| Injuries to Osseous Structures | 179 | ||
| Fracture of the Alveolar Process | 179 | ||
| Fracture of the Maxillary Tuberosity | 181 | ||
| Injuries to Adjacent Structures | 181 | ||
| Injury to Regional Nerves | 181 | ||
| Injury to the Temporomandibular Joint | 182 | ||
| Oroantral Communications | 182 | ||
| Postoperative Bleeding | 183 | ||
| Delayed Healing and Infection | 185 | ||
| Infection | 185 | ||
| Wound Dehiscence | 185 | ||
| Dry Socket | 186 | ||
| Fractures of the Mandible | 187 | ||
| Summary | 187 | ||
| 12 Medicolegal Considerations | 188 | ||
| Chapter Outline | 188 | ||
| Legal Concepts Influencing Liability | 188 | ||
| Duty | 189 | ||
| Breach of Duty | 189 | ||
| Damages | 189 | ||
| Causation | 189 | ||
| Risk Reduction | 189 | ||
| Patient Information and Office Communication | 189 | ||
| Informed Consent | 190 | ||
| Records and Documentation | 191 | ||
| Electronic Records | 191 | ||
| Referral to Another General Dentist or Specialist | 192 | ||
| Complications | 192 | ||
| Patient Management Problems | 192 | ||
| Noncompliant Patient | 192 | ||
| Patient Abandonment | 192 | ||
| Common Areas of Dental Litigation | 193 | ||
| When a Patient Threatens to Sue | 194 | ||
| Managed Care Issues | 194 | ||
| Telemedicine and the Internet | 195 | ||
| Rules and Regulations Affecting Practice | 195 | ||
| HIPAA Privacy and Security | 195 | ||
| HITECH Regulations | 196 | ||
| Title VI, Limited English Proficiency | 196 | ||
| Americans with Disabilities Act | 196 | ||
| EMTALA | 197 | ||
| Summary | 197 | ||
| References | 197 | ||
| Bibliography | 198 | ||
| III Preprosthetic and Implant Surgery | 199 | ||
| 13 Preprosthetic Surgery | 200 | ||
| Chapter Outline | 200 | ||
| Objectives of Preprosthetic Surgery | 200 | ||
| Principles of Patient Evaluation and Treatment Planning | 202 | ||
| Evaluation of Supporting Bony Tissue | 202 | ||
| Evaluation of Supporting Soft Tissue | 203 | ||
| Treatment Planning | 203 | ||
| Recontouring of Alveolar Ridges | 204 | ||
| Simple Alveoloplasty Associated with Removal of Multiple Teeth | 204 | ||
| Intraseptal Alveoloplasty | 204 | ||
| Maxillary Tuberosity Reduction (Hard Tissue) | 205 | ||
| Buccal Exostosis and Excessive Undercuts | 206 | ||
| Lateral Palatal Exostosis | 206 | ||
| Mylohyoid Ridge Reduction | 207 | ||
| Genial Tubercle Reduction | 208 | ||
| Tori Removal | 209 | ||
| Maxillary Tori | 209 | ||
| Mandibular Tori | 210 | ||
| Soft Tissue Abnormalities | 210 | ||
| Maxillary Tuberosity Reduction (Soft Tissue) | 215 | ||
| Mandibular Retromolar Pad Reduction | 215 | ||
| Lateral Palatal Soft Tissue Excess | 215 | ||
| Unsupported Hypermobile Tissue | 215 | ||
| Inflammatory Fibrous Hyperplasia | 217 | ||
| Labial Frenectomy | 217 | ||
| Lingual Frenectomy | 222 | ||
| Immediate Dentures | 223 | ||
| Alveolar Ridge Preservation | 224 | ||
| Overdenture Surgery | 225 | ||
| Advanced Preposthetic Surgical Procedures | 226 | ||
| Soft Tissue Surgery for Ridge Extension of the Mandible | 226 | ||
| Transpositional Flap Vestibuloplasty (Lip Switch) | 226 | ||
| Vestibule and Floor-of-Mouth Extension Procedures | 226 | ||
| Soft Tissue Surgery for Maxillary Ridge Extension | 228 | ||
| Submucosal Vestibuloplasty | 228 | ||
| Maxillary Vestibuloplasty with Tissue Grafting | 229 | ||
| Correction of Abnormal Ridge Relationships | 229 | ||
| Segmental Alveolar Surgery in the Partially Edentulous Patient | 229 | ||
| Correction of Skeletal Abnormalities in the Totally Edentulous Patient | 232 | ||
| Summary | 232 | ||
| References | 232 | ||
| 14 Implant Treatment: Basic Concepts and Techniques | 234 | ||
| Chapter Outline | 234 | ||
| Introduction to the Multidisciplinary Approach | 235 | ||
| Peri-Implantation Biologic and Functional Considerations | 235 | ||
| Hard Tissue Interface | 235 | ||
| Soft Tissue to Implant Interface | 236 | ||
| Biomechanical Considerations | 236 | ||
| Preoperative Assessment and Treatment Planning | 238 | ||
| Initial Observations and Patient Introduction | 238 | ||
| Chief Complaint | 238 | ||
| Medical History and Medical Risk Assessment | 238 | ||
| Dental History | 239 | ||
| Intraoral Examination | 239 | ||
| Diagnostic Casts and Photographs | 239 | ||
| Radiographic Examination | 240 | ||
| Prosthetic Considerations in Implant Treatment Planning | 240 | ||
| Surgical Treatment Planning Considerations | 243 | ||
| Final Treatment Planning | 245 | ||
| Surgical Techniques (Basic) | 245 | ||
| Surgical Armamentarium | 245 | ||
| Surgical Preparation | 245 | ||
| Implant Site Exposure | 245 | ||
| Implant Placement | 248 | ||
| Flap reflection | 248 | ||
| Preparing the osteotomy | 248 | ||
| Inserting implant | 248 | ||
| Suturing flap | 251 | ||
| Postoperative Management | 251 | ||
| Uncovering | 251 | ||
| Implant Stability | 251 | ||
| Complications | 252 | ||
| Implant Components | 253 | ||
| Implant Body or Fixture | 253 | ||
| Cover or Healing Screw | 254 | ||
| Healing or Interim Abutment | 254 | ||
| Impression Coping | 255 | ||
| Implant Analog or Replica | 255 | ||
| Implant Abutment | 255 | ||
| Prosthesis-Retaining Screw | 256 | ||
| Implant ProstheTic Options | 256 | ||
| Options for the Edentulous Patient | 256 | ||
| Options for the Partially Edentulous Patient | 257 | ||
| Prosthetic Complications | 259 | ||
| Acknowledgments | 259 | ||
| References | 263 | ||
| Bibliography | 263 | ||
| 15 Implant Treatment: Advanced Concepts and Complex Cases | 264 | ||
| Chapter Outline | 264 | ||
| Immediate Postextraction Placement of Implants | 264 | ||
| Bone Grafting and Graft Substitutes | 266 | ||
| Autogenous Grafts | 267 | ||
| Allografts | 267 | ||
| Xenografts | 267 | ||
| Bone Morphogenetic Proteins | 267 | ||
| Mandibular Augmentation | 268 | ||
| Maxillary Augmentation | 268 | ||
| Onlay Bone Grafting | 268 | ||
| Sinus Lift | 268 | ||
| Alveolar Ridge Distraction | 273 | ||
| Diagnostic Imaging and Virtual Treatment Planning | 274 | ||
| Special Implants | 275 | ||
| Zygomatic Implants | 275 | ||
| Extraoral Implants | 275 | ||
| Complex Cases | 275 | ||
| Acknowledgments | 294 | ||
| Bibliography | 294 | ||
| IV Infections | 295 | ||
| 16 Principles of Management and Prevention of Odontogenic Infections | 296 | ||
| Chapter Outline | 296 | ||
| Microbiology of Odontogenic Infections | 297 | ||
| Natural History of Progression of Odontogenic Infections | 298 | ||
| Principles of Therapy of Odontogenic Infections | 299 | ||
| Principle 1: Determine Severity of Infection | 300 | ||
| Complete history. | 300 | ||
| Physical examination. | 300 | ||
| Principle 2: Evaluate State of Patient’s Host Defense Mechanisms | 302 | ||
| Medical conditions that compromise host defenses. | 302 | ||
| Pharmaceuticals that compromise host defenses. | 302 | ||
| Principle 3: Determine Whether Patient Should Be Treated by General Dentist or Oral-Maxillofacial Surgeon | 303 | ||
| Principle 4: Treat Infection Surgically | 303 | ||
| Principle 5: Support Patient Medically | 306 | ||
| Principle 6: Choose and Prescribe Appropriate Antibiotic | 306 | ||
| Determine the need for antibiotic administration. | 306 | ||
| Use empirical therapy routinely. | 307 | ||
| Use the narrowest-spectrum antibiotic. | 308 | ||
| Use the antibiotic with the lowest incidence of toxicity and side effects. | 308 | ||
| Use a bactericidal antibiotic, if possible. | 309 | ||
| Be aware of the cost of antibiotics. | 309 | ||
| Summary. | 309 | ||
| Principle 7: Administer Antibiotic Properly | 310 | ||
| Principle 8: Evaluate Patient Frequently | 311 | ||
| Principles of Prevention of Infection | 311 | ||
| Principles of Prophylaxis of Wound Infection | 312 | ||
| Principle 1: Procedure Should Have Significant Risk of Infection | 312 | ||
| Principle 2: Choose Correct Antibiotic | 313 | ||
| Principle 3: Antibiotic Plasma Level Must Be High | 313 | ||
| Principle 4: Time Antibiotic Administration Correctly | 313 | ||
| Principle 5: Use Shortest Antibiotic Exposure That Is Effective | 313 | ||
| Summary | 313 | ||
| Principles of Prophylaxis Against Metastatic Infection | 314 | ||
| Prophylaxis Against Infectious Endocarditis | 314 | ||
| Prophylaxis in Patients with Other Cardiovascular Conditions | 316 | ||
| Prophylaxis Against Total Joint Replacement Infection | 316 | ||
| Bibliography | 317 | ||
| 17 Complex Odontogenic Infections | 319 | ||
| Chapter Outline | 319 | ||
| Deep Fascial Space Infections | 319 | ||
| Infections Arising from Any Tooth | 320 | ||
| Infections Arising from Maxillary Teeth | 320 | ||
| Infections Arising from Mandibular Teeth | 325 | ||
| Deep Cervical Fascial Space Infections | 330 | ||
| Management of Fascial Space Infections | 331 | ||
| Osteomyelitis | 333 | ||
| Actinomycosis | 335 | ||
| Candidiasis | 336 | ||
| References | 337 | ||
| Bibliography | 337 | ||
| 18 Principles of Endodontic Surgery | 339 | ||
| Chapter Outline | 339 | ||
| Drainage of an Abscess | 339 | ||
| Drainage of an Abscess | 340 | ||
| Periapical Surgery | 340 | ||
| Indications | 342 | ||
| Anatomic problems. | 342 | ||
| Restorative considerations. | 343 | ||
| Horizontal root fracture. | 343 | ||
| Irretrievable material in the canal. | 343 | ||
| Procedural error. | 343 | ||
| Large, unresolved lesions after root canal treatment. | 344 | ||
| Contraindications (or Cautions) | 344 | ||
| Unidentified cause of treatment failure. | 344 | ||
| When conventional endodontic treatment is possible. | 344 | ||
| Simultaneous root canal treatment and apical surgery. | 344 | ||
| Anatomic considerations. | 346 | ||
| Poor crown–root ratio. | 346 | ||
| Medical (systemic) complications. | 346 | ||
| Surgical Procedure | 346 | ||
| Antibiotics. | 346 | ||
| Flap design. | 346 | ||
| Semi-lunar incision. | 347 | ||
| Submarginal incision. | 347 | ||
| Full mucoperiosteal incision. | 348 | ||
| Anesthesia. | 350 | ||
| Incision and reflection. | 350 | ||
| Periapical exposure. | 350 | ||
| Curettage. | 351 | ||
| Root end resection. | 351 | ||
| Root end preparation and restoration. | 352 | ||
| Root end–filling materials. | 353 | ||
| Irrigation. | 354 | ||
| Radiographic verification. | 354 | ||
| Flap replacement and suturing. | 354 | ||
| Postoperative instructions. | 354 | ||
| Suture removal and evaluation. | 354 | ||
| Corrective Surgery | 355 | ||
| Indications | 355 | ||
| Procedural errors. | 355 | ||
| Resorptive perforations. | 355 | ||
| Contraindications | 355 | ||
| Anatomic considerations. | 355 | ||
| Location of perforation. | 355 | ||
| Accessibility. | 355 | ||
| Considerations | 356 | ||
| Surgical approach. | 356 | ||
| Repair material. | 356 | ||
| Prognosis. | 357 | ||
| Surgical Procedure | 357 | ||
| Fractured Teeth | 358 | ||
| Healing | 358 | ||
| Recall | 358 | ||
| To Perform a Biopsy or Not | 359 | ||
| Adjuncts | 360 | ||
| Light and Magnification Devices | 360 | ||
| Surgical microscope. | 360 | ||
| Fiberoptics. | 361 | ||
| Guided Tissue Regeneration | 361 | ||
| Bone Augmentation | 361 | ||
| When to Consider Referral | 361 | ||
| Training and Experience | 361 | ||
| Determining the Cause of Root Canal Treatment Failure | 361 | ||
| Surgical Difficulties | 361 | ||
| References | 361 | ||
| Bibliography | 362 | ||
| 19 Management of the Patient Undergoing Radiotherapy or Chemotherapy | 363 | ||
| Chapter Outline | 363 | ||
| Dental Management of Patients Undergoing Radiotherapy to the Head and Neck | 363 | ||
| Radiation Effects on Oral Mucosa | 364 | ||
| Radiation Effects on Mandibular Mobility | 364 | ||
| Radiation Effects on Salivary Glands | 364 | ||
| Treatment of xerostomia. | 364 | ||
| Radiation Effects on Bone | 365 | ||
| Other Effects of Radiation | 365 | ||
| Evaluation of Dentition before Radiotherapy | 365 | ||
| Condition of residual dentition. | 366 | ||
| Patient’s dental awareness. | 366 | ||
| Immediacy of radiotherapy. | 366 | ||
| Radiation location. | 366 | ||
| Radiation dose. | 366 | ||
| Preparation of Dentition for Radiotherapy and Maintenance after Irradiation | 367 | ||
| Method of Performing Pre-irradiation Extractions | 368 | ||
| Interval between Pre-irradiation Extractions and Beginning of Radiotherapy | 368 | ||
| Impacted Third Molar Removal before Radiotherapy | 368 | ||
| Methods of Managing Carious Teeth after Radiotherapy | 368 | ||
| Tooth Extraction after Radiotherapy | 368 | ||
| Denture Wear in Post-irradiation Edentulous Patients | 369 | ||
| Use of Dental Implants in Irradiated Patients | 369 | ||
| Management of Patients Who Have Osteoradionecrosis | 371 | ||
| Dental Management of Patients Receiving Systemic Chemotherapy for Malignant Disease | 375 | ||
| Effects on Oral Mucosa | 375 | ||
| Effects on Hematopoietic System | 375 | ||
| Effects on Oral Microbiology | 375 | ||
| General Dental Management | 375 | ||
| Treatment of Oral Candidiasis | 376 | ||
| Dental Management of Patients with Bisphosphonate-Induced Osteonecrosis of the Jaws (BOJ) | 376 | ||
| Bisphosphonates | 376 | ||
| Mechanism of BOJ | 377 | ||
| Clinical Signs and Symptoms of BOJ | 377 | ||
| Dental Care for Patients Who Are About to Start Taking Bisphosphonates | 377 | ||
| Dental Care for Patients Who Are Taking Bisphosphonates | 378 | ||
| Role of Orally Administered Alendronate | 378 | ||
| Dental Care for Patients with BOJ | 379 | ||
| References | 379 | ||
| 20 Odontogenic Diseases of the Maxillary Sinus | 382 | ||
| Chapter Outline | 382 | ||
| Embryology and Anatomy | 382 | ||
| Clinical Examination of the Maxillary Sinus | 383 | ||
| Radiographic Examination of the Maxillary Sinus | 383 | ||
| Nonodontogenic Infections of the Maxillary Sinus | 385 | ||
| Odontogenic Infections of the Maxillary Sinus | 387 | ||
| Treatment of Maxillary Sinusitis | 387 | ||
| Antral Pseudocysts | 388 | ||
| Complications of Oral Surgery Involving the Maxillary Sinus | 389 | ||
| Oroantral Communications: Immediate Treatment | 389 | ||
| Oroantral Fistulae: Delayed Treatment | 391 | ||
| References | 393 | ||
| 21 Diagnosis and Management of Salivary Gland Disorders | 394 | ||
| Chapter Outline | 394 | ||
| Embryology, Anatomy, and Physiology | 394 | ||
| Diagnostic Modalities | 398 | ||
| History and Clinical Examination | 398 | ||
| Salivary Gland Radiology | 398 | ||
| Plain-film radiographs. | 398 | ||
| Sialography. | 399 | ||
| Computed tomography, magnetic resonance imaging, and ultrasonography. | 401 | ||
| Salivary scintigraphy (radioactive isotope scanning). | 403 | ||
| Salivary Gland Endoscopy (Sialoendoscopy) | 403 | ||
| Sialochemistry | 404 | ||
| Fine-Needle Aspiration Biopsy | 404 | ||
| Salivary Gland Biopsy | 405 | ||
| Obstructive Salivary Gland Disease: Sialolithiasis | 405 | ||
| Mucus Retention and Extravasation Phenomena | 408 | ||
| Mucocele | 408 | ||
| Ranula | 409 | ||
| Salivary Gland Infections | 410 | ||
| Necrotizing Sialometaplasia | 412 | ||
| Sjögren Syndrome | 414 | ||
| Traumatic Salivary Gland Injuries | 415 | ||
| Salivary Gland Neoplasms | 415 | ||
| Benign Salivary Gland Tumors | 416 | ||
| Malignant Salivary Gland Tumors | 418 | ||
| Suggested Readings | 419 | ||
| V Management of Oral Pathologic Lesions | 421 | ||
| 22 Principles of Differential Diagnosis and Biopsy | 422 | ||
| Chapter Outline | 422 | ||
| Examination and Diagnostic Methods | 422 | ||
| Health History | 422 | ||
| History of the Specific Lesion | 423 | ||
| Clinical Examination | 424 | ||
| Light-Enhanced Adjuncts for Clinical Screening | 429 | ||
| Radiographic Examination | 429 | ||
| Laboratory Investigation | 429 | ||
| Presumptive Clinical Differential Diagnosis | 429 | ||
| Prebiopsy Monitoring | 430 | ||
| Basic Tenets of Follow-Up and Referral | 430 | ||
| Biopsy or Referral | 431 | ||
| Informed Consent and Shared Risk | 431 | ||
| Postbiopsy Monitoring | 431 | ||
| General Principles of Biopsy | 431 | ||
| Oral Cytology-Based Procedures | 431 | ||
| Technique of oral brush cytologic examination. | 432 | ||
| Incisional Biopsy | 432 | ||
| Excisional Biopsy | 434 | ||
| Aspiration Biopsy | 434 | ||
| Soft Tissue Biopsy Techniques and Surgical Principles | 434 | ||
| Anesthesia | 434 | ||
| Tissue Stabilization | 436 | ||
| Hemostasis | 436 | ||
| Incisions | 436 | ||
| Wound Closure | 436 | ||
| Handling of Tissues; Specimen Care | 438 | ||
| Suture tagging of specimens; margin identification. | 439 | ||
| Submission of Specimens | 439 | ||
| Biopsy submission data form. | 440 | ||
| Intraosseous (Hard Tissue) Biopsy Techniques and Principles | 440 | ||
| Mucoperiosteal Flaps | 442 | ||
| Precautionary Aspiration | 442 | ||
| Osseous Window | 442 | ||
| Specimen Management | 442 | ||
| Postbiopsy Follow-Up | 444 | ||
| References | 446 | ||
| 23 Surgical Management of Oral Pathologic Lesions | 448 | ||
| Chapter Outline | 448 | ||
| Basic Surgical Goals | 448 | ||
| Eradication of Pathologic Condition | 448 | ||
| Functional Rehabilitation of Patient | 449 | ||
| Surgical Management of Cysts and Cystlike Lesions of the Jaws | 449 | ||
| Enucleation | 450 | ||
| Indications. | 450 | ||
| Advantages. | 450 | ||
| Disadvantages. | 450 | ||
| Technique. | 450 | ||
| Marsupialization | 454 | ||
| Indications. | 454 | ||
| Advantages. | 454 | ||
| Disadvantages. | 454 | ||
| Technique. | 454 | ||
| Enucleation after Marsupialization | 457 | ||
| VI Oral and Maxillofacial Trauma | 469 | ||
| 24 Soft Tissue and Dentoalveolar Injuries | 470 | ||
| Chapter Outline | 470 | ||
| Soft Tissue Injuries | 470 | ||
| Abrasion | 470 | ||
| Contusion | 471 | ||
| Laceration | 471 | ||
| Cleansing of wound. | 472 | ||
| Débridement of wound. | 472 | ||
| Hemostasis in wound. | 472 | ||
| Closure of wound. | 472 | ||
| Dentoalveolar Injuries | 473 | ||
| Management of Dentoalveolar Injuries | 473 | ||
| History | 473 | ||
| Clinical Examination | 474 | ||
| Radiographic Examination | 475 | ||
| Classification of Traumatic Injuries to Teeth and Supporting Structures | 476 | ||
| Treatment of Dentoalveolar Injuries* | 477 | ||
| Crown craze or crack. | 478 | ||
| Crown fracture. | 478 | ||
| Crown-root fracture. | 480 | ||
| Horizontal root fracture. | 480 | ||
| Sensitivity. | 480 | ||
| Mobility. | 481 | ||
| Intrusion. | 481 | ||
| Extrusion. | 483 | ||
| Lateral displacement. | 483 | ||
| Avulsion. | 483 | ||
| Alveolar fractures. | 487 | ||
| Treatment of pulp. | 488 | ||
| References | 490 | ||
| 25 Management of Facial Fractures | 491 | ||
| Chapter Outline | 491 | ||
| Evaluation of Patients with Facial Trauma | 491 | ||
| Immediate Assessment | 491 | ||
| History and Physical Examination | 492 | ||
| Radiographic Evaluation | 493 | ||
| Cause and Classification of Facial Fractures | 496 | ||
| Causes of Facial Fractures | 496 | ||
| Mandibular Fractures | 497 | ||
| Midface Fractures | 498 | ||
| Treatment of Facial Fractures | 500 | ||
| Mandibular Fractures | 501 | ||
| Midface Fractures | 508 | ||
| Lacerations | 516 | ||
| References | 517 | ||
| VII Dentofacial Deformities | 519 | ||
| 26 Correction of Dentofacial Deformities | 520 | ||
| Chapter Outline | 520 | ||
| Prevalence of Dentofacial Deformities | 520 | ||
| Causes of Dentofacial Deformity | 521 | ||
| General Principles of Facial Growth | 521 | ||
| Genetic and Environmental Influences | 521 | ||
| Evaluation of Patients with Dentofacial Deformity | 522 | ||
| Presurgical Treatment Phase | 524 | ||
| Periodontal Considerations | 524 | ||
| Restorative Considerations | 525 | ||
| Presurgical Orthodontic Considerations | 525 | ||
| Treatment timing. | 525 | ||
| Orthodontic treatment objectives. | 525 | ||
| Final Treatment Planning | 526 | ||
| Conventional treatment planning and image prediction. | 526 | ||
| Three-dimensional computerized surgical planning. | 530 | ||
| Surgical Treatment Phase | 530 | ||
| Mandibular Excess | 530 | ||
| Mandibular Deficiency | 532 | ||
| Maxillary Excess | 535 | ||
| Maxillary and Midface Deficiency | 535 | ||
| Combination Deformities and Asymmetries | 538 | ||
| Orthognathic Surgery for Obstructive Sleep Apnea | 538 | ||
| Distraction Osteogenesis | 538 | ||
| Perioperative Care of the Orthognathic Surgical Patient | 556 | ||
| Postsurgical Treatment Phase | 557 | ||
| Completion of Orthodontics | 557 | ||
| Postsurgical Restorative and Prosthetic Considerations | 557 | ||
| Postsurgical Dental and Periodontal Considerations | 557 | ||
| Summary | 557 | ||
| References | 563 | ||
| 27 Facial Cosmetic Surgery | 564 | ||
| Chapter Outline | 564 | ||
| Historical Perspective | 564 | ||
| Facial Aging and Analysis | 565 | ||
| Facial Aging | 565 | ||
| Facial Analysis | 566 | ||
| Skin analysis. | 566 | ||
| Nonsurgical Procedures | 566 | ||
| Skin Care | 566 | ||
| Dermal Fillers | 567 | ||
| Botulinum Toxin | 567 | ||
| Facial Resurfacing | 568 | ||
| Surgical Procedures | 570 | ||
| Upper Facial Third | 570 | ||
| Brow and forehead lift. | 570 | ||
| Blepharoplasty. | 571 | ||
| Middle Facial Third | 572 | ||
| Lower blepharoplasty. | 572 | ||
| Midfacial Implants | 574 | ||
| Rhinoplasty. | 575 | ||
| Otoplasty. | 577 | ||
| Lower Facial Third | 578 | ||
| Lower face and neck lift. | 578 | ||
| Genioplasty. | 580 | ||
| Lip augmentation or reduction. | 580 | ||
| Neck liposuction. | 583 | ||
| Summary | 584 | ||
| References | 584 | ||
| 28 Management of Patients with Orofacial Clefts | 585 | ||
| Chapter Outline | 585 | ||
| Embryology | 586 | ||
| Causative Factors | 587 | ||
| Problems of Individuals with Clefts | 590 | ||
| Dental Problems | 590 | ||
| Malocclusion | 590 | ||
| Nasal Deformity | 591 | ||
| Feeding | 591 | ||
| Ear Problems | 592 | ||
| Speech Difficulties | 592 | ||
| Associated Anomalies | 593 | ||
| Treatment of Cleft Lip and Palate | 593 | ||
| Timing of Surgical Repair | 593 | ||
| Cheilorrhaphy | 593 | ||
| Objectives. | 593 | ||
| VIII Temporomandibular and other Facial Pain Disorders | 617 | ||
| 30 Facial Neuropathology | 618 | ||
| Chapter Outline | 618 | ||
| Basics of Pain Neurophysiology | 618 | ||
| Classification of Orofacial Pains | 619 | ||
| Neuropathic Facial Pains | 619 | ||
| Trigeminal neuralgia | 620 | ||
| Pretrigeminal neuralgia | 620 | ||
| Odontalgia resulting from deafferentation (atypical odontalgia) | 621 | ||
| Postherpetic neuralgia | 621 | ||
| Neuroma | 622 | ||
| Burning mouth syndrome | 622 | ||
| Other cranial neuralgias | 622 | ||
| Chronic Headache | 622 | ||
| Migraine | 622 | ||
| Tension-Type Headache | 623 | ||
| Cluster Headache | 623 | ||
| Other Chronic Head Pains of Dental Interest | 624 | ||
| Temporal Arteritis (Giant Cell Arteritis) | 624 | ||
| Indomethacin-Responsive Headaches | 624 | ||
| Evaluation of Patient with Orofacial Pain | 624 | ||
| Bibliography | 626 | ||
| Journal Articles | 626 | ||
| Books | 626 | ||
| 31 Management of Temporomandibular Disorders | 627 | ||
| Chapter Outline | 627 | ||
| Evaluation | 627 | ||
| Interview | 627 | ||
| Examination | 628 | ||
| Radiographic Evaluation | 629 | ||
| Panoramic radiography. | 629 | ||
| Tomograms. | 629 | ||
| Temporomandibular joint arthrography. | 630 | ||
| Computed tomography. | 630 | ||
| Cone beam computed tomography. | 630 | ||
| Magnetic resonance imaging. | 631 | ||
| Nuclear imaging. | 631 | ||
| Psychological Evaluation | 631 | ||
| Classification of Temporomandibular Disorders | 632 | ||
| Myofascial Pain | 632 | ||
| Internal Derangements | 632 | ||
| Anterior disk displacement with reduction. | 632 | ||
| Anterior disk displacement without reduction. | 633 | ||
| Degenerative Joint Disease (Arthrosis, Osteoarthritis) | 633 | ||
| Systemic Arthritic Conditions | 634 | ||
| Chronic Recurrent Dislocation | 635 | ||
| Ankylosis | 635 | ||
| Intracapsular ankylosis. | 635 | ||
| Extracapsular ankylosis. | 636 | ||
| Neoplasia | 636 | ||
| Infections | 636 | ||
| Reversible Treatment | 636 | ||
| Patient Education | 636 | ||
| Medication | 637 | ||
| Physical Therapy | 638 | ||
| Splint Therapy | 639 | ||
| Autorepositioning splints. | 639 | ||
| Anterior repositioning splints. | 640 | ||
| Permanent Occlusion Modification | 640 | ||
| Temporomandibular Joint Surgery | 640 | ||
| Arthrocentesis | 641 | ||
| Arthroscopy | 641 | ||
| Disk-Repositioning Surgery | 641 | ||
| Disk Repair or Removal | 642 | ||
| Condylotomy for Treatment of Temporomandibular Joint Disorders | 644 | ||
| Total Joint Replacement | 644 | ||
| Distraction Osteogenesis | 645 | ||
| References | 647 | ||
| IX Management of Hospital Patients | 651 | ||
| 32 Management of Hospital Patients | 652 | ||
| Chapter Outline | 652 | ||
| Hospital Governance | 652 | ||
| Administrative Organization | 652 | ||
| Medical Staff Membership | 653 | ||
| Hospital Dentistry | 654 | ||
| Consultations | 654 | ||
| Emergency room consultations. | 654 | ||
| Inpatient consultations. | 654 | ||
| Requesting a consultation. | 654 | ||
| Hospitalizing Patients for Dental Care | 654 | ||
| Deciding on hospitalization. | 654 | ||
| Day surgery facilities. | 657 | ||
| Preoperative patient evaluation. | 658 | ||
| Care of Hospitalized Patient | 658 | ||
| Operating room protocols. | 658 | ||
| Dental surgeon and assistant preparation. | 658 | ||
| Postoperative responsibilities. | 661 | ||
| Management of Postoperative Problems | 665 | ||
| Airway problems. | 665 | ||
| Nausea and vomiting. | 665 | ||
| Fever. | 669 | ||
| Atelectasis. | 669 | ||
| Fluids and electrolytes. | 669 | ||
| Blood component transfusion. | 673 | ||
| Appendix 1 Instrument List and Typical Retail Prices (2013) | 675 | ||
| Appendix 2 Operative Note (Office Record) Component Parts | 677 | ||
| Appendix 3 Drug Enforcement Administration Schedule of Drug and Examples | 679 | ||
| Schedule I Controlled Substances | 679 | ||
| Schedule II Controlled Substances | 679 | ||
| Schedule III Controlled Substances | 679 | ||
| Schedule IV Controlled Substances | 679 | ||
| Schedule V Controlled Substances | 679 | ||
| Appendix 4 Examples of Useful Prescriptions | 681 | ||
| Appendix 5 Consent for Extractions and Anesthesia | 683 | ||
| Appendix 6 Antibiotic Overview | 685 | ||
| I. Penicillins | 685 | ||
| II. Clindamycin | 685 | ||
| III. Metronidazole | 685 | ||
| IV. Macrolides (Erythromycin Family) | 685 | ||
| V. Tetracyclines | 685 | ||
| VI. Cephalosporins | 686 | ||
| VII. Fluoroquinolones | 686 | ||
| VII. Antifungal Drugs | 686 | ||
| Index | 687 | ||
| A | 687 | ||
| B | 688 | ||
| C | 689 | ||
| D | 690 | ||
| E | 691 | ||
| F | 692 | ||
| G | 693 | ||
| H | 693 | ||
| I | 693 | ||
| J | 695 | ||
| K | 695 | ||
| L | 695 | ||
| M | 695 | ||
| N | 697 | ||
| O | 697 | ||
| P | 698 | ||
| Q | 699 | ||
| R | 699 | ||
| S | 700 | ||
| T | 701 | ||
| U | 702 | ||
| V | 702 | ||
| W | 703 | ||
| X | 703 | ||
| Y | 703 | ||
| Z | 703 |