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Dentoalveolar Surgery, An Issue of Oral and Maxillofacial Clinics of North America, E-Book

Dentoalveolar Surgery, An Issue of Oral and Maxillofacial Clinics of North America, E-Book

Michael A. Kleiman

(2015)

Additional Information

Book Details

Abstract

Editor Michael Kleiman, DMD and authors review the current state of Dentoalveolar Surgery. Articles include: Pre-prosthetic Surgery; Dentoalveolar Surgery for Patients on Modern Anticoagulants and Antiresorptive Medications; Dental Extractions and Preservation of Space; Managing Impacted Third Molars; Update on Coronectomy for Impacted Third Molars at High Risk for Paresthesia; Apicoectomies: Treatment Planning and Surgical Technique in a Modern World; Minimizing Pain, Swelling and Infections for Dentoalveolar Surgery; Implementing a “Culture of Safety” in Dentoalveolar Surgery; Strategies for Minimizing Nerve Injuries in Dentoalveolar Surgery and What To Do If It Happens; Soft Tissue Procedures to Preserve and Restore Healthy Attached Gingiva around Natural Teeth and Implants; Surgical Treatment of Impacted Canines: What the Orthodontist Would Like the Surgeon to Know, and more!

Table of Contents

Section Title Page Action Price
Front Cover Cover
Dentoalveolar Surgery i
Copyright\r ii
Contributors iii
Contents v
Oral And Maxillofacial Surgery Clinics Of North America\r viii
Preface\r ix
Medical Management of Patients Undergoing Dentoalveolar Surgery 345
Key points 345
Introduction 345
Presurgical evaluation 345
Cardiovascular 345
Hypertension 346
Pacemaker/Defibrillator 347
Coronary Artery Disease 347
Anticoagulation 349
Endocarditis prophylaxis 349
Medication-related osteonecrosis of the jaw 349
Summary 351
References 351
Dental Extractions and Preservation of Space for Implant Placement in Molar Sites 353
Key points 353
Introduction 353
Socket healing 353
Treatment planning 354
Anatomic configurations after tooth extraction 356
Loss of All Facial Bone to the Apex of the Tooth 356
Loss of a Portion (3–6 mm) of the Facial Bone 356
Loss of Less Than 3 mm of Facial Bone at the Crest 356
Lack of Bone Inferior to the Apex of the Socket, with Extreme Proximity of Adjacent Vital Structures, Such as the Inferior ... 356
Lack of Lingual Bone 356
Concavity Within the Extraction Site When Removing an Ankylosed Deciduous Molar 356
A Socket That is Larger Than the Proposed Diameter of the Implant in all Dimensions 357
Socket That is Oval in Shape, With the Long Dimension Palatal to Facial and the Short Dimension Mesial to Distal 357
Very Thin Surrounding Bone 357
Bone Adjacent to the Neighboring Tooth (or Teeth) Absent, and Root Surface of Adjacent Tooth Exposed 357
Treatment indications in 3 common situations 357
The Tooth is Nonrestorable but has Intact Surrounding Bone and Relatively Healthy Gingiva, with Minimal Pain 357
Surgical procedure 357
The Tooth is Nonrestorable and has Intact Surrounding Bone; however, the Tooth is Acutely Painful and May Have Purulent Exu ... 358
The Tooth is Nonrestorable but has Lost a Portion of the Buccal Bone 358
Grafting material 358
Bovine or equine sintered xenograft 359
Mineralized bone allograft 359
Autogenous bone 359
Postoperative care 361
Evidence for long-term preservation of bone 361
Summary 361
References 361
Managing Impacted Third Molars 363
Key points 363
Obstacles to consensus 363
Desires and perspectives of parties of interest 363
Uncertain Terminology 364
Misconceptions 364
Related organizational policy statements 364
American Association of Oral and Maxillofacial Surgeons 364
The American Dental Association 364
Academy of Pediatric Dentistry 365
Cochrane Systematic Review 365
United Kingdom’s National Health Service 365
National Health Service of Finland 365
United States Military 365
American Public Health Association 365
Third molars are different 365
Clinically relevant science 366
Known associated disease 366
Potential adverse outcomes associated with third molar removal 367
Consequences of third molar retention 367
Things considered certain about third molar behavior and management 367
Statements likely to be valid but requiring more study before being considered certain 368
Recommendations supported by clinically relevant evidence 368
Simplified approach to clinical decision making 368
Symptoms and disease present 369
Symptoms present/disease free 369
Symptom free/disease present 370
Symptom free/disease free 370
Summary 370
Acknowledgments 370
References 370
Coronectomy 373
Key points 373
Controversial issues concerning coronectomy 374
Indications for coronectomy 375
Contraindications for coronectomy 376
Surgical technique 376
Antibiotics 377
Suturing 377
The Distance Below the Alveolar Crest to Leave the Roots 378
Results 378
Alternative techniques 380
Orthodontic Extrusion of the Third Molars 380
Sequential Removal of Small Portions of the Occlusal Surface of the Impacted Third Molar 380
Summary 380
References 380
Current Concepts of Periapical Surgery 383
Key points 383
Preoperative planning 383
Determination of “success” 387
The cracked or fractured tooth 387
Concomitant periodontal procedures 387
Surgical procedures 388
Surgical access 390
To biopsy or not? 390
References 392
Best Practices for Management of Pain, Swelling, Nausea, and Vomiting in Dentoalveolar Surgery 393
Key points 393
Best practices for controlling pain, swelling, nausea, and vomiting from dentoalveolar surgery 393
Surgical technique from opening to closing 394
Pain control 394
Nonsteroidal antiinflammatory drugs and postoperative pain control 395
Narcotics 395
Acetaminophen 395
Psychology of pain 396
Swelling 396
Steroids 396
Protease inhibitors 397
The power of the pineapple 397
Low-level laser energy irradiation 397
Other methods to decrease swelling 397
Postoperative nausea and vomiting 397
Fear as a cause of nausea 398
Anesthetic drugs and nausea 398
Local anesthesia toxicity and nausea 399
Ingestion of blood and nausea 399
Hypoglycemia and dehydration causing nausea 399
Sex bias related to nausea 399
Type of surgery 399
Antiemetic medications for the prevention of nausea and vomiting: preemptive versus symptomatic management 399
Summary 401
References 402
Developing and Implementing a Culture of Safety in the Dentoalveolar Surgical Practice 405
Key points 405
Introduction 405
The culture of safety concept 405
Hospital safety practices 406
Culture of safety in oral-maxillofacial surgery 406
Clinical care safety 406
Intraoffice guest and health care team safety 407
Safety from extraoffice threats 408
Establishing a culture of safety 408
References 409
Trigeminal Nerve Injuries 411
Key points 411
Introduction 411
Preoperative evaluation 412
Surgical strategies for avoidance of injuries 415
When injury occurs 417
Summary 423
References 423
Soft Tissue Grafting Around Teeth and Implants 425
Key points 425
The ideal characteristics of the soft tissue tooth/implant interface 425
Development of mucogingival diagnosis and surgery 426
Gingival recession around teeth and implants 426
Classification of recession 426
Esthetic considerations 426
Thick versus thin gingival architecture 427
The relationship between implant placement and soft tissue 428
Implants Should Be Placed 3 mm Below the Facial Gingival Margin in an Apicocoronal Dimension for the Following Reasons 428
Implants Should Be Placed in a Buccolingual Dimension 1 to 2 mm Palatal from the Anticipated Facial Margin of the Restoration 428
The Implant Should Be Placed with the Platform at the Level of the Gingival Zenith and 3 mm Apical to the Soft Tissue Margin 428
Implants Should Be Placed with a Minimum of 1.5 mm Between the Adjacent Tooth and Implant 428
Implants Should Be Placed with an Interimplant Distance of at Least 3 mm in a 2-Stage Protocol 428
Papilla 429
Papilla Adjacent to Teeth 429
Papillae Adjacent to Implants 429
Provisional Restoration 429
Soft tissue management before implant placement 430
Extraction Sockets 430
Soft tissue management at the time of implant placement 431
Treatment Planning for Soft Tissue Grafting Around Teeth and Implants 431
Free soft tissue grafting 431
The free gingival graft 431
Indications for Free Gingival Graft 433
Technique 433
Soft tissue grafting on implants versus teeth 434
Subepithelial connective tissue graft 435
Technique for Subepithelial Connective Tissue Graft 435
Donor site for subepithelial connective tissue graft 435
Recipient Site for Subepithelial Connective Tissue Graft 436
Partially covered subepithelial connective tissue graft 436
Completely covered subepithelial connective tissue graft 436
Partial-thickness double pedicle graft 437
Technique for pedicle flap with vertical incisions 437
Technique for envelope flap 438
Semilunar and lateral sliding flaps 439
Pinhole surgical technique 439
Root surface and implant surface treatment 439
Alternatives to autogenous soft tissue grafts 439
Allograft 440
Xenograft 440
Guided Tissue Regeneration 440
Living Cellular Construct 440
Biologic agents 442
Soft tissue grafts for ridge augmentation 443
Donor and Recipient Wound Site Protection 443
Summary 444
Acknowledgments 444
References 444
Surgical Treatment of Impacted Canines 449
Key points 449
Introduction 449
The orthodontist must be the “master of ceremonies” 450
The surgical procedure 451
The Palatal Canine and the Open Exposure Technique 451
The Palatal Canine and the Closed Exposure Technique 452
The Labial Canine and the Window Technique 452
The Labial Canine and the Apically Repositioned Flap Technique 452
The Labial Canine and the Closed Exposure Technique 452
The Midalveolar Canine and the Tunnel (Closed Exposure) Technique 454
Bonding the attachment 454
It is all a question of making the right choices 456
Is this treatment urgent? 457
Supplementary data 458
References 458
Preprosthetic Surgery 459
Key points 459
Goals 459
Bony recontouring procedures 460
Preoperative Planning 460
Alveoloplasty 460
Maxillary Tuberosity Reduction 461
Torus Removal 463
Maxillary (palatal) torus removal 463
Removal of Mandibular Tori 464
Soft tissue procedures 465
Frenectomy 465
Skin Grafting 467
Vestibuloplasty 467
Index 473