Ch. 56 Oral and Maxillofacial Surgery

Chisel

A surgical instrument used for cutting or severing the tooth and bone structure

Elevator

The surgical instrument used to reflect and retract the periodontal ligament

Hard tissue impaction

When the tooth is partially to fully covered by bone and gingival tissue

Hemostat

An instrument used to hold or grasp items

Surgical curette

A surgical instrument used to remove tissue and debris from the tooth socket

Alveoplasty

The procedure of surgical reduction and reshaping of the alveolar ridge

Bone file

A surgical instrument used to smooth rough edges of bone structure

Soft tissue impaction

When a tooth is partially to fully covered by gingival tissue

Exfoliative biopsy

A procedure in which cells are scraped from a suspicious oral lesion for analysis

Forceps

A surgical instrument used to grasp and remove a tooth from its socket

Donning

The act of placing an item on, such as gloves

Impacted

A tooth that has not erupted yet

Incisional biopsy

The removal of a section of a questionable lesion for evaluation

Mallet

A hammer-like instrument used with a chisel to section teeth or bone

Scalpel

A surgical knife

Oral and Maxillofacial Surgeon

A dentist who specializes in surgeries of the head and neck region

Oral and Maxillofacial Surgery

The dental specialty that focuses on treatment of the head and neck

Outpatient

A patient who is seen and treated by a doctor and then is sent home for recovery

Retractor

An instrument used to hold back soft tissue

Rongeur

A surgical instrument used to cut and trim the alveolar bone

What type of surgical procedures would a general dentist most commonly perform?

Single extractions

How can a dental assistant further is or her career as a surgical assistant?

Further education in specialized program for surgical dental assitants, or on the job training. Obtain certification in advanced cardiac life support, and the use of additional monitoring procedures

In what type of setting are oral surgery procedures completed?

Dental office, Outpatient clinic, Hospital

Most oral and maxillofacial surgeries are considered?

Minor surgery

What does the periosteal elevator reflect and retract?

Periosteum

Universal forceps are designed to be used for?

Left or right of the same arch

What surgical instrument resembles a spoon excavator?

A surgical curette

What surgical instrument is used to trim and shape bone?

Ronguer

What equipment is used to perform a surgical scrub?

Orange stick, Antimicrobial soap, Scrub brush

What procedure is commonly performed by the surgeon directly after removal of multiple teeth adjacent to one another?

Alveoplasty

When a tooth is directly under gingival tissue, it is said to be?

Soft tissue impacted

What type of biopsy is completed when the surface lesion is scraped to obtain cells?

Exfoliative biopsy

Which is an absorbable suture material?

Catgut

What is the approximate time frame for removing nonabsorbable sutures?

5-7 days

How long should a pressure pack remain on the surgical site to control bleeding?

30 minutes

What analgesic may be prescribed for swelling?

Ibuprofen

What should a patient use to control bleeding?

Cold pack

What are the roles of a oral surgery assistant?

Patient assessment and monitoring, Use of specialized instruments, Surgical asepsis, Surgical procedures, Pain control techniques, Patient home care instructions

Alveolitis

Dry socket from removal of blood clot

What specific items in a surgical suite replace items seen in a general dentistry?

Monitoring equipment, pain control units, and mobile trays

Root tip picks

Instruments used for the removal of root tips or fragments that may break away from the tooth during the extraction procedure

Cowhorn 23

Forcep that gets into the furcation of the tooth

Cowhorn F16

Has a curved end of handle for the pinky

Cryer 150

Universal Maxillary forcep (angle is up)

Cryer 151

Universal Mandibular forcep (angle is down)

Bayonet 286

Forcep for premolars and sometimes canines

Seldon elevator

Periosteal elevator with an angle

What method is used for bone filing?

The push-pull motion to smooth the surface of the bone after the ronguer has removed most of the undesirable bone

Needle holder

Looks and operates similarly to a hemostat, the beaks are straight with cross-pattern serrations on the surface, allowing to surgeon to grasp a needle firmly

How is the handle of a needle holder designed and what purpose does this feature serve?

The handle is held in place by a ratchet action that holds and object until the dentist releases it, it allows the dentist to tie the suture material by using the needle holder without snagging it in the joint of the instrument

Surgical scissors

Available with curved or straight blades that have smooth or serrated cutting edges. They are used to trim soft tissue

Suture scissors

Are designed to cut sutures only, they are sturdier than surgical scissors and can have a small notch on the cutting edge of one blade

Mouth props

Also known as a bite block, is a rubber block that allows the patient to rest and relax the jaw muscles. It is placed on the opposite side of the mouth being treated

Complex extraction

Used when conditions require additional skill, knowledge, and instrumentation to remove a tooth. An extraction of an impacted tooth is an example of this

The most common types of absorbable suture materials are?

Plain catgut (provides the fastest healing), Chromic catgut (slower healing process), Polyglactin 910 (Vicryl) a synthetic absorbable material

Nonabsorbable suture materials include:

Silk (For strength and easy application), Polyester fiber (one of the strongest), Nylon (for strength and elasticity)

What are the most commonly placed sutures for a single tooth socket?

Interrupted or horizontal mattress sutures

What sutures are used for suturing two or more papillae together?

Mattress suture and Figure-eight suture

What are the steps when removing a nonabsorbable suture?

Remove surface debris from site with a sterile cotton tip applicator and peroxide or antiseptic solution, use sharp and pointed suture scissors, remove by pulling toward the incision line, not away from it.