Textbook of Oral and Maxillofacial Surgery
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نام کتاب : Textbook of Oral and Maxillofacial Surgery
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Section 1: Principles of Oral and Maxillofacial Surgery
1. Introduction to Oral and Maxillofacial Surgery .........................................................3
• Scope 3
• Multidisciplinary Team Approach 4
• Newer Advances 4
2. Art of Diagnosis .....................................................................................................................5
• History Taking 5
• Clinical Examination 7
• Clinical Diagnostic Aids 10
• Diagnostic Investigations 14
• Biopsy 18
3. Diagnostic Imaging ..........................................................................................................19
• Fundamental Tenet of Imaging Modality 20
• Diagnostic Imaging—As Low as Reasonably Achievable Principle 20
• Selection of Imaging Modality 20
4. Management of Medically Compromised Patients in Oral Surgery..........................36
• Classification of Physical Status 36
5. Armamentarium Used in Oral and Maxillofacial Surgery ........................................48
• Instrument Used for Picking Up Sterile Instruments 48
• Instrument Used for Preparing the Surgical Field 48
• Instrument Used for Holding the Drapes 48
• Instruments Used for Incising the Tissues 49
• Instruments Used for Retracting Tissues 49
• Instruments Used for Reflecting the Mucoperiosteal Flap 51
• Instruments Used for Holding the Soft Tissues 52
• Instruments Used to Keep the Mouth Open 53
• Instruments Used to Drain an Abscess 53
• Instruments Used to Remove Pathologic Tissue 54
• Instruments Used to Hold the Bone 54
• Instruments Used to Cut or Remove Bone 55
• Instruments Used to Suture the Tissues 57
• Miscellaneous Instruments 57
• Instruments Used to Maintain a Clean Surgical Field 57
• Instruments Used for the Treatment of Fractures of the Jaw Bones 58
• Drains Used in Oral and Maxillofacial Surgery 60
xviii Textbook of Oral and Maxillofacial Surgery
• Instruments Used for the Extraction of the Teeth and Root Remnants 62
• Surgical Diathermy (Cautery, Electrocautery) 66
• Cryosurgery 67
6. Suturing Materials and Techniques ................................................................................68
• Historical Background 68
• Principles of Suture Material Selection 69
• Suture Needles 71
• Nonabsorbable Sutures 73
• Natural Absorbable Sutures 74
• Synthetic Absorbable Sutures 74
• Coated Vicryl-Polyglactin 910 Braided Suture Material 75
• Suturing Techniques 77
• Suture Removal 79
• Mechanical Wound Closure Devices 79
7. Asepsis and Sterilization ...................................................................................................80
• Definitions of Various Terminologies 80
• Transport of Used Items 81
• Cleansing of Instruments 82
• Packaging or Wrapping Instruments for Autoclaving 83
• Methods of Sterilization 85
• Storage of Sterile Goods 88
• Disinfection 92
• Disinfectants 93
• Antiseptics 94
• Operating Room Procedures 95
8. Infection Control ........................................................................................................102
• Infection 102
• Infection Control 102
• Cross Infection 102
• Routes of Transmission 103
• Infectious Diseases of Concern in Dentistry 103
• General Principles 107
• Waste Disposal in a Health Care Setting 117
9. Antimicrobial Therapy ................................................................................................119
• Principles of Antibiotic Therapy 120
• Removal of Source of Infection 122
• Beta-Lactam Antibiotics 123
• Antiviral Antibiotics 130
• Antimycotic Agents 132
• Lincomycin and Clindamycin 135
• Guidelines for Antibiotic Prophylaxis 136
Contents xix
10. Minor Oral Surgical Procedures ..............................................................................138
• Minor Oral Surgery 138
• Basic Purpose of Surgery 138
• Principles of Oral Surgery 138
• Surgical Management of Impacted Teeth 145
• Classification of Impacted Teeth 145
• Surgical Removal of Impacted Teeth 152
• Complications 158
• Surgical Endodontics 159
Section 2: General Anesthesia and Sedation in Oral and Maxillofacial
11. Introduction to General Anesthesia and Sedation ................................................165
• Problems of General Anesthesia in a Dental Chair 166
12. Preanesthetic Evaluation .................................................................................167
• Purpose of Preoperative Preanesthetic Evaluation 167
13. Preoperative Anesthetic Preparation and Premedication .................................172
• Basic Plan of Preoperative Anesthetic Preparation 172
14. Anesthetic Equipment.........................................................................................180
• Anesthesia and Resuscitation Equipment 180
• Monitoring Equipment 190
• Oxygen Therapy Equipment 192
• Intravenous Infusion Equipment 193
15. Pharmacology of Commonly Used Anesthetic Drugs ...........................................195
• Intravenous (IV) Induction Agents 195
• Inhalational Induction Agents 195
• Muscle Relaxants 199
16. Sedation Techniques for Dentistry ...................................................................201
• Sedation Techniques 201
17. Short Anesthesia in a Dental Chair .............................................................206
• Definition of General Anesthesia 207
• History 207
• Equipment 207
• Indications for General Anesthesia 208
• Day Stay Surgery 209
• Position in Dental Chair: Horizontal/Sitting 209
• Preoperative Considerations 209
• Induction of Anesthesia 210
• Maintenance of Anesthesia 210
• Endotracheal Anesthesia 211
• Recovery 211
• Complications of Dental Anesthesia 212
xx Textbook of Oral and Maxillofacial Surgery
18. Tracheal Intubation for a Patient Undergoing Oral and Maxillofacial Surgery..........214
• Indications for Tracheal Intubation 214
• Armamentarium Required for Intubations 214
19. Complications of General Anesthesia .........................................................................221
• Anesthetic Complications 221
• Complications 222
• Postoperative Anesthetic Complications 226
20. Cardiopulmonary Resuscitation ...................................................................................229
• Cardiac Arrest and its Treatment 229
Section 3: Temporomandibular Joint Disorders
21. Temporomandibular Joint: Afflictions and Management .......................................239
• Anatomy of the Temporomandibular Joint 239
• Temporomandibular Joint Disorders 245
• Surgical Approaches to Mandibular Condyle and its Neck 254
22. Ankylosis of the Temporomandibular Joint and its Management .............................261
• Classification of Ankylosis 261
• Etiopathology 262
• Pathogenesis 263
• Diagnosis 263
• Clinical Manifestations 263
• Management of Temporomandibular Joint Ankylosis 266
23. Myofascial Pain Dysfunction Syndrome ................................................................275
• Clinical Characteristics 276
• Pathophysiology (Etiology) 276
• Symptoms 277
• History of the Patient 277
• Objectives of Treatment in Myofascial Pain Dysfunction Syndrome 284
Section 4: Orthognathic Surgery
24. Introduction to Orthognathic Surgery, Diagnosis and Treatment Planning ...............297
• Types of Severe Skeletal Dentofacial Deformities and Associated Problem List 305
• Treatment Options 305
• Facial Esthetic Analysis 307
• A “Quick Ceph” Dentofacial Planner for Orthognathic Surgery 312
• Final Treatment Plan 316
25. Presurgical Orthodontic Phase .......................................................................................317
• Presurgical Orthodontics Objectives 318
• Postsurgical Orthodontics Objectives 323
• Historical Development of Orthognathic Surgery 325
Contents xxi
26. Orthognathic Surgery: Osteotomy Procedures ............................................................325
• Protocol for Osteotomies 326
• Osteotomy Procedures 326
• Maxillary Osteotomy Procedures 342
Section 5: Maxillofacial Trauma
27. Basic Principles for the Management of Maxillofacial Injuries ...............................357
• General Care of the Injured Patient 357
• Basic Principles of Treatment of a Severe Maxillofacial Injuries 358
• Basic ABCs to be Followed for Preservation of Life 358
• Soft Tissue Injuries 361
28. Injuries of the Maxillofacial Skeleton ......................................................................365
• Etiology of Maxillofacial Injuries 365
• Local Clinical Examination of Maxillofacial Injuries 367
29. Fractures of the Middle Third of the Facial Skeleton ........................................394
• Middle Third of the Facial Skeleton 394
• Classification of Fractures of Middle Third of Facial Skeleton 399
• Fractures of the Zygomatic Complex 403
• Diplopia 406
• Enophthalmos 408
30. Principles of Treatment of Midfacial Fractures ..........................................................410
• Methods of Reduction for Midface Fractures 410
• Treatment of Fractures of the Zygomatic Bone 415
• Fractures of the Nasal Bone and Treatment 421
31. Applied Surgical Anatomy of the Mandible and
Classification of Mandibular Fractures ...............................................................425
• Anatomy of the Mandible 425
• Mandibular Fractures 428
32. Management of Mandibular Fractures ......................................................................433
• Mandibular Fractures in Children 433
• Management of Mandibular Fractures in Adults 434
• Surgical Approaches to the Mandible 435
• Bone Plating in Mandibular Fractures 442
33. Fractures of the Condylar Process and its Management ......................................452
• Classification of Condylar Fractures 452
• Diagnostic Findings of Condylar Fractures 457
• Treatment of Condylar Fractures 458
xxii Textbook of Oral and Maxillofacial Surgery
Section 6: Preprosthetic Surgery
34. Preprosthetic Surgery ................................................................................................467
• Oral and Maxillofacial Prosthetics 467
• Preprosthetic Surgical Procedures 471
• Alveolar Ridge Correction 471
• Ridge Extension Procedure 479
• Ridge Augmentation Procedures 483
Section 7: Cysts and Tumors of the Orofacial Region
35. Cysts of the Jaws and Oral/Facial Soft Tissues .......................................................491
• Cyst Formation 491
• Intraosseous Cysts 493
• Soft Tissue Cysts of the Oral Cavity 511
36. Benign Tumors of the Jaw Bones ..............................................................................525
• Odontogenic Tumors 525
• Nonodontogenic Tumors 526
• General Principles of Management of a Jaw Lesion 527
• Clinical Examination of the Lesion 528
• Principles of Surgical Management of Jaw Tumors 530
• Odontogenic Tumors of Various Origins 540
• Tumors Arising from Odontogenic Ectomesenchyme with or without Inclusion of
Odontogenic Epithelium 553
• Nonodontogenic Lesions of the Jaws 556
• Non-neoplastic Bone Lesions 563
• Keratocystic Odontogenic Tumor 572
Section 8: Salivary Gland Disorders
37. Diseases of the Salivary Glands .....................................................................................583
• Salivary Glands: Anatomy 583
• Salivary Glands: Physiology 585
• Classification of Salivary Gland Diseases 586
• Salivary Gland Dysfunction 586
• Sialolithiasis 588
• Cysts of the Salivary Glands 592
• Tumors of the Salivary Glands 595
• Necrotizing Sialometaplasia 597
• Sialadenosis 598
• Diagnostic Imaging 599
• Salivary Analysis 605
• Clinical Examination: Differential Diagnosis 606
• Surgical Management 607
• Complications of Surgery of Salivary Glands 610
Contents xxiii
Section 9: Orofacial Clefts
38. Cleft Lip and Cleft Palate Management .....................................................................615
• Incidence 616
• Etiology 616
• Embryological Aspects 617
• Classification 619
• Associated Deformities and Problems 620
• Aims and Objectives of Management of Cleft Lip and Palate 622
• General Management Protocol for the Cleft Patient 622
• Management of Cleft Lip 622
• Bilateral Cleft Lip 626
• Cleft Palate 628
• Complete Cleft Lip and Palate Deformity 631
• Orthodontics in Cleft Lip and Palate 632
Section 10: Maxillary Sinus and its Implications
39. Maxillary Sinus and its Implications .......................................................................635
• General Considerations 635
• Clinical Examination of Maxillary Sinus 640
• Radiology of Maxillary Sinus 640
• Infections of Maxillary Sinus 641
• Oroantral Communication and Fistula 644
• Functional Endoscopic Sinus Surgery 655
Section 11: Orofacial and Neck Infections
40. Orofacial and Neck Infections and their Management ............................................661
• Etiology 661
• Pathways of Odontogenic Infection 662
• Microbiology 665
• Spread of Orofacial Infection 668
• Evaluation of the Patient with Orofacial Infection 670
• Potential Spaces 678
• Classification of Fascial Spaces 680
• Possible Untoward or Life Threatening Complications of Orofacial Infection 701
41. Osteomyelitis and Osteoradionecrosis of the Jaw Bones ..........................................713
• Osteomyelitis of the Jaw Bones 713
• Types of Osteomyelitis 730
• Tuberculous Osteomyelitis of the Jaw Bones 736
• Osteoradionecrosis of the Facial Bones 740
xxiv Textbook of Oral and Maxillofacial Surgery
Section 12: Facial Neuropathology
42. The Trigeminal Nerve (V) .........................................................................................751
• Functions 751
• Attachment 751
• Course 751
• Divisions 751
• Trigeminal Ganglion 751
43. Orofacial Region Pain ...........................................................................................760
• Incidence 760
• Basic Classification of Pain 761
• Neurophysiology of Pain 761
• Transmission of Impulses in the CNS 762
44. Trigeminal Neuralgia and its Management ...........................................................764
• Etiology and Pathogenesis 764
• General Characteristics 765
• Clinical Characteristics 766
• Diagnosis 766
• Treatment 768
45. Sensory Disturbances of Face and Jaws .....................................................................781
• Impaired Sensation 781
• Etiology 782
• Incidence 782
• Classification of Mechanical Nerve Injuries 782
• Evaluation 786
• Management 788
46. Facial Nerve and Motor Disturbances of Face and Jaws ..........................................792
• Facial Nerve 792
• Motor Disturbances of Face and Jaws 797
Section 13: Oral Malignancies
47. Oral Cancer .......................................................................................................................809
• Incidence 809
• Anatomical Subsites of Cancer in the Oral Cavity 810
• Etiology 811
• Spread of Squamous Cell Carcinomas of the Oral Cavity 811
• Oral Precancer 812
• Risk of Malignant Transformation of Oral Premalignant Lesions 812
• Diagnosis and Staging of Oral Cavity Cancer 815
• Management 817
Contents xxv
• Management of the Neck Lymph Nodes 821
• Lymph Node Levels 822
• Classification of Neck Dissection 823
• Survival and Prognosis 824
• Role of Dental Practitioner in Oral Cancer Management 824
Section 14: Implantology in Oral and Maxillofacial Surgery
48. Dental Implants ...........................................................................................................829
• Implant Materials 829
• Titanium Implants 830
• Classifications of Dental Implants 830
• Biologic Parameters for Implants Acceptance 832
• Indications and Contraindications 833
• Presurgical Investigations 834
• Anesthesia 834
• Insertion of Implant 834
• Complications 836
• Ailing V/S Failing Implant 837
• Clinical Photographs 842
49. Implants—An Overview ...............................................................................................843
• Implantation 843
• Osseointegration or Osseous Integration (1993) Glossary of Prosthodontic Terms-8 843
• Rationale for Implant Treatment 845
• Classifications for Implant Treatment 845
• Advantages of Dental Implants 849
• Anatomy or Parts of an Implant 850
• Patient Selection Criteria 852
• Computed Tomography 853
• Armamentarium for Implant Surgery 854
• Basic Factors in Implant Surgery 855
• Placement of the Implant in an Acceptable Position 856
• Preoperative Care 856
• Anesthesia 856
• Incisions 857
• Basic Flap Design and Soft Tissue Handling 857
• Postoperative Instructions 857
• Abutment Connection 858
• Surgical Complications of Implant Therapy 858
• Nonsurgical Management of Perimplantitis 860
• Surgical Management of Perimplantitis 861
• Absolute Indication for Explantation 861
• Long Term Maintenance Protocol for Implants 861
xxvi Textbook of Oral and Maxillofacial Surgery
Section 15: Hemorrhage and Shock
50. Hemorrhage and Shock: Its Management in Oral Surgery ........................................865
• Hemorrhage 865
• Shock 877
Section 16: Miscellaneous
51. HIV Disease—An Overview .......................................................................................883
• History and Origin 883
• Rate of Progression 885
• Viral Lesions 889
• Bacterial Lesions 891
• Mycobacterium avium-intracellulare 892
• Neoplastic Lesions 893
• Lymphoma 893
• Other Lesions Associated with HIV Disease 894
• Salivary Gland Disease and Xerostomia 894
• Management of Occupational Exposure and Post Exposure Prophylaxis 895
• HIV Testing and Counseling 896
• Protocol for Treating HIV Positive Patients 897
• Disinfectants 898
Section 17: Recent Advances in Oral and Maxillofacial Surgery
52. Recent Advances in Oral and Maxillofacial Surgery .................................................901
• Intraoperative Navigation and Robotic Surgery 904
• Buccal Pad of Fat in TMJ Reconstruction 910
• Locking Plates and Screws System 914
53. Cone Beam Computed Tomography ......................................................................920
• Technical Basis of CBCT 921
• Application of CBCT Imaging to Clinical Dental Practice 927
• Role of CBCT in Dental Implantlogy 927
• Advantages of CBCT 929
• Word of Caution! 930
• Basic Principles for use of Dental Cone Beam CT 931
54. Lasers in Oral and Maxillofacial Surgery ...............................................................933
• Physical Properties of Laser 937
• Characteristics of Laser 937
• Laser Interaction with Oral Biologic Tissues 940
• Classification of Lasers 947
• Advantages of Laser 951
• Applications of Laser in Oral and Maxillofacial Surgery and Dentistry 952
Contents xxvii
• Techniques for use of Lasers in Oral and Maxillofacial Surgery 954
• Scar Revision with Laser 957
• Use of Er:YAG Laser 958
• Low Level Laser Therapy 958
• Connections and Traffic 961
• Sterilization and Infection Control of Laser Unit 961
55. Piezosurgery .....................................................................................................................962
• What is Piezosurgery? 962
• Piezosurgery Device 963
• Technique 966
• Advantages of Piezosurgery 966
• Biological Effects on Bone Cut by Piezosurgery Device 968
