made. If the lesion is not malignant, it is allowed to
heal without further surgery. If a laboratory test shows
the tissue is malignant, complete removal is indicated.
The excision method involves removal of the
entire lesion along with some adjacent normal tissue.
This procedure is done on small lesions where
complete removal would not create significant esthetic
or functional impairment.
FOREIGN BODY REMOVALS
This is the removal of any foreign body, such as a
needle, metallic restoration, or pieces of elevators,
forceps, or even bullets. Such a removal is considered
a surgical procedure. It is not always indicated, and is
often left up to the judgment and discretion of the
Sequestrectomy procedure involves the removal
of devitalized portions of the bone that have separated
from the adjacent bone. Often the devitalized portion
of bone will work its way partially through the tissue
and be sharp and rough.
After the extraction of a tooth from its alveolus,
healing begins immediately when blood oozes into the
alveolus and forms a clot. The clot is later replaced by
scar tissue and ultimately bone as healing progresses.
The blood clot also protects the alveolus from food, air,
and fluids. If the blood clot does not form or dislodges
from the tooth socket, a painful condition called
alveolar osteitis (also known as a dry socket) may
occur from 2 to 4 days after the removal of a tooth.
With the clot missing, healthy granulation is absent
and the tissue within the socket appears grayish in
color and often presents a foul odor. The patient is
usually in severe and persistent pain because of the
exposed bone in the open socket. In Dental
Technician, Volume 1, chapter 6, we describe
emergency treatment for this condition.
The procedure for pericoronitis involves the
treatment of the gingival tissue surrounding a partially
erupted or malposed tooth, that develops painful,
localized inflammation. In Dental Technician,
Volume 1, chapter 6, we also describe emergency
treatment for this condition.
TRAUMATIC WOUND REPAIR
Simple and complicated wounds of the facial and
or oral soft tissues may be repaired and or sutured in
INCISION AND DRAINAGE
Incision and drainage involves surgical
inter-vention for drainage of an abscess, cyst, or
hematoma. A surgical rubber drain can be sutured in
the area to establish drainage.
There are several types of surgical implant devices
and associated procedures. An endosseous implant is
a device placed in the alveolar bone to support an oral
or facial prosthesis. A transosteal or superiosteal
implant is a device placed to support an oral or fixed
prosthesis. A surgical abutment procedure involves
uncovering the implant and connection of the
abutment used in the prosthetic reconstruction of
single or multiple teeth.
Many surgical instruments are used in both oral
surgery and periodontic procedures. All surgical
instruments are made of high-grade steel, either
stainless or chrome-plated. Each instrument has a
particular purpose and should be handled with extreme
care. The instruments with cutting edges must be kept
sharp to prevent slippage. Hinged instruments should
be lubricated with a milk bath and sterilized in the wide
open position to keep them in good operating condition
and to prevent rusting.
No matter what kind of dental surgery is being
performed, some miscellaneous instruments will
almost certainly be required. Among these are surgical
suction, retractors, scalpels, suture needles and
materials, and surgical scissors. A few other
instruments, such as mouth props, mouth gags, and a
surgical mallet, will also be included with the
miscellaneous surgical instruments.