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.
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 dentist.
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.
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.
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.
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.
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