Textbook of Oral & Maxillofacial Surgery

SECTION I DEFINITION AND SCOPE OF ORAL SURGERY 1

Chapter 1 Definition and Scope of Oral Surgery 3

? Dentistry (ADA Defi nition) 4 ? Purpose of Specialisation 5 ? What a Graduate Should Know 6

SECTION II DIAGNOSIS 7

Chapter 2 History Taking and Clinical Examination 9

? History Taking 10 ? Clinical Examination 12 ? Examination of Ulcer 23 ? Examination of a

Swelling 25

Chapter 3 Radiodiagnosis 31

? Diagnostic Tools 32 ? Plain X-rays 33 ? Digital Imaging 43 ? Tomography 43 ? Magnetic Resonance

Imaging 47 ? Nuclear Medicine 47 ? Contrast Radiography 48 ? Ultrasonography 52

Chapter 4 Diagnostic Aid-Haematological, Biochemical and

Microbiological Investigations 53

? Haematological Investigations 54 ? Biochemical Investigations 62 ? Microbiologic Tests 66

Chapter 5 Histopathological Investigation 76

? Biopsy 78 ? Cytology 83 ? Immunohistochemistry 86

SECTION III MEDICAL MANAGEMENT IN ORAL SURGERY 89

Chapter 6 Management of Medically Compromised 91

? Hypertension 92 ? Diabetes Mellitus 93 ? Hypoglycaemia 93 ? Dysrhythmia 95 ? Angina

Pectoris 97 ? Myocardial Infarction 97 ? Congestive Heart Failure 98 ? Infective Endocarditis 99 ?

Asthma 100 ? Chronic Obstructive Pulmonary Disease 101 ? Renal Disorders 101 ? Adrenal

Insuffi ciency 102 ? Hyperthyroidism 103 ? Haematologic Diseases 103 ? Congenital Coagulation

Defects 103 ? Bleeding Disorders 106 ? Platelet Disorders 107 ? Neurologic Disorder 108 ?

Pregnancy 109 ? Infectious Diseases 109

Chapter 7 Medical Emergencies and their Management 117

Chapter 8 Therapeutics in Oral Surgery 140

? Antimicrobials 141 ? American Heart Association (AHA) Guidelines-May 2007 152 ?

Analgesics 154 ? Antiinfl ammatory 158 ? Antioedematous substances 161 ? Antiallergic 162 ?

Local Anaesthesia 163 ? Sedatives and Hypnotics 163 ? Muscle Relaxants 165 ? Dressings to

Protect Wounds and Relieve Pain 166 ? Stimulants for Circulatory Failure, Syncope and

Collapse 167

SECTION IV ANAESTHESIA IN ORAL SURGERY 169

Chapter 9 Local Anaesthesia 171

? Classifi cation 173 ? Intraoral Techniques 178 ? Extraoral Techniques 183 ? Block Anaesthesia for

the Mandible 185 ? Intraoral Techniques 185 ? Extraoral Techniques 191 ? Complications of Local

Anaesthesia 193

Chapter 10 General Anaesthesia 197

? Patient Evaluation for General Anaesthesia 198 ? Premedication 202 ? Delivery of Anaesthetic

Gases and Vapours 203 ? Managing the Airway 207 ? Induction of Anaesthesia 214 ? Maintenance

of Anaesthesia: Inhalational (Volatile) Agents and Intravenous Infusions 216 ? Muscle Relaxation

during Anaesthesia: Neuromuscular Blocking Drugs and their Antagonism 219 ? Conscious

Sedation 223

SECTION V PRINCIPLES OF PRACTISING ORAL SURGERY 227

Chapter 11 Armamentarium 229

? Airway Maintenance/Anaesthesia 230 ? Presurgical Asepsis and Draping 234 ? Soft Tissue

Handling Armamentarium 235 ? Hard Tissue Handling Instrument 242 ? Instruments Used for

Management of Fractures 246 ? Miscellaneous Instruments 250

Chapter 12 Sterilisation and Disinfection 255

? Cleansing of Instruments 256 ? Methods of Sterilisation 257 ? Operating Room Decorum 266 ?

Infection Control 268

Chapter 13 Incisions and Flaps 276

? Intraoral Incisions 278 ? Extraoral Incisions 282

Chapter 14 Suturing Materials and Techniques 285

? Classifi cation 286 ? Absorbable Suture Materials 287 ? Nonabsorbable Suture Materials 288 ?

Needles 290 ? Principles of Suturing 292 ? Suture Methods 293 ? Knot 295 ? Staples 297 ? Wound

Closure Tapes 298

Chapter 15 Haemorrhage and Shock 299

? Haemorrhage 300 ? Haemostasis 301 ? Shock 308

Chapter 16 Wound Care 311

? Surgical Drains 312

SECTION VI MINOR ORAL SURGERY 315

Chapter 17 Exodontia 317

? Indications for Extraction 318 ? Contraindications for Extraction 318 ? Assessment of Teeth for

Extraction 320 ? Surgical Plan 321 ? Anaesthesia 321 ? Principles of Tooth Removal 321 ? Techniques

of Extraction of Teeth 321 ? Complications of Extraction 335

Chapter 18 Impaction 345

? Mandibular Third Molar 346 ? Maxillary Third Molars 372 ? Impacted Cuspids 377 ? Surgical

Technique 380

Chapter 19 Endodontic Surgery 383

? Classifi cation of Endodontic Surgery 384 ? Endodontic Microsurgery 402

Chapter 20 Preprosthetic Surgery 403

? Hard Tissue Surgeries 409 ? Soft Tissue Procedures 426

Chapter 21 Dental Implantology 436

SECTION VII SPACE INFECTIONS 465

Chapter 22 Odontogenic Infections and their Sequelae 467

Chapter 23 General Principles of Evaluation and Management 473

Chapter 24 Head and Neck Space Infections 477

? Classifi cation of Fascial Spaces 478 ? Canine Space 479 ? Buccal Space 480 ? Submandibular

Space 481 ? Submental Space 482 ? Sublingual Space 483 ? Ludwig's Angina 484 ? Pterygomandibular

Space 489 ? Submasseteric Space 490 ? Lateral Pharyngeal Space 491 ? Retropharyngeal Space 492

? Carotid Space Infection 493 ? Parotid Space Infection 493 ? Infratemporal Space 493 ? Temporal

Space 494 ? Peritonsillar Abscess (Quinsy) 494

Chapter 25 Osteomyelitis, Osteoradionecrosis and Osteochemonecrosis 496

? Osteomyelitis 497 ? Osteoradionecrosis 503 ? Osteochemonecrosis 506

SECTION VIII MAXILLOFACIAL PATHOLOGIES 509

Chapter 26 Cysts of the Oral Cavity 511

Chapter 27 Odontogenic Tumours 541

? Benign Tumours 542 ? Malignant Tumours 552

Chapter 28 Nonodontogenic Tumours 554

? Osteoma 555 ? Fibro-osseous Lesions 556

Chapter 29 Oral Cancer 564

? Staging and Grading of Oral Cancer 565 ? Aetiopathogenesis 565 ? Squamous Cell Carcinoma 566

? Histologic Variants of Squamous Cell Carcinoma 568 ? Basal Cell Carcinoma 569 ? Ewing's

Sarcoma (Endothelial Myeloma, Round Cell Sarcoma) 569 ? Osteosarcoma (Osteogenic

Sarcoma) 570 ? Multiple Myeloma (Plasma Cell Myeloma, Plasmacytoma) 571

Chapter 30 Management of Head and Neck Tumours 572

? Surgical Management 573 ? Radiotherapy 578 ? Chemotherapy 585

Chapter 31 Salivary Gland Pathologies 587

? Classifi cation of Salivary Gland Diseases 595

Chapter 32 Maxillary Sinus and its Implications 613

? Maxillary Sinus 615 ? Advances in the Management of Maxillary Sinus Disease 629

Chapter 33 Orofacial Cleft 631

? Prevalence 633 ? Evolution of Theories of Cleft Embryo Pathogenesis 633 ? Development of

Cleft Lip and Palate 634 ? Aetiology of Oral Cleft (OC) 647 ? Pathological Anatomy 649 ? Problems

Faced by Cleft Children and their Management 650 ? Management of Patients with Cleft Lip and

Palate 652 ? Primary Correction 652 ? Lip Repair 654 ? Secondary Corrections 664 ? Closure of

Alveolar Cleft 669

Chapter 34 Orofacial Neuropathy 687

? Anatomy of the Peripheral Nerve 688 ? Classifi cation of Disorders of the Nerve 689

SECTION IX DENTOFACIAL DEFORMITIES 711

Chapter 35 Orthognathic Surgery 713

? Clinical Features 714 ? Diagnosis and Treatment Planning 718

Chapter 36 Distraction Osteogenesis 753

? History of Development of Craniofacial Distraction 754 ? Stages of Distraction 756 ? Classifi cation

of Distraction 757 ? Distractor Device 758 ? Devices 761 ? Biologic Aspect of Distraction

Osteogenesis 763 ? Imaging of Callus and its Radiographic Stages 765

SECTION X TMJ 777

Chapter 37 Anatomy of TMJ 779

? Embryology 780 ? Joint Anatomy 780

Chapter 38 TMJ Disorders 787

? Classifi cation of TMJ Disorders 788 ? Diagnosis of TMJ Disorders 788 ? Structural and

Developmental Disorders of the Condyle 791 ? Functional Disorders 799 ? Surgical

Management 801

Chapter 39 TMJ Ankylosis 802

? Aetiology 803 ? Pathophysiology of TMJ Ankylosis 804 ? Classifi cation of Ankylosis 804 ?

Clinical Presentation 806 ? Radiologic Assessment 808 ? Management 808 ? False Ankylosis 814

Chapter 40 Internal Derangements and Condylar Dislocation 816

? Physiologic Movements of the TMJ 817 ? Internal Derangement 817 ? Condylar Dislocation 818

SECTION XI MAXILLOFACIAL TRAUMA 825

Chapter 41 Emergency Management and Preliminary Examination of

a Trauma Patient 827

Chapter 42 Basic Principles of Management of Maxillofacial Trauma 835

? Principles in Managing Panfacial Fractures 836 ? Fracture Healing 856 ? Complications 857 ?

Soft Tissue Injury and Management 860

Chapter 43 Dentoalveolar Fracture 864

Chapter 44 Fractures of the Mandible 875

? Classification of Mandibular Fracture 877 ? Condylar Fractures 892 ? Edentulous Mandible

Fracture 904

Chapter 45 Maxillary Fractures 908

? Hendrickson Classification of Palatal Fracture 916

Chapter 46 Orbitozygomatic Complex 924

? Anatomy 925 ? Mechanism of Zygomatico-orbital Fractures 925 ? Classifi cation of Zygomatic

Fracture 927 ? Clinical Finding 931 ? Timing of Repair 937 ? Surgical Approach 937 ? Fracture

Reduction 940 ? Fixation Technique 942 ? Zygomatic Arch Fractures 943 ? Orbital Floor

Reconstruction 943

Chapter 47 Naso-orbito-ethmoid Fracture 946

? Anatomy of Naso-orbito-ethmoid Region 947 ? Nasal Bone Fracture 949

Chapter 48 Frontal Bone Fractures 961

? Surgical Anatomy 962 ? Applied Anatomy 963 ? Biomechanics of Frontal Sinus Injury 963 ?

Types of Frontal Sinus Fractures 963 ? Evaluation of Frontal Sinus Injury 965 ? Management of

Frontal Sinus Fracture 968 ? Complications of Frontal Bone Fracture 972

SECTION XII MISCELLANEOUS 977

Chapter 49 Medicolegal Considerations in Dentistry 979

Chapter 50 Recent Advances 984

? Bone Substitutes 985 ? Bioresorbable Plates 993 ? Lasers in Oral Surgery 996 ? Piezoelectric

Surgery 1002 ? Robotic Surgery 1004

Index 1007