Oral surgical complications

• Dental Nomenclature

  Quadrants: right and left, upper and lower.

  Modified Triadan system

  1st number = quadrant

  2nd and 3rd identify the tooth

  Mesial, Distal

  Labial, buccal

  Lingual

  Palatal

  Occlusal

  
• Dental tissue

  Pulp-dentine organ

  • Maturation
  • Root - apical delta.

  Periodontium
• Periodontium

  Attach, support, protect.

  • Alveolar bone
  • Periodontal ligament (PDL_
  • Cementum
  • Gingiva

  
• Conscious oral investigation

  History.

  Conscious exam.

  Pre-operative testing.

  Extra-oral

  • Heart, chest, pulses
  • Head & neck
  • Symmetru
  • Lymph nodes, salivary glands.

  Intra-oral

  • General oral view
  • Occlusion
  • Specifics
• Anaesthetised oral investigation


  Extra-oral

  Intra-oral - diagnostics require GA.

  General oral view

  • Induction
  • Intubation
  • Stabilised under GA
  • Chlorhexidine prep
  • Soft tissue check
  • Debulk calculus.

  Detailed oral and dental exam.
• Oral examination equipment - dental chart

  Dentition map

  Permanent record

  Medico-legal

  Triage

  
• Charting abnormalities

  Oral mucosae

  Occlusion

  Periodontal disease

  Missing and extra teeth

  Damaged teeth

  Abscess and tract

  Resorptive lesions

  Caries

  Oral masses

  Pre and pst treatment e.g. extraction
• Periodontal disease - gingivitis

  Gingivitis severity score G0-G3 - tendency to bleed.

  Periodontal probe

  Gingival inflammation

  Erythema

  Swelling/oedema

  Bleeding
• Periodontal disease - periodontitis

  Attachment loss pattern

  • Periodontal pocket
  • Gingival recession
  • Furcation involvement (F0-F3)
  • Mobility (M0-M3)
• Intra-oral radiography - overview

  View the ‘hidden’ 60-70%

  Remove guesswork and surprises.

  Accurate diagnosis and treatment plan.

  Monitoring

  Advanced techniques.
• Intra-oral radiography - indications

  Oral masses

  Damaged teeth - treatment options

  Periodontitis

  Abscess

  Resorptive lesions

  Caries

  During treatment e.g. RCT

  Pre and post treatment extraction.
• Biopsy of oral masses

  All masses and abnormal lesions should be biopsied.

  Wedge

  Sufficient size, adequate depth, avoid ulcerated/ inflamed areas, label/orientate on dental chart.

  Twin with radiography.
• Oral investigation - anaesthetised

  Extra-oral

  Intra-oral - diagnostics require GA.

  General oral view:

  • Induction
  • Intubation
  • Stabilised under GA
  • Chlorhexidine prep
  • Soft tissue check
  • Debulk calculus