Introduction & Organization of Course:
Students are introduced to the definition & scope of the specialty, and informed of the organization, grading system, quizzes, tests, CE, Oral/Written presentations, and reading requirements of the course.
Classification of diabetes; effects of diabetes on systemic function, medication used in treatment of diabetes-modes of action, peak, duration, complications; differential diagnosis: diabetic coma vs. insulin shock; the gravid patient-hormonal and cardiovascular changes; factors in guiding treatment schedule; drug effects on fetus. Physical and laboratory evaluation of medically compromised patients with liver, adrenal or thyroid disease; effects of steroids on systemic function; patient management.
Definition of hypertension and review of etiologies, laboratory test for evaluation; review of drug therapy used in management; considerations in treatment of cardiac patients-angina pectoris. Clinical evaluation and management of patient with arrhythmias; interpretation of EKGs and pulses associated with arrhythmias; antiarrhythmic drugs.
Obstructive and restrictive pulmonary diseases and treatment considerations; Rheumatic fever?etiology, criteria for diagnosis, pathology, treatment; prevention of bacterial endocarditis-prophylaxis regimens; dental management of patients on anticoagulation therapy-heparin vs. Coumadin; laboratory evaluation; drug interactions.
Wound Classifications and Sterile Techniques:
Wound Classifications, concern of infections, and sterile techniques used in surgery.
Surgical Instruments and Suture materials:
Instruments used in outpatient oral and maxillofacial surgery practice; suture materials-absorbable vs. non-absorbable; consideration for selection.
Flap Design in Oral Surgery:
Principles of flap design and types of flaps; anatomical considerations; indications for flap procedures.
Review of fundamental techniques used in exodontia practice; cardinal forces, hand and chair position, use of elevators, surgical extractions.
Surgical Removal of Impacted Teeth:
Classification of impacted teeth -mandibular vs. maxillary; theories in regard to etiology and frequency of occurrence; indications for removal of impacted teeth and review of factors indicating non-removal. Case presentations of surgical removal of impacted teeth-Interpretation of radiographs, surgical approaches; management of pericoronitis prior to surgery.
Complications Following Odontectomies & Exodontia:
Management of complications associated with exodontia-including hemorrhage swelling and pain; review of routine postoperative care and instructions. Management of complications following odontectomies-swelling, infection, delayed healing (dry socket), trismus, altered sensation, displacement of teeth into spaces, sinus or canal fractures.
Management of Infection & Antibiotics in Infection:
Case presentations?management of facial infection involving major facial spaces; Ludwig’s angina and cavernous sinus thrombosis; signs and symptoms, pathways of infection spread, treatment. Review of antibiotics used in the management of facial infections; antibiotic classification, dosage, spectrum, mode of action, side effects; culture and staining techniques; bacterial identification and sensitivities.
Facial Space Infections-Criteria for Hospitalization of Infections:
Review of anatomy of fascial spaces, involvement by odontogenic infections, and criteria for specialist referral and hospitalization.
Care of the Hospitalized Patient:
Justifications for admission to hospital; types of admissions, hospital notes and orders, consultations-coordination of specialty services in the management of a traumatized, compromised patient. . Review of analgesics-prescription writing, classification, side effects, narcotics and NSAIDs.
Anatomy, bacteriology and histology of maxillary sinus, clinical and radiographic evaluation of sinusitis; removal of pathology from sinus; patient management and drug therapy; closure of oroantral fistula.
Endodontic Surgery & Management of Cystic Lesions:
Indications for apicoectomies and retrograde amalgams; surgical techniques; postoperative management; case presentations.
Clinical evaluation of edentulous ridges-reasons for alveoplasty; instrumentation and surgical techniques; types -interradicular, simple, radical; case presentation. Clinical evaluation of patients for preprosthetic surgery; surgical techniques in performing tuberosity and tori reductions; anatomical considerations. Indications for vestibuloplasty; surgical principles in performing vestibuloplasty-maxillary vs. mandibular; grafting procedures; postoperative management; case presentation.
Implant Surgery-Anatomic Considerations:
Review of residual ridge classifications, bone densities, implant and bone grafting options relating to the residual ridge orders.
Bone Grafting Considerations Related to Implant Dentistry:
Bone grafting biology; Bone graft materials: Autogenous, Allogeneic, Alloplastic; and Bone grafting procedures: sinus lifts and ridge augmentation techniques.
Radiographic considerations in Implant & Reconstructive Surgery:
Anatomical limitation in implant surgery, evaluation of bony anatomy using radiographic studies with emphasis on computed tomographic examinations and interactive CT treatment planning.
Care of the Traumatized Patient:
Considerations in initial treatment of the traumatized patient with multiple facial injuries-airway management, monitoring, vital signs, laboratory test, fluid replacement, radiographs, physical examination; case presentation.
Facial Fractures I:
Principles in management of facial fractures -dentoalveolar and mandibular fractures; diagnosis, classifications, methods of stabilization-unfavorable vs. favorable, edentulous vs. dentulous; case presentations.
Facial Fractures II:
Maxillary, Le Fort, Zygomaticomaxillary complex, nasal, frontal, NOE fractures and management techniques.
Surgical Correction of Dento-Facial Deformities I – Diagnosis and Treatment Planning:
Diagnosis and treatment planning in determination of specific skeletal deficiencies for surgical correction of facial deformities-interpretation of cephalometric x-ray and model surgery.
Surgical Correction of Dento-Facial Deformities II – Mandibular/Maxillary Considerations:
Mandibular considerations in surgical correction of facial deformities; case presentation of surgical techniques-vertical oblique, sagittal and horizontal osteotomies. Maxillary considerations in surgical correction of facial deformities-case presentation of surgical techniques-Le Fort procedures, midfacial augmentation.
Facial Neuralgia and Paralysis:
Signs, symptoms and therapy of facial neuralgias-tic douloureux, glossopharyngeal, sphenopalatine and atypical neuralgias; Bell’s palsy-etiology, signs, symptoms, management.
Temporomandibular Joint Surgical Aspects:
Anatomy of temporomandibular joint-review of muscles of mastication; evaluation of function-radiographic techniques and interpretation -tomography, CT scan, conservative therapy. Temporomandibular joint pathology -ankylosis, internal derangement, arthritis-degenerative joint disease-surgical management of TMJ disorders; case presentation.
Salivary Gland Diseases:
Review of salivary gland diseases with emphasis of those that require surgical management.
Management of emergency cases in the office, with emphasis in advanced techniques in the oral surgery office.