Unit Three – OMS Procedures

Common Procedures

Extractions – the removal of teeth

• single or multiple teeth
• 4×8 – extraction of 4 third molars (wisdom teeth)

Orthodontic Interventions – surgeries designed to assist in orthodontic treatment (correction of malocclusions)

• Bollard Plates – titanium plates that are temporarily screwed into the jaw; they provide anchorage for orthodontic movement
• Exposures – surgical uncovering of a tooth in preparation for orthodontic treatment
• Frenectomy – removal of tissue that prevents the normal position of teeth, tongue, (or prosthetic)
• Luxate – surgical dislocation or displacement of a tooth from the alveolus to assist in eruption
• Transplant – surgical removal of a tooth from one location to another

Biopsy – removal and examination of abnormal oral structures

• Cysts and periapical lesions
• Soft tissue lesions

Pre-Prosthetic Surgery – corrects abnormalities prior to prosthetic insertion (e.g. dentures and implants)

• Soft tissue: removal or repair of fibrous, hyperplastic, and hypertrophic tissue
• Alveolar ridge maintenance post-extraction: Allograft
• Platelet Rich Fibrin (PRF) membrane:  Autograft
• Collagen membranes: Allograft
• Block bone grafts from patient’s donor site: Autograft
• Bone grafts from patient’s donor site: Autograft
• Sinus lift: with allograft or autograft, osteotome, or elevation
• Tori Removal

Implantology – replacement of single tooth, multiple teeth, or full arches

• First stage (initial placement): single, multiple, all-on four (full arch)
• Second stage (typically 3-4 months post placement): assess for osseointegration, ISQ test, uncover

Orthognathic Surgery – corrects conditions of the jaw related to structure, growth, malocclusion or trauma

• BSSO – Bilateral Sagital Split Osteotomy
• Genioplasty – chin augmentation
• Le Fort 1 – Maxillary Osteotomy
• SARPE – Surgically Assisted Rapid Palatal Expansion

TMJ Surgery –

• Arthrocentesis – TMJ arthrocentesis is a surgical treatment that involves irrigating the joint with the possibility of depositing a therapeutic drug
• Eminectomy – A surgical reduction of the articular eminence of the TMJ

Emergency Surgery – emergent maintenance of circulation issues, pain, and infection

• Cautery – coagulation of tissue by an electric surgical device
• Debridement – removal of damaged tissue or foreign object from a wound
• Facial Trauma – jaw wire
• Incise and Drain (I & D) – clinical lancing
• Oral-Antral Fistula – sinus exposure

It is always best to confer with your surgeon when choosing procedure specific protocols to prevent healthcare associated infections. Below are some examples:

PROCEDURE SPECIFIC PROTOCOLS:

Planning reduces errors in OMS. Creating procedure specific checklists will ensure the utmost in perioperative care, and in maintaining asepsis or sterility

Surgical Tray:

The tray sets pictured are generic and are used for all procedures

Specialized equipment and instruments are picked for each procedure

Note: The sterile indicator tag on each tray (as seen above) is crucial to ensure sterility

Surgical Tray with Suction and Power:

Oral Surgery Instruments and Forceps