Unit Three – OMS Procedures

Learning Outcomes

Explain common OMS procedures and select the dedicated armamentarium for each procedure

Goal

Assist in common OMS procedures as an integral part of the surgical team

 

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
  • Block bone grafts from donor sites: 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

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

Basic Trays

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

Specialized equipment and instruments are picked for each procedure

OMS Tray
1 Lower Universal Forcep  13 Bone File
2. Seldane Retractor  14 #301 Straight Elevator
3.Upper Universal Forcep  15 Coupland Elevator
4 Small Mouth Prop  16 Crane Elevator
5 Large Mouth Prop  17 Rongeur
6 Tongue Retractor  18 Suture Needle Driver
7 Minnesota Retractor  19 Scissors
8 Local Anesthetic Syringe  20 Mosquito Hemostat
9 Scalpel Blade Handles  21 Hemostat
10 #12 Periosteal Elevator  22 Towel Clamp
11 #9 Periosteal Elevator  23 Tissue Forceps
12 Currette  24 Mouth Mirror

Note: The sterile indicator tag on each tray

Irrigation and Suction Tray

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