Controversies in Dental Traumatology.

The management of traumatic dental injuries is more a shade of gray than it is black and white because not all treatment procedures used for dental trauma management are fully evidence based. This chapter has highlighted some of the gray areas related to the treatment and outcome of traumatic dental injuries. Significant controversies in the management of luxation and avulsive injuries have been brought out.

Acute Pain Management.

Control of acute pain in oral and maxillofacial surgery is important for patient care and comfort. Oral surgical procedures are associated with tissue injury and inflammation. Acute pain can arise directly from a surgical procedure or from problems such as dental caries, infection, perforation of maxillary sinus, pericoronitis, and jaw fractures.

Excision of Sublingual Gland.

There are 2 types of ranulas: oral ranulas and plunging (cervical) ranulas. The management of the cervical ranula involves surgical excision of the oral portion of the ranula along with the associated sublingual salivary gland. The sublingual gland is easily removed from an intraoral approach.

Vertical and Horizontal Augmentation of Deficient Maxilla and Mandible for Implant Placement.

Ridge augmentation for implant procedures has been shown to be highly successful. There are several techniques available to the dentist, but they require some degree of surgical expertise and experience. No particular technique has been shown to be superior.

New Approaches to Pain Management.

Opioid addiction has reached epidemic proportions in the United States and it is thought that the problem started with the prescription for legal pain medications by health care professionals, particularly for treating patients who had undergone surgery. To reduce the reliance on opioids in dental pain management, increase use of nonsteroidal anti-inflammatory drugs (NSAIDs) and other adjunctive techniques have emerged. The use of NSAIDs, transdermal and transmucosal patches are presented.

Salivary Gland Diseases.

A variety of diseases ranging from obstructions, infections, to benign and malignant tumors occur in salivary glands. The most common problem is painful blockage of ducts by stones that prevents drainage of saliva. Sialadenitis can be due to either infectious or noninfectious factors.

Odontogenic Tumors.

Odontogenic tumors are a group of neoplastic growths that originate from the tissues responsible for tooth formation and the periodontal apparatus of the jaw. Odontogenic tumors usually present as radiolucent defect, which makes diagnosis somewhat confusing while differentiating them from cysts. Although cystic lesions are surrounded by sclerotic borders, few odontogenic tumors share similar features.

Odontogenic Infections.

The pathogenesis of odontogenic infection is polymicrobial, consisting of various facultative and strict anaerobes. The dominant isolates are strictly anaerobic gram-negative rods and gram-positive cocci. The periapical infection is the most common form of odontogenic infection.

Epidemiology of Oral and Maxillofacial Infections.

Dental caries and periodontal disease are the most common dental infections and are constantly increasing worldwide. Distribution, occurrence of dental caries, gingivitis, periodontitis, odontogenic infections, antibiotic resistance, oral mucosal infections, and microbe-related oral cancer are important to understand the public impact and methods of controlling such disease. Distribution of human papilloma virus and human immunodeficiency virus -related oral cancers in the US population is presented.

Medication Management of Jaw Lesions for Dental Patients.

Most pathologic lesions of the jaws or of oral mucosa are treated successfully by surgical interventions. For treatment of the central giant cell lesion, aneurysmal bone cysts, histiocytosis of the mandible, hemangioma, odontogenic keratocyst, Paget disease, oral submucous fibrosis, and oral lichen planus, medical management consisting of intralesional injections, sclerosing agents, and systemic bisphosphonates is as successful as surgical procedures with fewer complications. Pharmacology of agents used and protocols are presented.

Implant surface material, design, and osseointegration.

The structural and functional union of the implant with living bone is greatly influenced by the surface properties of the implant. The success of a dental implant depends on the chemical, physical, mechanical, and topographic characteristics of its surface. The influence of surface topography on osseointegration has translated to shorter healing times from implant placement to restoration.

Surgical anatomy of the nasal cavity and paranasal sinuses.

The oral cavity and its bony components (maxilla and mandible), along with the nose and its related sinuses, constitute most of the face. Because of their proximity, disease in one may affect the other, whereas trauma of the midface will involve bones common to the oral cavity, nose, and paranasal sinuses. The two serve important life-supporting functions, being the portals for nutrition and respiration.

Preoperative evaluation of the surgical patient.

A thorough preoperative evaluation to identify correctable medical abnormalities and understand the residual risk is mandatory for all patients undergoing any surgical procedure, including oral surgery. Routine preoperative evaluation will vary among patients, depending on age and general health. This article addresses the preoperative evaluation of surgical patients in general, and the evaluation for general anesthesia in the operating room.

Local anesthesia: agents, techniques, and complications.

This article outlines the different classes of local anesthetics available for dental procedures. It also gives an overview of the mechanism of action and metabolism of each different class of local anesthetic. Furthermore, it discusses indications and contraindications of each local anesthetic and the proper dosage of each.

Anxiety control in the dental patient.

Oral sedation with benzodiazepines and anxiolysis with nitrous oxide are 2 effective methods to help alleviate anxiety and fear of dental procedures. Many patients would prefer to have their dentistry performed with sedation if it were offered to them. This article presents a detailed discussion on minimal sedation that should give the reader a good understanding of this valuable aspect of clinical care.

A technique for long term decompression of large mandibular cysts.

Decompression is a conservative treatment that has frequently been used in the treatment of large odontogenic cysts. Techniques described in the recent literature have involved only fixation of a stent to soft tissue. In the present investigators' experiences, this technique has a high failure rate because of the dislodgement of the stent, due to tearing of the sutures over the course of a long-span treatment period.

Advances in local anesthesia in dentistry.

Local pain management is the most critical aspect of patient care in dentistry. The improvements in agents and techniques for local anesthesia are probably the most significant advances that have occurred in dental science. This article provides an update on the most recently introduced local anesthetic agents along with new technologies used to deliver local anesthetics.

Hemostatic agents.

Hemostasis is an integral and very important aspect of surgical practice. As a rule, most bleeding from dental surgery can be controlled by pressure. When the application of pressure does not yield satisfactory results, or where more effective hemostasis is required, hemostatic agents are used.

Credentialing.

Credentialing is the administrative process for validating the qualifications of licensed professionals and appraising their background. It is used by hospitals and other health care facilities, educational institutions, and insurance companies to ensure the qualification of their clinicians and to grant privileges to provide specific services and perform different medical or dental procedures. This article familiarizes the reader with the credentialing process and the documentation that is needed to be credentialed by certain organizations.