SCOPE AND PRACTICE OF DENTAL & MAXILLOFACIAL SURGERY AHMAD AMINU ABDULAZEEZ DR. OGUNDARE U.O 4/25/2017 Hospital presentation, NOHD

DENTAL SURGERY 4/25/2017 Hospital presentation, NOHD

Outline * Introduction * Professionals in dental practice * The dental Office * Specializations in dentistry 4/25/2017 Hospital presentation, NOHD

Dentistry A branch of medicine that is involved in the study, diagnosis, prevention and treatment of diseases, disorders and conditions of the oral cavity, commonly in the dentition but also in the oral mucosa, and of adjacent and related structures and tissues, particularly in the maxillofacial region. 4/25/2017 Hospital presentation, NOHD

Professionals in dental practice DENTIST – This is a doctor who specializes in dentistry. He is also known as a dental surgeon. DENTAL THERAPIST – This is a dental care giver who does professional tooth cleaning for patients. He/she is also involved in oral health education of patients. 4/25/2017 Hospital presentation, NOHD

DENTAL NURSE / DSA / DST – This is an assistant of the dental surgeon DENTAL NURSE / DSA / DST – This is an assistant of the dental surgeon. He is responsible for the clinic area, instruments and equipment management as well as pre & post operative care of patients. DENTAL TECHNOLOGIST – This is a member of the dental team who, upon prescription from a dental clinician, constructs custom–made prostheses and dental appliances. 4/25/2017 Hospital presentation, NOHD

The dental office This is also known as the dental clinic. It comprises the following; - Dental chair / unit - Air compressor - Autoclave - Dental X-ray including OPG - X-ray film processor - Instrument trays, dental materials etc 4/25/2017 Hospital presentation, NOHD

4/25/2017 Hospital presentation, NOHD

Specializations in Dentistry Oral & Maxillofacial Surgery:- This is concerned with treating diseases, injuries and defects of the head, neck, face, jaws and the hard & soft tissues of the mouth. Prosthodontics:- This is concerned with the design, manufacture and fitting of artificial replacements for teeth and other parts of the mouth. 4/25/2017 Hospital presentation, NOHD

Periodontology:- This deals with diseases and conditions affecting the gums and supporting structures of the teeth. Oral Medicine:- This is concerned with the medical (non-surgical) treatment of diseases of the oral mucosa. 4/25/2017 Hospital presentation, NOHD

Orthodontics:- This deals primarily with the diagnosis, prevention and correction of malposed teeth and jaw growth anomalies. Paedodontics:- This is concerned with the dental care and treatment of children. Oral pathology:- This is concerned with diagnosis and study of the causes and effects of diseases affecting the oral & maxillofacial region. 4/25/2017 Hospital presentation, NOHD

Conservative Dentistry:- This is concerned with conserving teeth in the mouth -----fillings, crowns, bridges, root canal therapy Oral Radiology:- This deals with performance and interpretation of diagnostic imaging used for examining the craniofacial, dental & adjacent structures. 4/25/2017 Hospital presentation, NOHD

4/25/2017 Hospital presentation, NOHD

ORAL & MAXILLOFACIAL SURGERY 4/25/2017 Hospital presentation, NOHD

Outline * Introduction * Scope : - Trauma - Infections - Tumours - Congenital anomalies 4/25/2017 Hospital presentation, NOHD

Introduction This is the branch of dentistry that deals with treatment of diseases, injuries and defects of the head, neck, face, jaws and the hard & soft tissues of the mouth. It also deals with reconstruction & restoration of facial aesthetics which may have been disrupted by trauma, surgery and other causes. 4/25/2017 Hospital presentation, NOHD

FACIAL TRAUMA This refers to any physical injury to the face. CAUSES – Vehicular crashes - Interpersonal violence - Falls - Industrial accidents - Sport injuries - Gunshot injuries - Blasts - Animal attacks 4/25/2017 Hospital presentation, NOHD

Soft tissue involvement – Contusion - Abrasion - Laceration - Avulsion - Burns 4/25/2017 Hospital presentation, NOHD

Bony involvement – Nasal complex fracture Zygomatic complex fracture Orbital fractures Le – Fort I fracture Le – Fort II fracture Le – Fort III fracture Mandibular fractures (Dento – alveolar, symphyseal, parasymphyseal, body, angle, ramus, condylar) # Radiographic investigations are important for proper management of facial trauma. OMV, SMV, PA Jaws, Lateral Skull, Lateral oblique mandible, CT Scan. 4/25/2017 Hospital presentation, NOHD

4/25/2017 Hospital presentation, NOHD

4/25/2017 Hospital presentation, NOHD

4/25/2017 Hospital presentation, NOHD

4/25/2017 Hospital presentation, NOHD

TMJ Ankylosis This is a pathologic condition where the mandible is fused to the glenoid fossa by bony or fibrotic tissues. CAUSES – Trauma or infection EFFECTS – Inability to open mouth Facial deformity Inability to chew Difficulty of speech Poor oral hygiene 4/25/2017 Hospital presentation, NOHD

AIM OF TREATMENT:- Improve mouth opening, correct associated facial deformity, decrease pain & prevent re-ankylosis 4/25/2017 Hospital presentation, NOHD

Ankylosed TMJ Normal TMJ 4/25/2017 Hospital presentation, NOHD

TMJ dislocation This is a distressing condition that occurs when the mandibular condyle becomes fixed in the articular eminence of the temporal bone. The TMJ locks in an open position. CAUSES – Excessive yawning - Trauma - Singing - Intubation - Dental procedures 4/25/2017 Hospital presentation, NOHD

EFFECTS – Inability to close the mouth Drooling of saliva Aim of treatment: - Reduce anxiety - Relieve pain - Reposition joint - Prevent recurrence 4/25/2017 Hospital presentation, NOHD

INFECTIONS Dental abscesses – Periapical abscess Periodontal abscess Dentoalveolar abscess Space infection – Buccal space abscess Submasseteric space abscess Submandibular space abscess Sublingual space abscess Submental space abscess LUDWIG’S ANGINA 4/25/2017 Hospital presentation, NOHD

Ludwig’s Angina 4/25/2017 Hospital presentation, NOHD

TUMOURS - Benign or Malignant neoplasm - Jaw or Soft tissue neoplasm - Cysts - Salivary gland tumours 4/25/2017 Hospital presentation, NOHD

Mandibular Ameloblastoma 4/25/2017 Hospital presentation, NOHD

4/25/2017 Hospital presentation, NOHD

Antral Carcinoma 4/25/2017 Hospital presentation, NOHD

Antral Carcinoma 4/25/2017 Hospital presentation, NOHD

Oral Carcinoma 4/25/2017 Hospital presentation, NOHD

4/25/2017 Hospital presentation, NOHD

Salivary gland tumors 4/25/2017 Hospital presentation, NOHD

Congenital anomalies ( Cleft Lip and Palate) A cleft lip contains an opening in the upper lip that may extend into the nose. A cleft palate is when the roof of the mouth contains an opening into the nose. CAUSE – Multifactorial RISK FACTORS – Increasing maternal age, Folic acid deficiency 4/25/2017 Hospital presentation, NOHD

Management - Maxillofacial surgeon and other specialists. Surgery – Cheiloplasty, Palatoplasty 4/25/2017 Hospital presentation, NOHD

4/25/2017 Hospital presentation, NOHD

BEFORE AFTER 4/25/2017 Hospital presentation, NOHD

Conclusion There are several conditions of the orofacial region that present to dental and Maxillofacial surgeons. Many of these conditions usually start small, with or without pain. In view of this, it is wise for patients to present early in order to prevent life – threatening complications. 4/25/2017 Hospital presentation, NOHD

Thank you for Listening 4/25/2017 Hospital presentation, NOHD

Next week (November 25th, 2015): INFORMATION TECHNOLOGY (I Next week (November 25th, 2015): INFORMATION TECHNOLOGY (I.T) Unit (Topic: Role of Information Technology in the Hospital) Fortnight December 2nd, 2015): ACCIDENT & EMERGENCY UNIT …Have a Nice Day 4/25/2017 Hospital presentation, NOHD