The programme of studies of oral and maxillofacial surgery teaches students about the first clinical examination of the patient, in particular taking into account the issues of oral surgery and differential diagnosis of pathological changes in the oral cavity. The objective is to enable students to recognise all clinical presentations of odontogenetic inflammations and treatment methods, including intraoral incisions and prescribing antibiotic therapy. During the exercises, students must master the possibilities of radiological diagnostics in oral surgery, learn the indications for surgery (apicoectomy and alveolotomy), recognise cystic changes and know the basic principles of surgical treatment of cysts of the jaws and surrounding tissues. Students also have to learn to identify premalignant and malignant lesions in a timely manner based on the teaching of differential diagnosis of benign and malignant changes. Students will learn how to set the indications for pre-prosthetic surgical procedures and provide assistance during surgeries. Students will also be introduced to the most important oral surgery procedures.
THEORY CLASSES
Introduction. Concept and objectives of oral and maxillofacial surgery. Role of oral surgery in surgical healthcare. Role of oral surgery in the education of oral hygiene students.
Applied surgical anatomy of the orofacial region. Osteology of the upper and lower jaw. Surgical morphology of tooth roots. Masticatory and facial musculature. Muscle attachments. Innervation and vascularisation of the upper and lower jaw.
Tooth extraction. Concept and general principles of tooth extraction. Indications and contraindications for tooth extraction. Instruments for tooth extraction. Stages of simple tooth extraction. Single tooth extraction. Tooth extraction aftercare.
Complications during tooth extraction. Complicated tooth extraction. Other complications during tooth extraction. Wound healing following tooth extraction. Stages of normal wound healing. Delayed healing and other complications following tooth extraction.
Basic principles of surgery. Basic principles of oral surgery. Surgical tooth extraction.
Impacted and supernumerary teeth. Concept and definition. Aetiological factors. Prevalence. Clinical presentation and diagnostics. Classification. Indications and contraindications for impacted tooth extraction. Course of surgical extraction of individual impacted teeth. Wound treatment and postoperative care. Supernumerary teeth. Types and diagnostics. Specificities of extraction.
Oroantral communication and fistulas. Diagnosis and differential diagnosis of oroantral communication and fistulas. Indications for surgical treatment. Methods of plastic surgery of the oroantral fistula. Chronic periapical processes and cysts of the jaw. Concept and definition. Subdivision and classification. Clinical presentation, diagnostics, differential diagnosis and treatment. Work methodology.
Surgical procedures in orthodontic treatments. Tooth eruption disorders and treatment methods. Surgical orthodontic treatment of unerupted teeth. Concept of germectomy. Odontogenic infections. Concept and types of odontogenic infections. Microflora. Clinical presentation and diagnostics. Differential diagnostics. Routes of infection transmission. Basic principles of treatment. Pharmacotherapy and surgical treatment. Spread of infection to interfascial spaces. Characteristics of infections of interfascial spaces and treatment.
Haemorrhaging and haemostasis. Spontaneous haemostasis. Clinical presentation of spontaneous haemostasis disorders. Haemorrhage classification. Diseases involving haemorrhagic syndrome. Artificial haemostatic agents. Choice of haemostatic methods and agents. Trauma of teeth and alveolar process. Replantation and transplantation. Trauma of the crown and tooth root. Trauma of the soft and bone tissue. Diagnostics and treatment. Indications and contraindications for replantation. Surgical procedure.
Tooth transplantation. Pre-prosthetic surgery. Deformities in the area of alveolar and palatal process of the maxilla. Pre-prosthetic surgery of bone tissue. Corrections of soft tissues. Deepening of the vestibular sulcus, indications and surgical procedures. Benign tumours of soft and bone tissues. Concept. Classification. Prevalence in the orofacial region. Clinical presentation. Specificities of surgical treatment.
Aspects of oral surgery of high-risk patients. Specificities of individual general diseases, risks of oral surgeries and procedures on patients suffering from ischemic heart diseases, bacterial endocarditis, myocardiopathy, endocrine diseases, liver diseases, etc.
PRACTICAL CLASSES
Introductory exercises. Workplace. Patient admission. Medical history. Clinical examination. Sterilisation and preparation for oral surgeries. Instruments for tooth extraction. Single tooth extraction technique. Demonstrative exercises. Medical history and clinical examination. Local anaesthesia. Tooth extraction using forceps and root elevators. Tooth extraction aftercare.
Treatment of high-risk patients. Treatment of tooth extraction complications. Haemostatic methods. Diagnostics and treatment of acute odontogenic infections. Practical work with patients. Patient admission. Motivation and preparation of patients for oral surgeries. Demonstration of various oral surgeries and provision of assistance during their performance. Check-ups following oral surgeries. Conservative treatment of post-extraction pain – local administration of analgesics and physical measures.
Assigned reading:
- Ćabov T. Oralnokirurški priručnik. Medicinska naklada. Zagreb; 2009
- Gabrić D. Lokalna anestezija u dentalnoj medicini. Zagreb: Medicinska naklada. 2015.
Further reading:
- Bagatin M., Virag M. i suradnici. Maksilofacijalna kirurgija. Školska knjiga. Zagreb; 1991.