Learning Outcomes:

– Start with the Anatomical considerations opens a new knowledge for your dental surgery, cranial nerves as a start tell trigeminal nerve.

– ophthalmic branch, maxillary nerve,palatal mucoperiosteum

– Greater and lesser palatine nerves,posterior superior& middle alveolar Ns.,Infraorbital N, Ant.sup.Alv. N

– Mandibular N. route

– Ant and post divisions OF MANDIBULAR NERVE

– Inf.alv. n and mental n.

– Incisive n.,Ms of mastication supply,Mylohyoid n.,Lingual N., Chorda Tympani N., Tongue supply.

– Muscles of the tongue .

– Mandibular landmarks related to oral surgery

– Alveiolar bone,Mand. Landmark,Muscles of mastication,Temporalis muscle

– Masseter muscle, Medial and Lateral pterygoid muscles

– Disc displacement with or without reduction,Pterygoid venous plexus ,Medical pterygoid muscle,Pterygo mandibular space.

– Hyoglossus, palatoglossus, styloglossus and genioglossus muscle,Infra hyoid muscles.

– Digastric fossa and muscle, Mentalis muscle, Buccinators muscle, Orbicularis oris, Pterygo mandibular raphe

– External oblique ridge,Inf.Alv. and mental Foramina , Lingula.

– Anti lingula ,Sub mand. And S. ling. salivary glands and fossae, Ling N and lower8 relation,Long Bucc. N.AND Bucc.Artery

– Long Bucc. N.AND Bucc.Artery incision complications

– Anesthesia , Def. of nerve block and infiltration, Indications acc.to bone type, Infiltration technique

– Infiltration (Main and supplemental),Supra and para periosteal inf. Technique,Needle type

– Ultra-short needle, Buccal technique, Needle bevel, Pt.venous plexus, Palatal inf. Tech.

– Para-periosteal palatal infiltration tech. and steps

– Amount of injection needed to make anesthesia

– Lower anterior infiltration tech.(labial –lingual), Advantages and disadvantages-indications and contra indications.

– Supplemental infiltration tech., Objective and subjective symptoms, Complication (failure)

– Maxillary nerve block techniques, Nasopalatine N.block .

– Greater palatine N.Block.

– Infra Orbital N.block.(Anterior-Superior N.Block),steps (intra-extra )oral technique

– symptoms and duration, Adv. disadv.,complication

– Local anesthetic agents ,Adrenaline (conc.-Max. Dose), levonordefrin

– Octapressen& Felypressin, Indications &contraindications

– Local anesthetic instrumentation,Carpule components,Needle forms and components

– Needle types and gauge

– Intra ligamental injection

– Syringe armontarium ,Syringes Components and types

– Syringes loading ,usage methods and cartage removal ,Topical anesthesia application

– Syringe grasping and cartilage distribution

– Complications of Local Anastasia,Systemic complications,toxicity

– Complications of Local Anastasia/ Systemic complications/systemic toxicity

– Management and avoidance of systemic toxicity

– Cause and management of vasovagal attack ,Allergic reaction to anesthesia

– Allergic reaction to anesthesia signs, symptoms and management

– Anaphylactic shock ,Difference between toxicity and allergy – Local complications of local anesthesia ,ballooning, pain

– Abscess after infection,Trismus, Hematoma

– Local complications during injection Ecchymosis, edema, whitening of tissues

– Local complications during injection Temp.facial paralysis ,electric shock, prolonged anesthesia ,Diplopia -eye trauma (orbital floor)

– Local complications during injection Brocken needle

– Neuro physiology of local anesthesia, nerve cell, action potential,theories of Local anesthesia action

– Difference between hypo, hyper-sthesia and paralysis, sensory and motor fibers

– Fasciculi, Nerve layer, anesthesia relief ,tachyphylaxis tolerance

– Components of local anesthetic carpule ,properties of local anesthesia

– What will happen if Injection in acidic media occurs, dissociation constant ,types of LA (ester-amide) and their biotransformation

– Properties of local anesthetic agent

– Concentrations, types of L.A.

– Contents of carpule, effect of L.A in blood, CNS & Myocardium.

– Intravenous L.A injection and Topical anesthesia usages

– Mandibular anesthesia ,inferior alveolar nerve block, indications ,land marks

– Mistakes and troubles during injection, Mental N.Blcok technique

– Cutaneous colli plexus branches, mylohyoid N.

– Complications of Inf.Alv.N.Block,long buccal N.block.

– Complications of extraction,and management ,fracture during extraction

– Alv.bone fracture, tuberosity and basal bone fracture and management

– Soft tissue injury and management during extraction

– Oro antral communications with Max. Sinus, dislodgement of roots in sinus, confirmation of oro antral communication, closure of O.A.C

– closure of O.A.C, foreign bodies removal, bleeding (during-after) extraction causes-management

– Alveolar osteitis, dry socket management

– TMJ dislocation ,management

– Exodontia,Upper Ant. Forceps and upper lateral forceps -grasping, and movement

– Upper premolar forceps and red’s forceps grasping and movement.

– Upper molar forceps, upper 8 forceps (jockey), bayonet forceps grasping and movement.

– lower anterior forceps, lower premolar forceps, lower molar forceps, grasping of forceps all a whole

– Closed Extraction, indication ,principles, deep grip, chair position and support, first movement

– movements and type of bone, second movement -dilatation of socket and tearing of PDL ,exceptions

– third movement ,jaw support, maxillary teeth extraction position and support

– Impaction, diff. between impacted ,unerupted, embedded and malposed tooth,causes of impaction (systemic-local)

– Diagnosis of Impaction,pericoronitis ,Treatment of acute pericoronitis

– Chronic pericoronitis ,decision of extraction with pericoronitis ,classification of lower 8 impaction (position)

– Difficulty index of impacted lower 8, steps of removal ,flap and incision , shape and extension

– Distal incision of lower 8 impaction, guttering, sectioning and decapitation, root separation, point of applications, approximation to inferior alv. Canal protection, ling. Plate of bone preservation and dental follicle removal

– Impacted upper 8, classification, complications, fracture tuberosity, sinus approximation, accessibility, zygomatic interference, exposure, flap of upper 8 and used scalpel numbers.

– Bone removal, wedging, Impacted Canine ,causes of Can. Impaction ,Classifications of impacted canine,determination of C. position,surgical exposure of canine ,palatal incision

– palatal incision,bone removal ,midway impacted canine,medico legal orthodontic consultation ,complication during extraction of impacted tooth

– Management of systemic patient during surgical procedure , (ASA) Classification AMERICAN SOCIETY OF ANESTHESIOLOGISTS/

– SRP Stress Reduction Protocol per-during-after surgery

– CVS cardiovascular system troubles and dental management ,patient with Hypertension (classification)

– NSAID and hyper tension

– Medications given to hypertensive pt.,Angina Pectoris,definition and physiology ,types of angina,management

– Dental management of stable angina,Orthostatic Hypotension ,Cardiac Arrhythmia,diff. and physiology

– Cardiac Arrhythmia, management and precautions,management of myocardial infarction pt.

– blood analysis requested

– Transalveolar extraction (surgical extraction),indications ,radiographs needed

– Rules of surgical extraction, Mucoperiosteal flap, incision requirements and design

– Types of Mucoperiosteal flaps,envelop flap ,indications

– Pyramidal flap, indication , trapezoidal flap ,semilunar flap, indications and design, decreasing resistance (tooth division) ,steps (upper molars -3 roots )

– lower molars surgical extraction ,impacted tooth (decapitation), decreasing resistance (bone removal),methods of bone removal (chisel and mallet-surgical bur)

– effect of heat generation during bone removal and how to avoid, bone rongeurs, bone file, bone curette, Chesil

– Elevators ,principles of usage ,wedging actions (steps-indications),straight elevator

– levering action ,indication and steps , wheel and axis ,indication and steps

– Criteria of elevators’ components

– Curved elevators (types-shapes-indications )

– Rules, indications and contraindications of elevator usage

– Wound closure, debridement, cleaning and curettage of socket, Healing (1ry-2nd),steps of suturing ,needles,suturing material

– Suturing pack -Needle curvature types and indications ,traumatic and a traumatic needle (cross sections),inward and outward cutting needles

– Suture material thickness, principles followed during suturing the wound

– Introduction to middles third fracture, zygomatic complex fracture ,components and articulations of zygomatic bone ,orbital bone ,Z.Arch

– Effect zygomatic maxillary suture fracture on Coronoid process , infraorbital nerve, zygomatic facial , zygomatic temporal branches and orbicularis oculi muscle