Dental Terminology Ch. 14

Oral and Maxillofacial surgery

Oral maxillofacial surgeon

A dentist who has completed additional oral surgical and anesthesia studies of 2-3 years, as well as a hospital internship and residency program

Exodontia

(extraction of a tooth)

Forceps

Pincers for seizing, holding, or extracting, made for maxillary or mandibular use

Scalpel

A small surgical knife used to cut open or excise tissue form a surgical area, made of metal or disposable plastic

Bone file

Serrated file edges and different head sizes on opposite sides, they are used to smooth off irregular bone edges remaining from extracted teeth or bone restructure

Elevators

Devices used to raise the tooth; 3 types of elevators are used in oral surgery, periosteal, exolever, and apical

Periosteal

Concerning the periosteum, used to loosen the periosteum tissue from bone, or detach the tissue around the cervix of the tooth and retract tissue in the surgical site, aka the periosteotome (cutting tissue around bone)

Exolever

Device to raise or elevate, used to elevate or luxate a tooth from its natural socket; aka root elevators, Tips are designed to be used in the mesial or distal, and maxillary or mandibular area, handles may be the grasp type or T-handed for extra leverage

Apical

Pertaining to apex or tip, used to elevate or pick out remains of a fractured root top; aka root tip elevators/picks, these elevators have thinner handles and longer shanked tips than another tooth elevator

Hemostat

Device or drug used to arrest blood flow, scissors-style device with a locking joint and serrated beaks; used to clamp off or hold onto and transfer, may have straight or curved beaks

Needle holder

Similar to a hemostat except that the nose of the instrument is rounded and blunted with serrated crisscrossed edges inside its beaks to assist with holding a needle, suture needles are curved and triangular in shape to avoid tissue trauma during puncturing, needles are numbered according to their sizes

Scissors

Various specialized scissors used in oral surgery

Tissue

Longer handled scissors with a serrated blade edge that is used to grasp and hold the tissue during cutting

Suture

Smaller scissors with one curved, half-moon blade that is inserted under the suture thread during cutting

Bandage

Scissors used to cut materials and dressings during surgery; usually have one longer, blunted blade tip to insert under material

Rongeurs

Grasp-handled instrument similar to forceps but with a spring in the handle to provide a “nipping” action. Beaks may be sharp cutting points(ends) or round sided(blades); used to snip off bony edges and rough areas

Aspirating tips

Disposable or metal suction tips with longer handles and narrower tip openings; used to aspirate sockets, deeper throat areas, and surgical sites

Chisel

Device that is longer, thicker, and heavier than tooth chisels, available in small, medium, and large blade-width tips, used to chip away bone and apply force enough to break impacted molar teeth that will be removed in sections

Mallet

Hammer-like device used to apply pressure to chisels, a mallet may have a plain metal face or removable nylon-padded facing

Curette

Hand instrument with a spoon-shaped face that is inserted in the socket or surgical site to scrape out infection and debris, a surgical curette is larger than a dental operative curette, may be single or double ended

Retractor

A hand device used to draw back cheeks and/or tissue to provide more access or light to the surgical area, the three types are tissue, cheek, and tongue retractor

Tissue retractor

May be a hemostat-type device with notched tips to hold tissue, assistants use these with holding tips to retract and hold tissue during surgical procedures

Cheek retractor

May be bent wire-shaped device or flat, curved handles used to scoop and hold cheek tissue; may be metal or plastic, after position is obtained, the retractor is hand stabilized against the bone to avoid cheeks and tissues from moving around, excessive movement may be the cause of swelling and bruising after surgery

Tongue retractor

Scissor type of instrument with longer shaft and padded or serrated edges; used to grasp and hold the tongue. Occasionally, the operator will use a sterile piece of gauze to grasp, hold, and extend the tongue for examination

Mouth prop

Small, medium, or large pieces of hard rubber; aka a bite block

Suture

Used to close up a wound or incision; to remove the suture, suture thread of silk or nylon material is required

Surgical bur

Similar to dental burs but larger in size; used to remove bone, to expose root tips, or to score and divide teeth in preparation for forced sectioning and removal

Horizontal impaction

The tooth is horizontally tilted; may be leaning parallel to the floor at various angles; crown may be perpendicular to an adjacent tooth crown

Vertical impaction

Tooth is in upright position but in close proximity to or under the crown of a nearby tooth

Distoangular impaction

Crown of the tooth is slanted toward the distal surface and is covered by tissue and/or bone

Mesioangular impaction

The crown of the tooth is mesially tilted and covered by tissue and/or bone

Transverse impaction

Tooth is situated sideways to the adjacent teeth and occlusal plane, and it is covered by tissue and/or bone

Alveolectomy

When multiple teeth are extracted, the alveolar bone crests have to be removed and smoothed to prepare the ridges for denture or appliance wear

Alveolitis

Infection or inflammation of the alveolar process

Dry socket

Loss of natural clotting

Gingivectomy

Surgical excision of unattached gingival tissue

Gingivoplasty

Surgical recountour of the gingival tissues

Periodontal flap surgery

Surgical excision and removal of pocket or tissue extensions

Frenectomy

Surgical removal or resectioning of a frenum

Diastema

A space between two teeth

Ankyloglossia

Shortness of the tongue frenum, tongue tied

Incision and drainage

Procedure performed for a periodontal abscess

Malady

disease or disorder

Biopsy

Small tissue incision

Incision biopsy

Removing a wedge-shaped section of affected tissue along with some normal adjacent tissue

Exfoliative biopsy

Scraping with glass slide or tongue depressor to collect tissue cells for microscopic study

Brush biopsy

Much like exfoliative test, a pipe stem brush is drawn across the mouth tissues, scraped against a glass slide, fixed with a solution, and sent to the lab for a computer-assisted reading

Malignant

Harmful or growing worse

Benign

Nonmalignant

Leukoplakia

Formation of white patches on the mucous membrane of the oral cavity that cannot be scraped off and have the potential for malignancy

Fibroma

Benign, fibrous, encapsulated connective tissue tumor

Papilloma

Benign, epithelial tumor of the skin or mucous membrane

Hemangioma

Benign tumor of dilatated blood vessels

Granuloma

Granular tumor usually occurring with other diseases

Melanoma

Malignant, pigmented mole or tumor

Basal or squamous cell carcinoma

Malignant growth of epithelial cells

Osteoplasty

Forming or recontouring bones

Alveolectomy

Usually performed to remove alveolar bone crests remaining after tooth extraction in preparation for a smooth bone ridge for denture wear

Apicoectomy

Usually requires opening of the periodontium, including some alveolar bone, and exposure with removal of the root apex, many times followed with a retrofill root canal treatment

Exostosis

(bony outgrowth) removing overgrowths and smoothing off of bone edges in preparation for dentures

Torus

(rounded elevation) and excessive bone growth; a torus on the lingual side of the mandible is termed a torus mandibularis (concerning the mandible) in the roof of the mouth it is termed torus palatinus (in the palate)

Cysts

(abnormal, closed-walled sac present in or around tissue) usually X-ray detected and removed before they enlarge and destroy bone tissue

Dentigerous cysts

Cystic sac containing a tooth or tooth bud particle

Radicular cysts

Cysts located alongside or at the apex of a tooth root; also called periapical cyst

Ranula cyst

Cystic tumor found on the underside of the tongue or in the sublingual or submaxillary ducts, usually the result of a blocked duct

Closed fracture reduction

Repair with interoral fixation, tooth wiring, or ligation methods in which the teeth are “wired together” in proper alignment while awaiting bone healing

Open fracture reduction

More complicated procedure involving osteotomy and rigid fixation, perhaps bone plate, mesh, pins, grafts, and other fixation devices

Genioplasty

Plastic surgery of the chin or cheek

Macrogenia cheek size

Large or excessive chin

Microgenia cheek size

Undersized chin

Lateral excessive/deficient cheek size

Excessive bone in one direction and deficient bone in another

Asymmetrical

Lack of balance of size and shape on opposite sides

Pseudomacrogenia

Excess of soft tissue presenting a chin with the look of abnormal size

“Witch’s chin”

Soft tissue ptosis (dropping or sagging of an organ

Osteotomy

(bone incision) surgical movement of bone

Osteoplasty

(to form bones) removal of bone, usually completed with surgical burs

Chin augmentation

“Sliding genioplasty” The option of moving the chin forward by making an incision inside the lower lip and inserting an artificial chin implant or moving the severed bone tip segment forward

Ridge augmentation

Use of bone grafts to build or correct an underdeveloped or missing ridge possibly needed for tooth or denture implant or preparation for denture wear

Surgical correction

In conjunction with the orthodontist and/or the prosthodontist, the oral surgeon may expose and band or peg erupting teeth to prepare the mouth for orthodontic treatment or may remove hidden or retained root tips, cysts, or foreign bodies before taking denture impressions

Arthrotomy

(cutting into a joint) Reconstruction and alignment of the mandible for TMJ disorders, has retrusive, protrusive and lateral movements

Retrusive movements

Position with mandible backward

Protrusive movement

Position with mandible forward

Lateral movement

Position to the side; mesiolateral is toward the center of the face, and distolateral is toward the outside of the face

Cleft lip repair

Tissue fissure or incomplete juncture of maxillary lip tissues; congenital effect

Cleft palate repair

Congenital fissure in roof of mouth with an opening into the nasal cavity; may be unilateral or bilateral; also, may be complete or incomplete

Orthognathic surgery

Surgical manipulation of the facial skeleton to restore facial esthetics and proper function to a congenital, developmental, or traumatic-affected patient

Wilkes classification of TMJ Internal derangement

Computerized mandibular scan

3D tracking device to record functional movement of the jaw during opening, closing, chewing, and swallowing

Electyromyograph

Surface electrodes instrument to determine muscle activity during function; healthy muscles have low levels of electrical activity, and disarranged muscles register high activity

Electrosonograph

Recording of sounds during opening and closing of the jaw; also observed by use of a stethoscope to

Hemiarthroplasty

Surgical repair of a joint with a partial joint implant reconstruction

Autogenous reconstruction

Rebuilding of the joint using organic material supplied by the patient, such as toe or rib bone grafts

Alloplastic reconstruction

Rebuilding of the joint using inert, synthetic man-made materials; can be manufactured to be resorbable or nonresorbable

Allograft reconstruction

Graft material taken from human donors, which can be tested, sterilized, and accepted by patient’s body to rebuild the jawbone

Xenograft

Harvested from animals, most commonly the cow; specially processed to become biocompatible

Total joint reconstruction

Surgical intervention and use of artificial prostheses for the condyle, disc, and fossa of the temporal bone

Revision surgery

Surgical correction of an area that has been operated on previously, occurring when further degermation happens, when previous implants have failed, or when going from a partial joint implant to a total implant

Endosteal

(placement within the bone) aka osseointegrated implants'; can be used as an anchor for a single tooth or multiple areas, depending on the style of implant

Subperiosteal

(beneath the periosteum and placed onto the bone) usually a cast framework implant with protruding pegs that is placed over the bone and covered by the periosteum; used to hold a base plate for tooth-replacing device, similar to a denture base

Transosteal

(Through the mandibular bone) anchor implants that are placed all the way through the mandible, aka staple implants