Surgical dentistry - tasks and modern place in medicine. Surgical dentistry Inflammatory diseases in surgical dentistry

Most people who are not directly involved in dentistry believe that dentist and dentist are the same profession, just called differently. However, this is a big misconception. To know which specialist to contact if a problem arises, you should understand the difference between a dentist and a dentist.

Dentist and dentist: what is the difference

Let's figure it out. What is the difference between a dentist and a dentist?

Dentist is a profession that requires secondary education. After graduating from medical school, the newly minted dentist specializes only in the treatment of hard dental tissues, namely dentin and enamel. Therefore, to help a patient who comes with acute pain, he won't be able to. His narrow specialization is based on the treatment of common caries.

A dentist is a medical specialist who has 6 years of university education and a year of internship behind him. He is endowed with a wide medical specialization and is able to perform various manipulations in oral cavity: treatment and removal of teeth, insertion of dental implants, bite straightening and much more.

The difference between a dentist and a dentist is obvious and quite significant. In this case, the question arises: why is a dentist needed if his powers are not as broad as those of a dentist?

In dental clinics there is no profession of “dentist” as such. There are quite a few highly specialized dentists of various specialties there. In addition, the dentist cannot be left as an on-duty specialist, since if necessary, he will not be able to provide the necessary assistance to the patient.

Having found out the difference between a dentist and a dentist, the advantage of the second specialist becomes obvious. That is why oral health should be entrusted to a doctor with a full university education.

Dentistry. Is it necessary?

The dentist deals exclusively with simple manipulations in the field of dental treatment. He does not have the right to provide more complex types of dental services.

Is this profession necessary then? The dentist performs the following list of works:

1. Examines the oral cavity and assesses the condition of the teeth.

2. Determines the cause of concern.

3. Treats gum diseases.

4. Engaged in filling small areas of damaged dental tissue.

5. Explains the rules of proper oral hygiene.

6. Consults on the choice of dental accessories, selects them based on the condition of the teeth.

7. When identified serious problems with the condition of the teeth, refers the patient to an appointment with a competent specialist.

From the list of responsibilities, the need for the profession of a dentist is obvious, which makes it relevant.

However, this profession also has its downside: the lack of career prospects. Unfortunately, a dentist is not appointed to the position of head of the department.

Categories of dentists

To improve his specialization, after a certain amount of time, the dentist must upgrade his category.

Children's doctor

A pediatric dentist treats simple dental problems that arise in children. As a rule, this is caries that develops in young patients due to a sweet tooth.

However, there are often cases when a pediatric dentist is not able to provide qualified assistance to a child, and he has to refuse to treat the patient. There are several reasons for this:

Problems in the treatment of children's teeth due to the differences that a child's jaw has compared to an adult's.

Dental treatment may require special equipment and a different approach that the dentist does not have.

Lack of drugs suitable for children.

Inability to find an approach to a small patient.

If the pediatric dentist is unable to provide the necessary care to the child, you must make an appointment with the pediatric dentist.

In most cases, a pediatric dentist is able to help a small patient, since the oral cavity of children is more often susceptible to ordinary caries, which requires simple treatment. Also, do not forget to take your child for a preventive examination twice a year.

Dentist

A dentist has a wider range of powers in the field of dental treatment than a dentist. During 6 years of university training, in addition to studying “dental” topics, dentists master a number of other important disciplines that improve the training of a future specialist.

Upon completion of training, doctors are invited to choose one of several specializations in dentistry:

Dentist-therapist.

Periodontist.

Orthodontist.

Dental surgeon.

Prosthetist.

Pediatric dentist.

Dentist-therapist

The activities of this specialist are the same as those of a dentist, but the dentist-therapist is vested with a wider range of powers:

Treatment of more acute dental problems.

Filling of teeth with severe destruction.

Treatment of inflammatory diseases of the gums, oral mucosa, tongue.

Teeth whitening.

Ultrasound cleaning.

Conducting preventive examinations, followed by recommendations.

Periodontist

Periodontists deal exclusively with the treatment of periodontal disease, that is, the soft tissues surrounding the tooth (gums, periodontium, cementum and alveolar processes).

Orthodontist

An orthodontist specializes in correcting malocclusions:

Alignment of teeth.

Elimination of interdental spaces, “gaps”.

Stabilization of proper growth of primary and permanent teeth.

Tracking proper development jaws in childhood.

Dental surgeon

Dental surgeons are competent in the following matters:

Removal of diseased teeth that cannot be restored.

Removal of healthy teeth that are interfering with the growth of adjacent units.

Implantation, prosthetics.

Correction of the dentition.

Carrying out a number of operations, for example, incision of the gums, resection of tooth roots.

The difference between a dentist and a dentist is worth knowing for those who have decided to devote themselves to this profession.

A dentist, endowed with a minimum set of medical powers, still remains a sought-after specialist. It is especially in demand in small provincial towns or villages, where, in the absence of dentists, the dentist copes with the treatment of various diseases.

Who are dentists?

In the field of dentistry, there is another concept - dentist. How is he different from a dentist and a dentist?

Essentially, a dentist is a dentist (corresponding to a medical assistant). This concept applies to dental professionals working abroad. It has not taken root in our country. And many people have heard the word “dentist” only in foreign films; in everyday life it is “unheard of.”

Since a dentist is the same as a dentist, dentists are therefore mid-level doctors, that is, without a full higher education and with a limited range of services provided.

So, having figured out who a dentist and a dentist are and realizing that these are specialists in the same medical specialization, but with different tasks, you can easily contact a dental clinic for help if the need arises.

It is worth considering that there is also a difference between a dentist and a dentist in the prices for services. Dentists' prices will be significantly higher than the price for dentists' work.

Now we know who a dentist is. We also looked at what it does and its relevance, so you can safely contact any clinic, having the right concepts about dentists and dentists.

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Dentist and dental therapist: the difference

By and large, the only difference between a dental therapist and a dentist is that a dental therapist is a more specific name that more narrowly describes the doctor’s specialization. And dentist is a more general, short name that simply means a doctor working in dentistry.

Therapeutic dentistry is the dentistry that is responsible for our teeth. A therapist is a specialist who sees and treats problems that many, many people have.

What is the difference between a dentist and a dental therapist?

It will not be possible to accurately determine the difference between a dentist and a dental therapist. Most likely, if you hear “dentist”, it means a dentist-therapist.

The main area of ​​work and the flow of patients falls on the dentist-therapist to treat the scourge of dental health - caries and its complications.

Caries is a pathological process accompanied by gradual demineralization and tooth decay. This is one of the most common diseases. It arises from the influence acidic environment, which occurs after eating a carbohydrate-rich meal. Prevention is effective in the fight against caries.

Pulpitis is an acute inflammation of the pulp - the nerve bundle of the tooth. This is a complication of caries, an acute condition in which rapid intervention by a dentist is necessary, and the sooner the better. If a tooth has reached the point of pulpitis, you should not hesitate to go to the dentist.

Periodontitis is a disease of the periodontium – the bone tissue located at the base of the tooth. It can cause tooth loss.

Periostitis is what is sometimes called gumboil - inflammation of the periosteum. This is a very painful swelling of the gums.

All these carious diseases are the main things we face and fight against. by various means dentist-therapist.

The therapist also treats diseases of non-carious origin. Such as enamel hypoplasia - a violation of the mineralization of dental tissues, as a result of which stains appear on the teeth. Enamel fluorosis is a disease in the form of brown spots that appears due to the accumulation of fluoride in drinking water. A wedge-shaped defect is a stepped growth at the junction of the gum and tooth. Teeth abrasion is a pathological tendency to smoothing and abrasion, which appears due to malocclusion and metabolic disorders. Necrosis of hard tissues - can develop due to exposure to chemicals. This disease struck match factory workers at the end of the 19th century, who had to work around the clock in an atmosphere poisoned by phosphorus and other harmful substances. Dental hyperesthesia – i.e. their increased sensitivity to temperature and physical effects. Also, dental damage such as enamel erosion and traumatic injuries. And also, diseases of the oral mucosa, such as various stomatitis.

If the patient’s dental condition requires the intervention of other specialists, the dentist-therapist refers him to the right doctor.

So, by and large, there is nothing that distinguishes a dentist from a general dentist. Therapist means doctor general practice, who receives all patients and refers them to specialists. It’s just that no one in life says: I’ll go see a dentist. Everyone says simply - I’ll go to the dentist.

medcollege5.ru

Initially, barbers and ministers of various religious organizations performed dental treatment. As dentistry developed into a separate, isolated craft, people appeared who were engaged exclusively in dental treatment, which mainly consisted of their removal.

Since the formation of dentistry as a science, three main directions have been identified - surgical, orthopedic and therapeutic. Much later, even narrower areas appeared in therapeutic dentistry:

• Propaedeutics (diagnosis) of dental diseases;
• Prevention of dentistry. diseases;
• Treatment of diseases of the oral mucosa;
• Periodontology,
• Children's dentistry.

In theory, we can talk about smaller division into narrow specializations, but such a division does not have significant practical significance. Many dental therapists have the necessary knowledge and practical skills to treat periodontal diseases and oral mucosa, including gingivitis, cheilitis (lip diseases), glossitis (tongue diseases), etc.

In fact, there is no difference between a dentist and a dental therapist; this opposition is fundamentally wrong. A dentist-therapist is one of the specialists involved in the treatment of the oral cavity.

Of course, the main work of a dentist-therapist is the prevention and treatment of caries and its complications, pulpitis and periodontitis. Some doctors specialize in a narrower area, such as endontics, which deals exclusively with work inside the tooth, in the root canals.

In addition to caries, the dentist-therapist treats other pathological conditions of hard dental tissues:

• wedge-shaped defects;
• increased tooth wear;
• hypoplasia;
• fluorosis;
• violation of the color and shape of teeth.

Part of dental technology aimed at improving appearance teeth and oral cavity, are now combined into a separate direction - cosmetic dentistry. Whitening, restoration of teeth with light-curing composite materials, fixation of various decorations on the surface of the tooth - this is an incomplete list of services provided. Fighting halitosis, unpleasant smell from the mouth is also included in the range of services of these specialists. Therefore, dental therapists are full-fledged employees of many large cosmetology centers, along with cosmetologists and plastic surgeons.

In medical institutions that do not have a specialist periodontist, treatment of gum and periodontal diseases is carried out by dental therapists. They remove dental plaque, conduct anti-inflammatory therapy and other types of treatment. They also treat cheilitis - lip diseases, glossitis - various diseases tongue and sialadenitis, pathology of the salivary glands.

About one percent of the total work of a dental therapist is devoted to the treatment of pathologies of the oral mucosa. Special attention focuses on the diagnosis of precancerous conditions and malignant neoplasms.

Modern therapeutic dentistry is a high-tech direction in medicine. Doctors use ultrasound, laser, digital X-ray equipment and much more, which allows them to solve a variety of problems to treat oral diseases.

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What is the difference between a dentist and a dentist?

Each dentist is a graduate of a medical university - institute, academy, university (5 years of study), and is required to undergo:

• internship (1 year) – medical practice in a dental clinic, after which he has the right to independently accept patients as a dental therapist;
• residency (2 years) – practice with training in a narrower specialization: orthodontist, orthopedist, surgeon or periodontist. A specialist who has completed his residency has the right to open his own dental office and conduct private consultations.

Like a dentist, a dentist specializes in diseases of the teeth, gums, jaw joints and oral mucosa. But his diploma gives him the right to perform only a limited number of procedures.

Procedures that a dentist has the right to perform

The dentist does not perform complex surgical interventions, such as correction of a gummy smile, bone augmentation and cyst removal, implantation and prosthetics.

But you can always contact this specialist for:

• undergoing a preventive examination;
• diagnosis of diseases of the oral cavity and teeth;
• ordering an x-ray examination;
• caries treatment;
• installation of temporary fillings and polishing of permanent ones;
• tooth extraction in the absence of complications in the periodontal zone;
• taking impressions for the manufacture of dentures;
• measuring the depth of gum pockets;
• removing hard deposits from teeth - stone and “smoker’s plaque”.

mydentist.ru

What is the difference?

What is the difference between a dentist and a dentist? Despite the fact that these two words are synonymous, there are still significant differences between these medical professions. Specialists who have completed secondary education medical institution After studying there for 3 years, they receive the qualification “dentist” and have the right to treat teeth and oral cavity for limited medical reasons. These are simple manifestations of caries, periodontal disease, and stomatitis. College graduates can provide care for patients with maxillofacial injuries and carry out simple physiotherapeutic procedures, diagnose the disease and, in cases where the situation is complex, refer them for treatment to a more qualified doctor.

A dentist will take on any possible diseases of the mouth and teeth; he is entitled to this by graduating from a dental university, where he studied for 5 years, plus completing a two-year residency or a year of internship. Therefore, he has a higher qualification and level of training.

But the development of medical dental science and the demands of the time have shown that simply being a dentist is not enough, so narrow specializations of this area of ​​medicine have appeared:

• dental surgeons;
• dental therapists;
• general dentists;
• orthodontists;
• pediatric dentists;
• orthopedic dentists.

These highly qualified professionals each specialize in their own field, which allows them to penetrate deeper into the intricacies of the field, get acquainted with new achievements of science, high technology and put them into practice.

Dentist-therapist

What is the difference between a dentist and a dental therapist? The dentist is limited in his capabilities: his qualifications will not allow him to cure deep caries complicated by pulpitis, or restore a severely damaged tooth. Of course, it is within his power to fill a small hole in a tooth, but more complex cases are dealt with by a dentist-therapist.

At the appointment, the doctor, examining the patient’s oral cavity, will make the correct diagnosis, cure caries, pulpitis, periodontitis of any complexity, prepare the mouth for prosthetics, remove the inflamed nerve, and ideally restore the shape of a broken tooth.

Patients who care about the health and condition of their mouth visit this specialist at least once every six months. Then the emerging caries will not have a chance to develop. And if there is bleeding in the gums, their redness, incomprehensible pain for no apparent reason, reaction of the teeth to the temperature when eating, in this situation you should not put off visiting a professional for later.

So, we found out what is the difference between a dentist and a dental therapist. Let's look at other specializations of doctors in this area.

Dental surgeon

What is the difference between a dentist and a dental surgeon? If a tooth is completely destroyed and there is no way to restore it, it’s time to contact a dental surgeon. He will remove the breeding ground for infection in the mouth and give recommendations on what needs to be done to make the wound heal faster. He can even pull out a healthy tooth that is growing incorrectly and interfering with its neighbors. Surgeons can not only prepare the oral cavity for implantation, they themselves can implant the implant, and also perform surgery in case of injury to the jaw or its joint.

An ordinary dentist cannot perform these manipulations. His qualifications and knowledge do not give him the opportunity to perform such complex operations.

Pediatric dentist

What is the difference between a dentist and a pediatric dentist? The structure of a child’s oral cavity, like the whole body, has its own characteristics, therefore the teeth of young patients should be treated directly by a pediatric dentist.

Many people believe that baby teeth will fall out on their own and there is no need to fill them, and if they start to deteriorate, then they just need to be removed. In fact, the future health of the child depends on their condition, and if diseased teeth are destroyed without a second thought, then their original followers will also be susceptible to caries and will grow crooked.

Treatment of children's teeth requires special tools and materials, special equipment and methods of pain relief - all this must be known to the pediatric dentist. To this we must add that correcting malocclusion is also part of his responsibilities. He is required to have knowledge of child psychology, the ability to handle a child during treatment, charm, restraint, and goodwill. A professional working with children should have these qualities so that the child can overcome fear and, without falling into hysterics, allow him to do his job efficiently and well. And what memories a child will have from visiting the dental office will determine how he will subsequently relate to visits there throughout his life. This is the difference between a dentist and a dentist in a children's clinic.

General dentist

What is the difference between a dentist and a general dentist? This specialty is in demand in areas where there are no clinics with specialized specialists. Such a dentist must know and be able to do quite a lot; in fact, he can do almost everything in this specialty, because he is a bit of a dentist-therapist, an orthopedist, a hygienist, and a surgeon. He will inform the population how to care for the oral cavity, provide first aid, and cure the damaged tooth, remove it if necessary, prescribe tests and x-rays. It can help almost any patient suffering from toothache and various types of inflammation of the oral cavity. He will not take on only the most complex cases and operations.

Dentist-orthodontist

This area of ​​dentistry deals with the correction of the pathological structure of the jaw. Such a specialist can correct abnormal growth of teeth, their curvature, and reduce the distance between them. The orthodontist will also install the currently popular braces. This method does not injure the tissues of the oral cavity, but the alignment is delayed for a longer period.

Orthopedic dentist

What is the difference between a dentist and an orthopedic dentist? Nowadays, this is one of the most necessary and sought-after specialties. Losing teeth, a person loses the ability to chew food fully and efficiently, and an orthopedist helps restore this function through prosthetics. There are now several such methods, and dentures can be removed at night or permanently left in the mouth. There are also conditionally removable prostheses - these are crowns, bridges, pins, implants.

Removable dentures are relatively inexpensive and are installed quickly, look natural and last a long time. Crowns and bridges are placed when one or more teeth are removed. The doctor may also offer several options for modern techniques to choose from.

Dental hygienist

The priority in medicine is disease prevention, and dentistry is no exception. This is done by a professional dental hygienist. He will show the patient how to maintain the health of teeth and oral cavity in inexpensive but effective ways for a long time, inform the population about how to take care of themselves, and explain how to choose the right products that are important for dental tissues and how to use drugs that restore them.

Doctors periodically conduct examinations in kindergartens, schools, and enterprises, educate the population, correct minor deficiencies, treat teeth with fluoride, and etch them with sealants for those who need it. In children's institutions they teach how to use toothbrushes, recommend the best dental cleansers to people, and convey to the masses the necessary information to maintain oral health.

Dentist and dentist - are there any differences?

Although the names of these professions sound different, their representatives are engaged in one thing - maintaining oral health. In dictionaries, dentists are characterized as specialists involved in the treatment and prosthetics of teeth, but without higher education. This name is now practically not used in Russia; it is popular in Western countries. And with us it corresponds to the category of dentist or technician.

Having fully understood the difference between a dentist and a dentist-therapist, surgeon, orthodontist and orthopedist, having unraveled the mysteries and subtleties of specialization, you can safely go to the dental clinic without fear of getting into trouble and turn to exactly the specialist who is needed at this moment .

Section description

Surgical dentistry is a branch of medicine. The actions of specialists are aimed at restoring and preserving problematic components of the jaw arch. Modern approach to treatment ensures the integrity of the teeth, their aesthetics and functionality.

High-quality equipment, work using unique methods and the creation of innovative materials made it possible to make a new round in the development of dentistry.

Types of services in surgical dentistry

Modern surgical dentistry provides a number of services to the population:

• Complete or partial root resection.
• Treatment of sinusitis, abscesses, phlegmon, periodontitis, etc.
• Implantation.
• Delete.
• Plastic surgeries.
• Treatment of the trigeminal nerve, temporomandibular joints.
• Surgical interventions for diseases of the salivary gland.
• Operations on periodontal tissues, removal of tumors.

All types of surgical dentistry provide services using new technologies and techniques.

What problems do patients present with?

People come to the Department of Dental Surgery only for medical reasons.

Doctors in this field are contacted in the following cases:

• with purulent formations at the apex of the roots - cysts, granulomas, abscesses;
• periodontitis;
• damage to two roots at once; periodontal disease, periodontitis;
• pericoronaritis (formation of a hood on the gum when the unit failed to erupt);
• for the purpose of implantation;
• with various anomalies in the development of the organs of the masticatory apparatus;
• neuralgia in the facial area;
• for tooth extraction.

What kind of help is provided to children?

Surgical pediatric dentistry has a number of features. The specialist must be highly qualified. Even the simplest manipulations require a lot of experience and careful attention in treatment.

Opportunities and methods in surgical pediatric dentistry can successfully solve the following problems:

• congenital and acquired facial anomalies;
• underdevelopment and defects ears, lower and upper jaws;
• tumors of various etiologies, hemangiomas;
• cysts, ;
• age spots, moles;
• paralysis of facial muscles;
• pathologies of the masticatory apparatus;
• removal of unhealthy units.

Procedures that save teeth

Not so long ago, the only way to cope with many diseases was to remove a tooth. Today, treatment in surgical dentistry involves preserving manipulations. Statistics indicate their effectiveness and rapid adaptation of patients after surgery.

What are these procedures:

• Root resection - allows you to eliminate the manifestations of periodontitis.
• Hemisection is a surgical intervention, the purpose of which is to cut out the root from the adjacent coronal part.
• The procedure for lengthening the tooth crown leads to the restoration of the relationship between soft and hard tissues.
• Flap surgery is designed to preserve jaw units during periodontitis.
• Carrying out cystotomy and cystectomy eliminates inflammatory processes at the apex of the roots. The doctor removes the cyst and then sutures the wound.
• Guided tissue regeneration procedure. This type of surgery increases the volume of bone tissue. It is used in preparation for the implantation of artificial roots.

Restoring lost units

Surgeons have been performing dental implants for decades. This method allows you to restore lost units by implanting artificial roots. A prerequisite for the operation is a sufficient volume of bone tissue.

Factors for successful implant healing:

• correct diagnosis, drawing up a plan;
• satisfactory oral health;
• execution of all operation protocols;
• doctor's professionalism;
• the quality of the implant itself.

The use of modern equipment and innovative materials in combination with professionalism at all stages can significantly improve the quality of dental services. There is no place for trifles and shortcomings in solving problems of any complexity. The health of a person’s smile will depend on this.

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Surgical

dentistry

Edited by T. G. Robustova

Educational literature for medical students

EDUCATIONAL LITERATURE For students of medical universities

Faculty of Dentistry

Surgical

dentistry

Second edition, revised and expanded

Edited by Prof. T. G. ROBUSTOVA

„Medicine44 2000

UDC 616.31-089(02)

T. G. ROBUSTOVA, I. S. KARAPETYAN I. F. ROMACHEV, V. V. AFANASYEV,

Y. M. BIBERMAN, V. S. STARODUBTSEV, Y. I. CHERGESHTOV, E. Y. GUBAIDULLINA. L. N. TSEGELNIK.

REVIEWER M. A. GUBIN, DOC. honey. Sciences, prof., head. Department of Surgical Dentistry, Voronezh medical academy them. N. N. Burdenko

Surgical dentistry: Textbook/Ed. T.G. RoX50 boost. - 2nd ed., revised. and additional - M.: Medicine, 1996. - 688 p.: ill.: l. ill. (Text. lit. For students of medical universities). ISBN 5-225-00928-Х

The textbook provides brief information about the history of the development of surgical dentistry and the organization of dental surgical care in a clinic and hospital. Provides data on general and local anesthesia and features of its use in operations on the maxillofacial region. Infectious odontogenic and non-odontogenic inflammatory diseases, diseases of the salivary glands, modern methods their diagnosis and treatment. The clinical picture, features of the development of tumors and tumor-like diseases of the maxillofacial region and modern methods of their treatment are presented. Data on reconstructive surgery of the face and jaws are provided.

TATIANA GRIGORIEVNA ROBUSTOVA, IRINA FEDOROVNA ROM ACH EVA et al.

SURGICAL DENTISTRY

Head Edited by A. K Yashdiirov. Publishing editor I. S. Afanasyeva Editor 3 V Kolesnikova. Art editor O. A. Chetverikova Technical editor G I Zhtsoka. Proofreader M. P

Molokova.

J1P No. 010215 dated April 29 97. Signed for printing on March 16, 2000. Paper size 60x90/Jf. Offset paper No. 1, Typeface Literat Offset printing Uel printing. l 43.5. Uel. cr-ott. 45.0 Academic ed. l. 50.33. Doptir. 5000 copies Order No. 3129 of the Order of the Red Banner of Labor, publishing house "Medicine"

101000, Moscow, Petroverigsky lane, 6/8.

JSC "Shiko" Moscow, 2nd Setunsky pr., 11-27 The quality of printing corresponds to the quality of the provided transparencies.

Printed from ready-made transparencies at the State Unitary Enterprise of the Order of the Badge of Honor of the Smolensk Regional Printing House named after. V I Smirnova. 214000, Smolensk, pr. Yu. Gagarina, 2.

FOREWORD

The textbook of surgical dentistry was created by a group of authors from the departments of surgical dentistry at the Moscow Medical Dental Institute, which is an educational and methodological center for higher dental education in Russia. It reflects the experience of one of the oldest schools of surgical dentistry in our country - the school of the founder of national dentistry, prof. A. N. Evdokimova and prof. G. A. Vasiliev and includes new provisions, classifications, treatment methods that have been established in this specialty. The textbook also reflects the experience of the country's leading dental surgery clinics.

The material is presented taking into account the latest achievements of medical science and practice. In the sections of surgical dentistry concerning the history of the development of the specialty, the organization of the work of outpatient and inpatient departments, examination of the patient, anesthesia, tooth extraction, inflammatory diseases, along with generally accepted principles and rules, new data are reflected. The section devoted to the organization of surgical dental services provides the main policy documents and orders and provides recommendations for the work of a dentist in modern economic conditions. The principles of ethics and deontology that a specialist must follow in his work are highlighted.

When presenting inflammatory diseases, due attention is paid to the etiology, pathogenesis, pathological anatomy, clinical picture, diagnosis and treatment of each nosological form, as well as rehabilitation and principles of prevention.

Among inflammatory diseases, the most numerous group is odontogenic processes - periodontitis, periostitis, osteomyelitis of the jaw, abscess, phlegmon, lymphadenitis, etc. The textbook describes their current course and changes clinical picture. Particular attention is paid surgical treatment, methods of surgical interventions, outcomes, complications and prognosis.

The textbook covers trauma to the maxillofacial region from a modern perspective and outlines traditional methods of diagnosis and treatment. The issues of gunshot wounds of the face and jaws, combined lesions, different kinds burns, frostbite and methods of their treatment. The basic principles of diagnosis, treatment of tumors and tumor-like formations, dispensary

observation and rehabilitation of a large group of patients with these diseases. The main methods of surgical interventions and complex therapy with these diseases. Considerable attention is paid to reconstructive surgery of the face and jaws, new methods of compensation of defects and elimination of deformation of the maxillofacial area.

The textbook will allow you to study the theoretical and practical issues necessary for a future specialist to work in the field of surgical dentistry.

Chapter I

SURGICAL DENTISTRY. ITS CONTENT, RELATIONSHIP WITH OTHER MEDICAL DISCIPLINES AND STAGES OF DEVELOPMENT

Surgical dentistry is one of the independent clinical disciplines of dentistry that studies surgical diseases and damage to the teeth, oral organs, face and neck, and bones of the facial skeleton, which require complex treatment. Among the methods of such treatment, surgical interventions are leading.

Surgical dentistry is closely related to other dental specialties - therapy, orthopedics, dentistry childhood and uses diagnostic and treatment methods common to them. This connection is due to the anatomical, topographical and physiological unity of teeth, oral organs, tissues of the maxillofacial region and the pathological processes that develop in them* Complex treatment of dental diseases often consists of sequential treatment measures using therapeutic, surgical and orthopedic dentistry.

Surgical dentistry is closely related to other medical specialties - therapy, surgery, otorhinolaryngology.

gology, ophthalmology, neurology, radiology and radiology, which opens up great opportunities for its development and improvement. This discipline is also based on the achievements of the natural sciences, physics, chemistry and many sections of fundamental medicine: normal and topographic anatomy, normal and pathological physiology, microbiology, pathological anatomy, pharmacology, operative surgery and

Diseases within the profile of surgical dentistry are divided into a number of groups depending on the etiology, pathogenesis, pathomorphology, clinical picture and features of surgical treatment.

1. Inflammatory diseases teeth, jaws, facial and neck tissues, oral organs. These include odontogenic inflammatory processes (acute and chronic periodontitis, acute periostitis of the jaw, osteomyelitis of the jaw, abscesses, phlegmons, lymphadenitis), difficult teething, odontogenic inflammation of the maxillary sinus; infectious diseases- specific (actinomycosis, tuberculosis, syphilis), non-odontogenic (furuncle, carbuncle, erysipelas, anthrax, noma), inflammatory diseases salivary glands. They occupy one of the first places in frequency among pathological processes observed in a clinic and dental surgical hospital.

2. Injuries of the organs of the oral cavity, face, bones of the facial skeleton of non-gunshot and gunshot origin, combined injuries, as well as combined injuries due to radiation exposure, thermal, chemical and other damage, frostbite.

3. Tumors and tumor-like diseases of the face, jaws and oral cavity, modern methods of their diagnosis according to the WHO International Classification.

4. Congenital and acquired defects and deformations of the face and jaws.

Surgical dental diseases often require emergency surgical interventions (acute inflammatory and traumatic diseases, including the resulting suffocation, bleeding, shock, etc.) and planned operations (chronic inflammatory diseases, trauma, tumors and tumor-like diseases, defects and deformities of the face , birth defects and developmental anomalies, etc.).

A dentist, regardless of his work profile, must be able to provide emergency assistance in case of fainting, collapse, shock, coma, cardiac and respiratory failure, myocardial infarction, hypertensive crisis, epileptic condition, allergic reactions, acute injury, including thermal injury, snake bites, poisoning, etc.

Among the operations that a dentist must be able to perform, tracheotomy occupies a special place.

The path of development of surgical dentistry reflects the path of development of other medical specialties, and each of its stages is

determined by the social system, the level of development of the economy, science, and culture.

IN Over the course of many centuries, surgery of the teeth and oral cavity developed slowly, outside of medical science and practice, remaining one of the branches of dentistry. An important role in the development of dentistry was played by the French surgeon of the 16th century Ambroise Pare, who designed instruments for tooth extraction, determined the indications and contraindications for this intervention, and developed the technique of some operations, including tooth replantation.

For the development of the surgical aspect of dentistry in the 18th century in France, the work of the founder of dentistry, Pierre Fauchard, who outlined the issues of dental surgery in his first manual on dentistry, was of great importance.

IN In feudal and serf Russia, the development of dental and oral surgery was slower than in European countries. For many centuries, surgical procedures were limited to tooth extraction, which was performed artisan doctors. And only at the royal court did foreign doctors perform dental surgery.

Development of domestic dentistry, including individual surgical interventions, is associated with the name of Peter I, with the appearance of foreign doctors at his court.

IN In the development of dental and oral surgery, apprenticeship schools for foreign dentists, training for dental doctors and dentists were of great importance, and in late XIX- early 20th century - dentists. In the 19th century, surgery, along with other medical specialties, had a great influence on the development of dentistry. During this period, various sections of surgery began to take shape, develop and acquire independence, including maxillofacial surgery.

IN 1808 Professor A. Bush performed the first operation for cleft lip. In 1820, a student of A. Bush, professor Medical University A.I. Pol developed techniques for some operations, including resection of the lower jaw. In 1843, I.V. Buyalsky successfully performed resection of the lower jaw, simplifying the operation.

The attention of surgeons to the surgical section of dentistry contributed to the improvement of maxillofacial operations within the framework of general surgery. The founder of many of them should rightfully be considered the remarkable Russian doctor and scientist N.I. Pirogov. He developed the basics of treating tumors of the maxillofacial region. He proposed one-stage plastic surgery of postoperative defects, gave basic recommendations for the treatment and surgical treatment of gunshot wounds of the face and jaws, and for plastic surgery after injury.

For the development of facial plastic surgery, the activities of Kyiv University Professor Yu. K. Shi played a great role

Manovsky. He developed a systematic principle for indications for plastic surgery, proposed improved versions of them, and created original methods of surgical interventions. The studies of V. Khandrikov, A. Dudukalov, N. Vorontsovsky, A. Pelshansky, N.V. Vysotsky, I. Korovin, V. Antonevich, N.V. Sklifosovsky and others were of great importance in the development of jaw operations.

Schools maxillofacial surgery became surgical clinics of the medical faculties of Moscow and Kyiv universities, the Medical-Surgical Academy of St. Petersburg. State-controlled dental education was of great importance for organizing dental care for the population.

The first educational school for future dentists was the private assistant professor courses of odontology at the Department of Hospital Surgery of Moscow University (N. N. Znamensky), the St. Petersburg Medical-Surgical Academy (P. F. Fedorov) and the St. Petersburg Higher Women's Medical Courses (A. K. Limberg).

All the shortcomings and difficulties of dentistry were clearly revealed during the Russian-Japanese and the First World War, when a large number of wounded in the maxillofacial area were observed. During this period, the Russian dentist S. S. Tigerstedt (1914) proposed a technique for immobilizing jaw fragments during fractures using dental wire splints; G.I. Vilga (1915) developed a method for securing jaw fragments with stamped cap splints with elastic traction; R. Faltin, having systematized gunshot injuries to the face, gave specific practical recommendations for their treatment.

The separation of surgical dentistry into an independent discipline began after the First World War and was finally realized in the 20-30s.

A major role in the development of surgical dentistry was played by: the State Odontological Institute, first organized in 1919 in Kyiv (later transformed into the Faculty of Odontology); from 1919 - Department of Odontology (then Dentistry) at the Donetsk Medical Institute (N. A. Astakhov); from 1920 - Department of Odontology and Maxillofacial Surgery at the Faculty of Medicine of Moscow University (JI. A. Govseev); Department of Odontology and Dentistry at the Kazan Medical Institute (P. A. Glushkov); from 1921 - the Faculty of Odontology of the Kharkov State Medical Institute (E.M. Gofung) and from 1922 - the State Institute of Dentistry, renamed the State Institute of Dentistry and Odontology in Moscow, the director of which from November 1922 was Professor A.I. Evdokimov.

Since 1920, the study of odontology (later

Dentistry). This made it possible to create a personnel basis for dentistry, including surgical dentistry, and at the same time lay the main organizational, scientific and practical basis for the specialty.

Surgical dentistry is a special branch of medicine, the main tasks of which are solved through surgical intervention, and as a result, it is possible to relieve the patient from pain and discomfort in the oral cavity. But the common belief that tooth extraction is the only result of dental surgery is erroneous. The main goal of dentistry is to preserve teeth, and surgery is assigned the role of an auxiliary tool on the way to this goal.

Patients of the Creative Dent clinic can be sure that doctors will do everything possible to preserve the beauty and integrity of the dentition, and all necessary operations will be performed as comfortably, carefully and painlessly as possible.

Tooth extraction in Moscow is safe and always under control

Indeed, the most famous operation of surgical dentistry is tooth extraction, but it is performed only in cases where this is the only option to prevent unwanted and dangerous complications in the oral cavity and maxillofacial area. The decision is made by a dental surgeon after a thorough examination, and indications may include:

• dystopic and/or impacted tooth (improper position, delayed eruption);
• a tooth root broken due to injury or a chronic inflammatory process (or its exacerbation);
• severe periodontitis;
• complex orthodontic situation;
• significant destruction of the crown part of the tooth, when the doctor no longer has the opportunity to put a filling or install a stump with a crown;
• large angle of inclination of the tooth when injured soft tissues oral cavity (most often this happens with wisdom teeth due to the same dystopia);
• ineffectiveness of endodontic therapy (root canal treatment).

Surgical dentistry today can be not only visual (with a demonstration of the expected result of treatment), but also atraumatic, only slightly damaging the periodontal tissues. Patients of the Creative Dent clinic can verify this. This approach is optimal, it allows you to prevent complications, reduce postoperative period rehabilitation, provide fast healing and minimize the bone tissue defect at the site where one or more teeth are removed.

Tooth-preserving surgical dentistry in Moscow

You can see for yourself that even surgical dentistry can be painless and comfortable for the patient thanks to the development of advanced technologies. The image of a dental surgeon whose goal is to remove a tooth at any cost has long been out of date. Modern doctors consider the timeliness of tooth-preserving procedures to be the most promising and important.

Patients of our clinic can be sure that any operation, as well as the solution to dental problems different levels, will be carried out painlessly. Modern anesthetics and the skillful hands of our specialists work wonders, and visiting a dental surgeon today is as comfortable as possible for patients.

75% of patients need the services of a dental surgeon

Yes, a dental surgeon removes teeth, installs implants, and performs tooth-preserving operations. But his area of ​​activity is not limited to this. Orthodontic treatment and complex cases of dental prosthetics are often not possible without his participation.

With atrophied bone, for example, it is difficult or impossible to install an implant. But a dental surgeon can create the necessary conditions and perform operations: bone tissue augmentation and/or sinus lift. As a result, the doctor can work efficiently, and the patient does not have to worry about the result of treatment. Moreover, today we actively practice the visibility of results - the patient can see what his smile will look like even before the start of treatment.

Surgical dentistry

Surgical dentistry- a branch of dentistry that practices such treatment methods as: tooth preservation operations, bone grafting, preparation and implantation of teeth, as well as various aesthetic operations in periodontology.

Questions studied

Surgical dentistry in its practice also includes tooth extraction. In cases where treatment is ineffective and tooth extraction is inevitable, the dental surgeon will professionally, quickly and without pain will remove the required tooth. It is also possible to remove wisdom teeth that have grown incorrectly and are in the way. When a professional dental surgeon performs tooth extraction, the occurrence of all kinds of complications is minimized. Surgeons also remove cysts located on the top of the tooth.

In addition, each surgical dentist, before removing a tooth, will advise the patient about prosthetics or even implantation in place of the missing tooth.

Surgical dentistry includes:

• Implantation,
• Dental-preserving procedures
• Treatment inflammatory processes(periodontitis, periostitis, osteomyelitis, sinusitis, abscesses, phlegmon)
• Tooth extraction (partial or complete removal)
• Treatment of oral tumors
• Preparing the oral cavity for subsequent prosthetics
• Removal of small tumors on the face
• Treatment of TMJ diseases
• Treatment of trigeminal nerve diseases
• Treatment of diseases of the salivary glands
• Primary surgical treatment of wounds of the face, neck, oral cavity
• Reconstructive and plastic surgery on the jaws
• Diagnosis of specific diseases when they manifest themselves in the oral cavity (atinomycosis, tuberculosis, syphilis)
• Operations on periodontal tissues

Surgical dentistry in Russia

Thanks to high level development of modern surgical dentistry, today it is possible to preserve hopeless teeth.

At the moment, surgical dentistry closely connects its practice with such areas of medicine as aesthetic surgery, orthodontics, and implantology. Therefore, dental surgeons are increasingly collaborating with other specialists.

Every year, cosmetic manipulations on the gums become more and more in demand in dental surgery. The following techniques are especially often performed: gingivoplasty, frenuloplasty, elimination of gum recession, vestibuloplasty, corrective manipulation of the alveolar process, removal of the crown of the tooth.

In addition to the above treatment methods, dental surgery also prepares for jaw implantation. For non-standard placement maxillary sinuses, atrophy or thinning of the jaw bone, this anomaly is corrected or the altered bone is built up to install an implant.

Surgical dentistry studies the surgical aspects of diseases of the oral cavity, face and neck. Contrary to the popular belief that dental surgeons only remove teeth and perform implantation, they perform a large number of different manipulations, including operations from tooth extraction to plastic surgery.

Sources

Wikimedia Foundation. 2010 .

• Surgeon Nikolai Pirogov (train)
• Surgical instrument

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