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口腔临床操作技术丛书(第3辑):口腔外科门诊手术操作规范

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口腔临床操作技术丛书(第3辑):口腔外科门诊手术操作规范

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《口腔临床操作技术丛书(第3辑):口腔外科门诊手术操作规范》适应了这种教学和临床工作的需求。系统深入地介绍了局部麻醉、牙拔除术、牙再植与牙移植术、修复前外科及口腔病变等口腔外科基本临床操作的规范和准则。外科拔牙术是《口腔临床操作技术丛书(第3辑):口腔外科门诊手术操作规范》的重点,系统地介绍了外科拔牙术的适应证、手术器械以及操作规范,还以大量的图片形象直观地介绍了微创理念指导下各类牙齿的拔除方法。镇静技术在口腔外科中的应用也是《口腔临床操作技术丛书(第3辑):口腔外科门诊手术操作规范》的亮点之一。随着社会的进步,人文关怀受到了越来越多的关注。让牙科恐惧症患者、儿童患者及患有某些全身系统性疾病的患者在镇静条件下接受口腔外科治疗,不但可以减少患者的痛苦、使患者感到舒适和轻松,还可以简化操作过程、缩短操作时间、减少并发症的发生。广大口腔医学生和口腔外科医师可以通过这《口腔临床操作技术丛书(第3辑):口腔外科门诊手术操作规范》系统地了解口腔外科领域的新理念、新技术、新知识和新器材,并能通过的学习,掌握口腔外科门诊手术操作规范,进而促进我国口腔外科临床操作的规范化,提升我国口腔外科治疗的整体水平。
Catalogue

第一章 口腔局部麻醉
第一节 口腔局部麻醉常用药物
第二节 口腔局部麻醉基本技术
第三节 口腔外科常用的局部麻醉方法
第四节 口腔局部麻醉常见并发症

第二章 普通牙拔除术
第一节 拔牙适应证
第二节 拔牙禁忌证
第三节 拔牙器械
第四节 拔牙术前准备
第五节 普通牙拔除术的基本步骤及各类牙的拔除方法

第三章 外科拔牙术
第一节 外科拔牙术的适应证
第二节 外科拔牙术器械
第三节 外科拔牙术的操作规范
第四节 外科拔牙术对各类牙的拔除

第四章 阻生牙拔除术
第一节 适应证和禁忌证
第二节 阻生牙拔除术前准备
第三节 下颌阻生第三磨牙拔除
第四节 上颌阻生第三磨牙及其他阻生牙拔除

第五章 拔牙并发症及其防治
第一节 拔牙术基本原则
第二节 拔牙术中并发症
第三节 拔牙术后并发症

第六章 镇静技术在口腔外科中的应用
第一节 镇静技术在口腔外科中的应用前景与范围
第二节 口腔外科常用的镇静技术
第三节 口腔外科镇静技术的操作流程
第四节 特殊人群镇静下口腔外科治疗的注意事项

第七章 牙再植与牙移植术
第一节 牙再植术
第二节 牙移植术

第八章 牙及牙槽突损伤
第一节 牙折和牙槽突骨折
第二节 牙齿脱位性损伤
第三节 牙齿撕脱性损伤
第四节 乳牙损伤
第五节 临床操作技术

第九章 修复前外科
第一节 唇系带修整术
第二节 舌系带修整术
第三节 牙槽突修整术
第四节 上颌隆突修整术
第五节 下颌舌侧隆突修整术
第六节 上颌结节修整术
第七节 缝龈瘤
第八节 前庭沟成形术
第九节 牙槽窝植骨术

第十章 口腔病变的外科处理
第一节 基本原则
第二节 口腔软组织良性病变的处理
第三节 口腔软组织恶性或可疑恶性病变的切取活检
第四节 口腔硬组织病变的处理
参考文献
Book Abstract

五、说明
患牙是否应该拔除与当代医疗技术发展水平、医生的技术水平和诊疗条件、患者整体治疗计划、患者的要求、生理特点、心理承受能力以及患者的经济条件等多种因素有关,因此具体情况应具体分析。例如:
1.残根是否拔除与残根本身的情况有关,另外还与患者的整体治疗计划密切相关。如果患者缺牙较多,且欲通过种植义齿进行整体修复时,可以考虑尽早拔除残根。反之,对于准备行活动或固定义齿修复的患者,可以对残根进行彻底的牙体治疗后进行覆盖义齿或固定义齿修复。
2.对牙周病累及的患牙是拔除还是保留,除了考虑骨组织丧失情况外,还应综合考虑患者的年龄和要求等。对于采用常规牙周治疗无法确定治疗效果的患牙,如患者年轻且要求种植修复时应建议尽早拔除以避免骨质进一步破坏;而对于老年患者且要求后期行活动义齿修复时,可以先尝试进行常规的牙周治疗,视日后的治疗效果再做进一步决定。
3.因外伤而导致松动的牙齿是否保留,与患者年龄及有无牙周病密切相关。对于年轻且牙周状况良好的患者,通过松牙固定后,一般可以取得良好的效果。但对于老年患者或患有严重牙周病的患者,建议早期拔除外伤所致的松动牙后择期修复。
4.多生牙及错位牙的处理,除了应考虑其对周围正常组织的影响外,还应考虑患者的全身状况及要求。特别是埋藏牙的拔除,因为手术难度相对较大,耗时较长,对于年龄较大、全身情况较差的患者拔除时应慎重。
5.根尖周病和牙髓病患者进行患牙拔除时常因局部炎症导致麻醉效果不佳。对于患有心脏病、高血压、拔牙恐惧症的患者来说,在患牙拔除时一定要保证无痛操作,因为疼痛、恐惧可能会导致此类患者发生危及生命的严重并发症。因此,面对此类患者时,应对患者的全身情况、术者技术水平、拔除方法、是否具备镇痛镇静及急救设备与技术等方面综合评估后再决定。
……
Introduction

口腔外科是口腔颌面外科的基本分支,主要内容是牙及牙槽外科,同时包括口腔颌面部炎症、外伤、硬软组织病变及发育异常等疾患的诊断和门诊治疗,因而绝大多数口腔颌面外科患者属于口腔外科的诊治范畴,口腔外科突出的临床特点是治疗对象随机性强,治疗方法依靠实际操作,要求医生必须在有限的时间内针对各种各样、表现不同的患者尽快作出个体化的诊疗计划,并给予安全、有效、微创、无痛的实际操作,避免患者离开医院后出现各种并发症。这就要求口腔外科医生不仅掌握专科理论知识,还必须具备内外科基础知识,不断提高专业技术操作水平,加强综合判断和整体计划能力。如认为口腔外科只是小学科、小手术而加以轻视,没有敬业精神和风险意识,没有掌握规范化的操作技术,就可能导致各种医疗意外或并发症的发生,并给患者带来较大痛苦甚至危险。
随着口腔医学科学技术的迅猛发展,新理论、新方法、新技术、新材料、新设备不断在口腔外科临床实践中得到广泛推广和应用。随着人们生活水平的不断提高,对医疗服务的质量和水平提出了更高的要求,系统总结近年来口腔外科发展的最新成果和技术,科学规范医护人员的临床技术操作是提高医疗质量、确保医疗安全、防范医疗风险的重要举措。
由于我国口腔专业医师的教育和培训程度在不同地区有较大差异,即使是同一地区的医生或同一院校毕业的学生,也会因各种原因使其在标准化的临床操作和临床经验上有所差异。本书的目的是通过大量图片和临床病例帮助口腔医生形象直观地理解和认识口腔外科临床操作规范化步骤和原则,使其在临床工作中尽快提高操作能力,避免不正确、不规范的操作给患者带来的不必要痛苦。本书删除了一些容易引起并发症的操作技术(如敲击拔牙方法),增加了一些新技术(如牙槽窝植骨术)。

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