Syllabus of Intermediate module In Oral & Maxillofacial Surgery

PRINCIPLES OF OMFS REGARDING:

● Evaluation of the preoperative health status of the surgical patient ● Making a surgical diagnosis and prerequisites of surgery
● Principles & types of incisions, flap design & methods of tissue handling

● Haemostasis, edema control, decontamination, surgical wound toilet
● Patho-physiology and principles of wound repair/ significance of wound healing
● Mechanisms of scar and contracture formation & its prevention
● Surgical infection and its prevention and control
● Body response to infection and appropriate methods for carrying out surgery in Hepatitis, HIV carriers and all other medically compromised conditions.
● Use of common surgical instruments and operation theatre appliances (suction, diathermy, retractors, general instruments etc) ● Appropriate uses of suture/ ligature materials and basic Principles of anastamosis.
● Management of postoperative patients by taking appropriate measures to prevent complications.

EXODONTIA:

a) General Principles

– Armamentarium used for basic Oral surgical practice
– Assesses medical condition of patient preoperatively and knows basic principles of managing pain and anxiety control
– Indications and contraindications of performing tooth extraction & related procedures
– Clinical and radiological assessment for tooth extraction

b) Uncomplicated Exodontia

– Patient and surgeon preparation, chair positioning and mechanical principles involved in tooth extraction.
– Principles of Forceps, Elevator use and procedures for closed extractions including specific techniques for removal of each tooth
– Post-extraction care of alveolar socket

c) Complicated Exodontia

– Flap design, types & development technique and management
– Basic principles of suturing for complex cases
– Indications and contraindications of surgical extractions
– Techniques for performing surgical removal of single, multi-rooted teeth, & root fragments
– Extraction sequence & technique when planning multiple extractions for special scenarios.
– Management of post extraction complication.

MANAGEMENT OF IMPACTED TEETH:

● Indications and contraindications for removal of impacted teeth
● Classification of impacted teeth of Upper & Lower Jaws
● Difficulty Index of removal of impacted teeth
● Pre, Per and Post-operative Complications & management when removing impacted teeth

ASEPSIS, STERILIZATION & CROSS INFECTION CONTROL:

● Surgically important and communicable microbes related to OMFS
● Differentiation between sterilization, disinfection, asepsis etc
● Different techniques of instrument sterilization by heat, gas and by chemicals
● Methods of maintenance of sterility in Dental Surgery Unit, Room and OT
● Methods of scrubbing, gowning, gloving and assisting the surgical staff
● Managing postsurgical asepsis

ANTIMICROBIAL THERAPY / ANALGESICS USE IN OMFS / DENTISTRY

● Commonly used antimicrobials and analgesics
● Basic principles of prophylactic and therapeutic antibiotic use
● Basic principles of analgesic use
● Indications, precautions & contraindications of antibiotic therapy ● Drug interactions, advantages & disadvantages of combination therapy
● Significance of culture and sensitivity testing with basic knowledge of dosage and routes of administration & their issues
● Consequences of under or over dosage, allergic reactions to antibiotics and analgesics & their management

DIAGNOSTIC TECHNIQUES AND INVESTIGATIONS REQUIRED FOR PATHOLOGIES OF HEAD AND NECK REGION:

● Appropriate radiological investigations
● Appropriate surgical diagnostic investigations including biopsies

RADIOLOGY AND IMAGING TECHNIQUES USED IN OMFS/ DENTISTRY:

● Ordering various techniques of radiology and imaging used, including intra- and extraoral radiological investigations
● Evaluates and interprets them for providing OMF Surgical Care

MEDICAL EMERGENCIES IN OMFS / DENTISTRY :

● Common medical conditions which are likely to develop into emergencies in the dental office
● Drugs that should be included in a dental emergency kit.
● When, how & whom to refer patients, having serious medical emergencies.

MANAGEMENT, PREVENTION AND SPREAD OF ODONTOGENIC INFECTIONS:

● Basic microbiology of odontogenic infections
● Routes of odontogenic infections, spread and its natural progression
● Principles of managing and preventing odontogenic infections
● Prophylaxis against spread of infection
● Management of all complex odontogenic facial space infections
● Diseases of the maxillary sinus and their management

MANAGEMENT OF PATHOLOGIC LESIONS AFFECTING OMFS REGION:

● Basic principles of biopsy procedure
● Differential diagnosis
● Goals and principles of surgical management of oral pathologic lesions
● Cysts and tumors of the OMFS region.

TREATMENT OF PRE-CANCEROUS LESIONS AND ORAL MALIGNANCES:

● Diagnosis of various precancerous lesions and conditions and their management
● Identification of etiology and risk factors and the preventions of oral cancer
● Clinical evaluation and differential diagnosis of suspected lesions of the head and neck
● Principles and mode of action of chemotherapy and associated medicines.
● Manage dental problems in patients undergoing brachytherapy, radiotherapy & chemotherapy

DIAGNOSE AND OFFERS BASIC TREATMENT TO GENERAL AND MAXILLOFACIAL TRAUMA PATIENT WITH:

● Management of the trauma patient using ATLS principles.
● Role and utility of oral and maxillofacial surgeon in the trauma team
● Identification and management principles of life threatening, sight threatening and limb threatening injuries.
● Soft tissue injuries such as abrasions, contusions and lacerations
● Traumatic injuries to teeth and supporting structures , including dentoalveolar fractures.
● Facial trauma : Clinical and Radiological evaluation
● Fractures of mandible ,condyle, maxilla and other mid facial bones ● Closed reduction techniques in management of facial fractures.
● Application of basis ORIF (Open Reduction And Internal Fixation) and Reconstructive Surgery principles.

PRE-PROSTHETIC ORAL SURGERY:

● Objectives of pre-prosthetic surgery
● Principles of evaluation, treatment planning & needs of the patient ● Various procedures of alveolar ridge augmentaion and their relation with the jaws
● Maxillary and mandibular tori procedures and etc

DENTAL IMPLANTOLOGY AND ITS IMPLICATION:

● Biological considerations of osseointegration
● Dental implant types and its components
● Evaluation of medical condition of the patient preoperatively
● Planning & evaluation of surgical treatment procedure including clinical and radiographic assessment of implant site and associated structures
● Basic and advanced surgical Implant techniques their complications and management

TEMPOROMANDIBULAR JOINT & FACIAL PAIN:

● Classification of temporomandibular Joint disorders
● Congenital and infectious disorders of the TMJ
● Internal derangement of the TMJ; including its management with different reversible and irreversible treatment methods
● Degenerative joint disease and systemic arthritic conditions affecting TMJ
● TMJ hypomobility disorders; including TMJ ankylosis and their management
● TMJ hypomobility disorders; recurrent dislocation and their management
● Pain neurophysiology
● Facial pain management and related neuralgias
● Oral facial and its other types; including neuropathic facial pains and chronic headache

ANAESTHESIA (LOCAL/ REGIONAL/ GENERAL):

● Primary goals of giving local, general and sedation anesthesia
● Requesting preoperative G/A fitness from Anesthesiologist
● Classification, chemistry and pharmacologic effects of local and general anesthetic drugs
● Adverse effects and drug interactions of local and general anesthetic drugs
● Preparations and dosage of local anesthetic drugs, their general therapeutic uses and side effects when used in dentistry
● Methods of administration and mechanisms of action of general anesthetic drugs including inhalation agents and intravenous agents ● Differentiation between analgesia and sedation and their application in oral surgery
● Principles of general anesthesia and IV sedation

ESSENTIAL ORAL MEDICINE FOR THE OMFS:

● Vesiculobullous lesion of the oral cavity
● Oral ulcerations
● Autoimmune disorders related to OMFS
● Red and blue lesion of the oral cavity
● White lesion of the oral cavity

BONE PATHOLOGY RELATED TO OMFS:

● Fibro osseous lesions of the OMFS region
● Giant cell lesions of the OMFS region
● Metabolic bone diseases
● Developmental bone disorders

ORTHOGNATHIC SURGERY:

● Dentofacial deformities
● Assessment of the dentofacial deformity patient; including clinical assessment, essential imaging, cephalometry and current assessment tools.
● Liason between orthodontic and maxillofacialsurgery in planning for orthognathic surgery
● Model surgery; inclucing facebow transfer and articulator mounting ● Maxillary, mandibular and genioplasty osteotomies ; indications and surgical technique
● Patients , attendants etc counseling where needed
● Basic concepts of distraction osteogenesis
● Perioperative care of the orthognathic surgical patient

DEVELOPMENTAL ANOMALIES RELATED TO OMFS:

● Causative factors and embryology of Cleft lip and Palate
● Problems experienced by cleft lip and palate -afflicted individuals ● Timing and principles of treatment of cleft lip and palate and alveolar grafting
● Correction of maxillomandibular disharmonies and secondary surgical procedures
● Dental needs of cleft-afflicted patients and the concepts of multi disciplinary management

MEDICO-LEGAL AND ETHICAL ISSUES IN ORAL SURGERY/ DENTISTRY:

● Legal concepts influencing liability and risk reduction
● Principles of dental ethics and steps in ethical decision making
● Basis of obligations in the Dentist-Patient relationship
● Informed consent, informed refusal, record keeping and documentation including referral letters
● Counseling in cases of complications
● Documentation of patient management problems in case of non-compliance or patient abandonment








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