Читать книгу Principles of Dentoalveolar Extractions - Seth Delpachitra - Страница 9

The attachment of teeth to bone, facilitated by the periodontal ligament, is a unique connective tissue articulation. It enables tooth eruption, appropriate physiological responses to compressive force, and planned orthodontic tooth movement. However, as odontogenic infections may be potentially fatal, specialised skills for efficient tooth extraction have evolved from the days of the ‘barber-surgeons’ of the Middle Ages to contemporary exodontia. Today, every conceivable type of useful instrumentation and imaging is available to the clinician.

Tooth removal in the middle of the last century occupied a large part of the dental practitioner’s work and skill set, but this has markedly reduced due to better dental care and tooth maintenance. The time devoted to the discipline of exodontia in the dental curriculum has thus diminished proportionally, and many graduates emerge with minimal experience in removing teeth. A fresh, comprehensive guide to the principles of dentoalveolar extractions for all interested practitioners who wish to underpin their clinical experience with clear guidelines is therefore most welcome.

In a logical sequence, the authors have addressed all aspects of managing a patient for simple and surgical extractions. By introducing the ‘principles of surgery’ from the outset, the reader is reminded that tooth removal is within the surgical spectrum and carries the same responsibilities in terms of providing careful patient assessment, consent, a controlled clinical environment, and necessary documentation. A detailed knowledge of the associated anatomy and competence in the administration of local anaesthesia are fundamental for successful dentoalveolar surgery in the outpatient setting and are well covered in this book, as are the available surgical instruments.

A methodical approach in performing simple and surgical extractions, including the management of intraoperative events and third molar surgery, is also provided, with headings for assessment, equipment, and patient position. These chapters are supported by good-quality anatomical diagrams to assist in the understanding of the suggested techniques.

With our ageing population, there are many medications and diseases that must be thoroughly understood by the dental practitioner. A chapter on medical compromise is an important addition to this text as it covers issues such as the newer anticoagulant agents and medications for bone loss that influence healing. The taking of these drugs may significantly modify a treatment plan, and decisions regarding joint management with the patient’s prescribing physician are often indicated. Finally, postoperative care and complications are discussed, as these represent vital knowledge in surgical care.

Many books covering this field have included chapters devoted to exodontia, as part of a broader spectrum of oral and maxillofacial surgery. However, this neat, clear, and inclusive volume fulfills the objective of providing a modern reference text devoted to dentoalveolar surgery alone. It will instruct all those who set out to master the skills of exodontia in their practising lives, from undergraduate students to surgical trainees and newly qualified dental practitioners. I have no doubt that this excellent resource will be consumed and enjoyed by many in the years to come.

Professor Andrew A.C. Heggie, AM

Oral and Maxillofacial Surgeon

Melbourne, Australia