The editors Harry Dym, DDS, FACS, is Chairman of the Department of Dentistry and Oral and Maxillofacial Surgery at the Brooklyn Hospital Center and Clinical Professor of Oral and Maxillofacial Surgery at Columbia University College of Dental Medicine, in New York City, New York, United States. Leslie Halpern, DDS, MD, PhD, MPH, FACS, is Section Chief and Program Director of Oral and Maxillofacial Surgery, Clinical Professor at New York Medical College/Metropolitan Hospital in New York City, New York, United States. Orrett Ogle, DDS, is Former Chief of the Oral and Maxillofacial Surgical Service at Woodhull Hospital in Brooklyn, New York, United States.

• Contributors xviiPreface xixPart I Basics 11 Patient Evaluation and Management of Medical Problems in the Oral Surgery Patient 3Risk Assessment 3Documentation 4Management of Patients with Medical Problems 5Cardiovascular Disease 6Hypertension 6Angina Pectoris 7Myocardial Infarction 8Stroke/Cerebrovascular Accident 9Cardiac Arrhythmias 9Heart Failure 10Treatment Guidelines 10Endocrine Disorders 11Diabetes Mellitus 11Thyroid Disease 12Adrenal Insufficiency 13Hepatic Disease 13Renal Disease 15Dialyzed Patients 15Pulmonary Disease 15Asthma 15Chronic Obstructive Pulmonary Disease 15Pregnancy 16Conclusion 18References 182 Risk Reduction Strategies 21Methods of Risk Reduction 21Faulty Record Keeping 21Informed Consent 21Conclusion 23Reference 233 Preparing the Dental Office for Medical Emergencies: Essentials of an Emergency Kit 25Staff 25Equipment 26Oxygen 26Airway Adjuncts 26Automated External Defibrillators (Figure 3.2) 26Vitals Monitoring 27Intravenous Kits 27Emergency Drug Kit 27Oxygen 27Aromatic Ammonia 27Aspirin 28Albuterol 28Glucose 28Nitroglycerin 28Diphenhydramine 29Epinephrine 29Sedation-Specific Emergencies 29Summary 29References 29Part II Dentoalveolar Surgery 314 Surgical Management of the Impacted Canine 33Etiology 33Diagnosis 33Treatment and Management of the Impacted Canine 35Goals 35Interceptive Treatment to Prevent Impactions 35Surgical Management of the Impacted Canine 35Open vs Closed Surgery 35Palatal Maxillary Impactions 36Labial Maxillary Impactions 36Mandibular Impactions 37Complications 37References 385 Crown Lengthening 39Biologic Width 39Indications for Crown Lengthening [3] 39Contraindications for Crown Lengthening [1] 40Procedures Carried Out Prior to Crown Lengthening [4] 40Bone Sounding [2] 40Sequence of Treatment for Crown Lengthening 40External Bevel Gingivectomy 40Internal Bevel Gingivectomy 40Flap Surgery with Osseous Surgery 41Apically Positioned Flap With or Without Osseous Surgery 42Combined with Orthodontic Extrusion 42Classification of Esthetic Crown Lengthening [2] 42Postoperative Care [3] 43References 43Part III Implantology 456 Bone-Grafting Techniques and Biomaterials for Alveolar Ridge Augmentation 47Bone Graft Materials and Healing Physiology 47Introduction 47Bone Graft and Tissue Engineering Materials – Outline 47Autogenous (Natural) 47Allograft (Natural) 47Xenograft – Bovine, Porcine, Equine, Marine Coral, or Algal Sources 47Alloplast 47Other Synthetic Sources (Engineered) 48Autologous Platelet Concentrate 48Bone Graft and Tissue Engineering Materials 48Autograft 48Allograft 48Mineralized Freeze-Dried Bone Allograft 49Demineralized Freeze-Dried Bone Allograft 49Particulate Cortical, Cancellous, and Corticocancellous Allograft 49Xenograft 49Natural Hydroxyapatite 49Bio-Oss – Bovine Derived 49Natural Hydroxyapatite – Marine Coral Derived 49Calcium Carbonate – Biocoral 49Fluorohydroxyapatite (FHA) – Natural Sea Algae Derived 50Alloplast (Synthetic Sources) 50Hydroxyapatite Based (Synthetic HA) 50Marine Coral Derived (Hydroxyapatite) 50Coralline Porous Hydroxyapatite – Interpore (Synthetic HA) 50Coralline Porous Hydroxyapatite – Pro Osteon (Synthetic HA) 50Nanocrystalline Hydroxyapatite (Synthetic HA) 51Tricalcium Phosphate (Synthetic) 51Biphasic HA and B-TCP Material (Synthetic Combination) 51Calcium Sulfate – Gypsum Based (Synthetic) 51Calcium Sulfate – Nanocrystalline (Synthetic) 51Biphasic Calcium Sulfate (Synthetic) 51Bioactive Glass Ceramics (Synthetic) 52Other Synthetic Sources – Recombinant Bone Morphogenetic Protein (rhBMP) 52Autologous Platelet Concentrates (See Table 6.1 for Complete Formulations) 52Platelet-Rich Plasma 52Platelet-Rich Fibrin 52Ridge Preservation 54Ridge Preservation Indications 54Ridge Preservation Algorithm 54Ridge Preservation Surgical Technique 55Ridge Preservation Surgical Complications 57Ridge Preservation Implant Survival and Success Rates 57Ridge Preservation Conclusion (Box 6.4) 58Guided Bone Regeneration (GBR) 59Guided Bone Regeneration Indications 59Nonabsorbable Membrane 59Titanium Mesh 59e-PTFE [51, 52] 59Nonexpanded d-PTFE (Osteogenics Biomedical) [6, 49–51, 53] 59Titanium-reinforced PTFE [51, 54] 60Absorbable Membrane 61Collagen Base (Bovine, Porcine, or Human Tendon, Dermis, Skin, or Pericardium) 61Polymeric Membrane (Manufactured Synthetic Membrane) 61Tuberosity Harvest Technique (Figures 6.9–6.11, Box 6.5) 62Guided Bone Regeneration 62Surgical Technique for Three Wall Defect (Figures 6.15–6.18) 62Surgical Technique for Moderate-to-Severe Defect 62Particulate Graft Resorption Post Grafting 64Guided Bone Regeneration Complications 65Guided Bone Regeneration Implant Survival and Success Rates 65Guided Bone Regeneration Conclusion (Box 6.6) 65Intraoral Onlay Graft 66Indications (Particulate and Block Graft) 66Subperiosteal Tunneling Technique with Absorbable Membrane 67Autogenous Onlay Corticocancellous Grafts Healing 68Surgical Harvest Technique: Intraoral Lateral Ramal Shelf and Symphysis (Figure 6.8) 68Autogenous Intraoral Block Grafts – Surgical Complications 70Allogeneic Block Bone (Cadaver Bone) 70Block Graft Implant Survival and Success Rate 70Block Graft Conclusion (Box 6.7) 70Ridge Split 71Indications 71Ridge Split Surgical Technique 71Ridge Split Complications 71Ridge Split Implant Survival and Success Rates 72Ridge Split Conclusion (Box 6.8) 72Interpositional Bone Graft or “Sandwich Osteotomy” 73Indications 73Interpositional Bone Graft Surgical Technique 73Interpositional Bone Graft Complications 74Interpositional Bone Graft Implant Survival and Success Rates 74Interpositional Bone Graft Conclusion (Box 6.9) 74Distraction Osteogenesis 75Indications 75Distraction Osteogenesis Surgical Technique 77Distraction Osteogenesis Complications 77Distraction Osteogenesis Implant Survival and Success Rates 77Distraction Osteogenesis Conclusion (Box 6.10) 77Postoperative Instructions 77Conclusion 78Horizontal Augmentation Recap (Tables 6.5 and 6.6) 78Horizontal Augmentation Complication Recap 78Vertical Augmentation Recap (Tables 6.5 and 6.6) 79References 817 Maxillary Sinus Augmentation 85Introduction 85Maxillary Sinus Anatomy 85Indications, Contraindications, Limitations 85Lateral Window Approach 86Transalveolar (Crestal) Approach 86Bone-Grafting Material 87Complications 87References 898 Technologic, Material, and Procedural Advancements in Dental Implant Surgery 91Introduction 91Three-Dimensional Imaging 91Computerized Implant Planning Technology 92Intraoral Optical Impressions and Integration with CBCT, CAD/CAM, and Stereolithography 92Surgical Drilling Guide Integration and Fabrication 94Guided Navigation in Osteotomy Preparation and Implant Placement 94Membranes for Bone Grafting 95BMP, PRGF, and PRP 96Implant-Supported, Full-Arch, Fixed Prostheses with Immediate Loading and “All-on-Four” 97Zygomatic Implants 98Lasers 99Conclusion 100References 100Part IV Trauma 1019 Diagnosis and Management of Dentoalveolar Trauma 103Introduction 103Evaluation 103History 103Physical Examination 103Radiographic Studies 104Diagnosis and Management of Dentoalveolar Injuries 104Injuries to the Dental Hard Tissue and Pulp 104Crown Infraction 104Crown Fracture 104Crown-Root Fracture 105Root Fracture 105Injuries to the Periodontal Tissues 105Concussion 105Subluxation 105Intrusion 105Extrusion 106Lateral Luxation 106Avulsion 106Dentoalveolar Injuries in the Primary Dentition 107Splinting 108Injuries to the Gingiva or Oral Mucosa 108Injuries to Supporting Bone 108Follow-Up 109Conclusion 109References 109Part V Pathology 11310 Biopsy Technique: When, Where, and How? 115Introduction 115Patient Evaluation: Health History, Medications 115Lesion History 116Clinical Examination 117Indications for Biopsies 120Precancerous Lesion: “Potentially Malignant Disorders” 120Biopsy Techniques 123Incisional Biopsy 123Excisional Biopsy 124Punch Biopsy 124Adjunctive Techniques 124Lugol’s Iodine 126Toluidine Blue 126Brush Biopsy/Cytology 128References 12811 Diagnosis and Management of Recurrent Lesions of the Oral Mucosa 131Introduction 131Aphthous Lesions and Recurrent Aphthous Stomatitis 131Presentation 131Etiology 131Diagnosis 132Treatment 132Herpetic Lesions 133Course of the Disease 133Diagnosis 133Treatment 133Candidiasis 134Clinical Presentation 134Diagnosis 134Treatment 134Lichen Planus 135Clinical Presentation 135Diagnosis 135Treatment 135Pemphigus Vulgaris 136Clinical Presentation 136Etiology 136Diagnosis 137Treatment 137Erythema Multiforme 137Clinical Presentation 137Diagnosis 138Treatment 138Fixed Drug Eruptions 138Clinical Presentation 138Etiology 138Diagnosis 139Treatment 139References 13912 Benign Pediatric Pathology: Diagnosis and Management 143Introduction 143Eruption Cyst 144Ameloblastoma 145Aneurysmal Bone Cyst 146Melanotic Neuroectodermal Tumor of Infancy 147Juvenile Ossifying Fibroma 148Cherubism 149Hemangioma 150Vascular Malformation 151Verrucous Vulgaris and Condyloma Acuminatum 152References 15313 Diagnosis and Management of Salivary Gland Pathology 157Introduction 157Management of Sialolithiasis 158Bacterial Salivary Gland Infections 159Viral Sialadenitis 160Granulomatous Disease of the Salivary Gland 160Autoimmune Diseases 161Warthin Tumor 162Conclusion 163References 16314 Odontogenic Cysts and Odontogenic Tumors 167Introduction 167Developmental Odontogenic Cysts 168Odontogenic Keratocyst (Keratocystic Odontogenic Tumor) 169Lateral Periodontal Cyst and Botryoid Odontogenic Cyst 171Gingival Cyst 172Orthokeratinized Odontongenic Cyst 173Ameloblastoma 174Clinical Presentation 175Histologic Features 176Squamous Odontogenic Tumor 177Histologic Features 178Histologic Features 179References 18015 Osteomyelitis of the Jaw 183Classification 183Laboratory Analysis 184Microbiology 186Treatment 187Case Presentations 188Osteomyelitis of the Maxilla 188Osteomyelitis of the Mandible 189References 19216 Obstructive Sleep Apnea 193Introduction 193Symptoms 194Surgical Procedures 195Uvulopalatopharyngoplasty 196Genial Tubercle Advancement 197Conclusion 198References 19817 Temporomandibular Disorders: A Clinician’s Guide for Nonsurgical and Surgical Interventions 201Introduction 201Nonsurgical Treatment Approaches 204Methods of Therapy 205Maxillary and Mandibular Full-Arch Splints 206Surgical Approaches 207Case Presentation 214Conclusion 216References 21618 Postoperative Complications in Oral Surgery 219Complications Arising During the Procedure 219Root Fracture and Displacement 220Nerve Injury 221Complications after Oral Surgery 222Infection 223Pain, Swelling, and Trismus 224References 22519 Odontogenic Infections: Anatomy, Etiology, and Treatment 227Introduction 227Physical Examination 228Radiographic Imaging 229Pain Control 230Treatment Techniques 231Method 231Palatal Abscess 232Method 233Buccal and Midfacial Abscess 234Method 235Methods 236Pterygomandibular Space 237Pericoronitis 238Antibiotic Therapy 239References 240Part VI Pain Control 24320 Approaches to the Management of Facial Pain 245Introduction 245Diagnostic Approach to Facial Pain Patients 246Neuropathic Pain 248Episodic Neuropathic Pain 249Continuous NP 250Neurovascular Pain 253Topical NSAIDs 254Injection Therapy 255Complications of Injection Therapy 256Summary and Future Directions 257References 25721 Local Anesthesia: Agents and Techniques 261Local Anesthetics 261Nerve Block Techniques 262Greater Palatine Approach 263Sigmoid Notch Approach 264Halstead Method 265Akinosi Technique (Figure 21.6) 266Auxilliary/Supplemental Techniques 267Intrasulcular Infusion 268Trigger Point Injections 270Nasal Spray 271References 27222 Nitrous Oxide 275History 275Use and Administration 275Contraindications 276Safety Mechanisms 277References 278Part VII Oral Medicine 28123 Antibiotic Prophylaxis in Oral and Maxillofacial Surgery: Recent Trends in Therapeutic Applications 283Introduction 283Infective Endocarditis 285Additional Considerations about Infective Endocarditis Antibiotic Prophylaxis (When Indicated) 286Third Molars/Extractions 287Cleft lip and palate 289Dental Implants 290Trauma 291Conclusion 292References 29224 Management of Patients on Anticoagulation 295Introduction 295Heparins 296Antiplatelet Agents 297Conclusion 299References 29925 Burning Mouth Syndrome 301Introduction 301Etiology and Risk Factors 302Diagnosis 303Treatment 304Primary Burning Mouth Syndrome 305Conclusion 306References 307Index 311

The editors Harry Dym, DDS, FACS, is Chairman of the Department of Dentistry and Oral and Maxillofacial Surgery at the Brooklyn Hospital Center and Clinical Professor of Oral and Maxillofacial Surgery at Columbia University College of Dental Medicine, in New York City, New York, United States. Leslie Halpern, DDS, MD, PhD, MPH, FACS, is Section Chief and Program Director of Oral and Maxillofacial Surgery, Clinical Professor at New York Medical College/Metropolitan Hospital in New York City, New York, United States. Orrett Ogle, DDS, is Former Chief of the Oral and Maxillofacial Surgical Service at Woodhull Hospital in Brooklyn, New York, United States.

• Contributors xviiPreface xixPart I Basics 11 Patient Evaluation and Management of Medical Problems in the Oral Surgery Patient 3Risk Assessment 3Documentation 4Management of Patients with Medical Problems 5Cardiovascular Disease 6Hypertension 6Angina Pectoris 7Myocardial Infarction 8Stroke/Cerebrovascular Accident 9Cardiac Arrhythmias 9Heart Failure 10Treatment Guidelines 10Endocrine Disorders 11Diabetes Mellitus 11Thyroid Disease 12Adrenal Insufficiency 13Hepatic Disease 13Renal Disease 15Dialyzed Patients 15Pulmonary Disease 15Asthma 15Chronic Obstructive Pulmonary Disease 15Pregnancy 16Conclusion 18References 182 Risk Reduction Strategies 21Methods of Risk Reduction 21Faulty Record Keeping 21Informed Consent 21Conclusion 23Reference 233 Preparing the Dental Office for Medical Emergencies: Essentials of an Emergency Kit 25Staff 25Equipment 26Oxygen 26Airway Adjuncts 26Automated External Defibrillators (Figure 3.2) 26Vitals Monitoring 27Intravenous Kits 27Emergency Drug Kit 27Oxygen 27Aromatic Ammonia 27Aspirin 28Albuterol 28Glucose 28Nitroglycerin 28Diphenhydramine 29Epinephrine 29Sedation-Specific Emergencies 29Summary 29References 29Part II Dentoalveolar Surgery 314 Surgical Management of the Impacted Canine 33Etiology 33Diagnosis 33Treatment and Management of the Impacted Canine 35Goals 35Interceptive Treatment to Prevent Impactions 35Surgical Management of the Impacted Canine 35Open vs Closed Surgery 35Palatal Maxillary Impactions 36Labial Maxillary Impactions 36Mandibular Impactions 37Complications 37References 385 Crown Lengthening 39Biologic Width 39Indications for Crown Lengthening [3] 39Contraindications for Crown Lengthening [1] 40Procedures Carried Out Prior to Crown Lengthening [4] 40Bone Sounding [2] 40Sequence of Treatment for Crown Lengthening 40External Bevel Gingivectomy 40Internal Bevel Gingivectomy 40Flap Surgery with Osseous Surgery 41Apically Positioned Flap With or Without Osseous Surgery 42Combined with Orthodontic Extrusion 42Classification of Esthetic Crown Lengthening [2] 42Postoperative Care [3] 43References 43Part III Implantology 456 Bone-Grafting Techniques and Biomaterials for Alveolar Ridge Augmentation 47Bone Graft Materials and Healing Physiology 47Introduction 47Bone Graft and Tissue Engineering Materials – Outline 47Autogenous (Natural) 47Allograft (Natural) 47Xenograft – Bovine, Porcine, Equine, Marine Coral, or Algal Sources 47Alloplast 47Other Synthetic Sources (Engineered) 48Autologous Platelet Concentrate 48Bone Graft and Tissue Engineering Materials 48Autograft 48Allograft 48Mineralized Freeze-Dried Bone Allograft 49Demineralized Freeze-Dried Bone Allograft 49Particulate Cortical, Cancellous, and Corticocancellous Allograft 49Xenograft 49Natural Hydroxyapatite 49Bio-Oss – Bovine Derived 49Natural Hydroxyapatite – Marine Coral Derived 49Calcium Carbonate – Biocoral 49Fluorohydroxyapatite (FHA) – Natural Sea Algae Derived 50Alloplast (Synthetic Sources) 50Hydroxyapatite Based (Synthetic HA) 50Marine Coral Derived (Hydroxyapatite) 50Coralline Porous Hydroxyapatite – Interpore (Synthetic HA) 50Coralline Porous Hydroxyapatite – Pro Osteon (Synthetic HA) 50Nanocrystalline Hydroxyapatite (Synthetic HA) 51Tricalcium Phosphate (Synthetic) 51Biphasic HA and B-TCP Material (Synthetic Combination) 51Calcium Sulfate – Gypsum Based (Synthetic) 51Calcium Sulfate – Nanocrystalline (Synthetic) 51Biphasic Calcium Sulfate (Synthetic) 51Bioactive Glass Ceramics (Synthetic) 52Other Synthetic Sources – Recombinant Bone Morphogenetic Protein (rhBMP) 52Autologous Platelet Concentrates (See Table 6.1 for Complete Formulations) 52Platelet-Rich Plasma 52Platelet-Rich Fibrin 52Ridge Preservation 54Ridge Preservation Indications 54Ridge Preservation Algorithm 54Ridge Preservation Surgical Technique 55Ridge Preservation Surgical Complications 57Ridge Preservation Implant Survival and Success Rates 57Ridge Preservation Conclusion (Box 6.4) 58Guided Bone Regeneration (GBR) 59Guided Bone Regeneration Indications 59Nonabsorbable Membrane 59Titanium Mesh 59e-PTFE [51, 52] 59Nonexpanded d-PTFE (Osteogenics Biomedical) [6, 49–51, 53] 59Titanium-reinforced PTFE [51, 54] 60Absorbable Membrane 61Collagen Base (Bovine, Porcine, or Human Tendon, Dermis, Skin, or Pericardium) 61Polymeric Membrane (Manufactured Synthetic Membrane) 61Tuberosity Harvest Technique (Figures 6.9–6.11, Box 6.5) 62Guided Bone Regeneration 62Surgical Technique for Three Wall Defect (Figures 6.15–6.18) 62Surgical Technique for Moderate-to-Severe Defect 62Particulate Graft Resorption Post Grafting 64Guided Bone Regeneration Complications 65Guided Bone Regeneration Implant Survival and Success Rates 65Guided Bone Regeneration Conclusion (Box 6.6) 65Intraoral Onlay Graft 66Indications (Particulate and Block Graft) 66Subperiosteal Tunneling Technique with Absorbable Membrane 67Autogenous Onlay Corticocancellous Grafts Healing 68Surgical Harvest Technique: Intraoral Lateral Ramal Shelf and Symphysis (Figure 6.8) 68Autogenous Intraoral Block Grafts – Surgical Complications 70Allogeneic Block Bone (Cadaver Bone) 70Block Graft Implant Survival and Success Rate 70Block Graft Conclusion (Box 6.7) 70Ridge Split 71Indications 71Ridge Split Surgical Technique 71Ridge Split Complications 71Ridge Split Implant Survival and Success Rates 72Ridge Split Conclusion (Box 6.8) 72Interpositional Bone Graft or “Sandwich Osteotomy” 73Indications 73Interpositional Bone Graft Surgical Technique 73Interpositional Bone Graft Complications 74Interpositional Bone Graft Implant Survival and Success Rates 74Interpositional Bone Graft Conclusion (Box 6.9) 74Distraction Osteogenesis 75Indications 75Distraction Osteogenesis Surgical Technique 77Distraction Osteogenesis Complications 77Distraction Osteogenesis Implant Survival and Success Rates 77Distraction Osteogenesis Conclusion (Box 6.10) 77Postoperative Instructions 77Conclusion 78Horizontal Augmentation Recap (Tables 6.5 and 6.6) 78Horizontal Augmentation Complication Recap 78Vertical Augmentation Recap (Tables 6.5 and 6.6) 79References 817 Maxillary Sinus Augmentation 85Introduction 85Maxillary Sinus Anatomy 85Indications, Contraindications, Limitations 85Lateral Window Approach 86Transalveolar (Crestal) Approach 86Bone-Grafting Material 87Complications 87References 898 Technologic, Material, and Procedural Advancements in Dental Implant Surgery 91Introduction 91Three-Dimensional Imaging 91Computerized Implant Planning Technology 92Intraoral Optical Impressions and Integration with CBCT, CAD/CAM, and Stereolithography 92Surgical Drilling Guide Integration and Fabrication 94Guided Navigation in Osteotomy Preparation and Implant Placement 94Membranes for Bone Grafting 95BMP, PRGF, and PRP 96Implant-Supported, Full-Arch, Fixed Prostheses with Immediate Loading and “All-on-Four” 97Zygomatic Implants 98Lasers 99Conclusion 100References 100Part IV Trauma 1019 Diagnosis and Management of Dentoalveolar Trauma 103Introduction 103Evaluation 103History 103Physical Examination 103Radiographic Studies 104Diagnosis and Management of Dentoalveolar Injuries 104Injuries to the Dental Hard Tissue and Pulp 104Crown Infraction 104Crown Fracture 104Crown-Root Fracture 105Root Fracture 105Injuries to the Periodontal Tissues 105Concussion 105Subluxation 105Intrusion 105Extrusion 106Lateral Luxation 106Avulsion 106Dentoalveolar Injuries in the Primary Dentition 107Splinting 108Injuries to the Gingiva or Oral Mucosa 108Injuries to Supporting Bone 108Follow-Up 109Conclusion 109References 109Part V Pathology 11310 Biopsy Technique: When, Where, and How? 115Introduction 115Patient Evaluation: Health History, Medications 115Lesion History 116Clinical Examination 117Indications for Biopsies 120Precancerous Lesion: “Potentially Malignant Disorders” 120Biopsy Techniques 123Incisional Biopsy 123Excisional Biopsy 124Punch Biopsy 124Adjunctive Techniques 124Lugol’s Iodine 126Toluidine Blue 126Brush Biopsy/Cytology 128References 12811 Diagnosis and Management of Recurrent Lesions of the Oral Mucosa 131Introduction 131Aphthous Lesions and Recurrent Aphthous Stomatitis 131Presentation 131Etiology 131Diagnosis 132Treatment 132Herpetic Lesions 133Course of the Disease 133Diagnosis 133Treatment 133Candidiasis 134Clinical Presentation 134Diagnosis 134Treatment 134Lichen Planus 135Clinical Presentation 135Diagnosis 135Treatment 135Pemphigus Vulgaris 136Clinical Presentation 136Etiology 136Diagnosis 137Treatment 137Erythema Multiforme 137Clinical Presentation 137Diagnosis 138Treatment 138Fixed Drug Eruptions 138Clinical Presentation 138Etiology 138Diagnosis 139Treatment 139References 13912 Benign Pediatric Pathology: Diagnosis and Management 143Introduction 143Eruption Cyst 144Ameloblastoma 145Aneurysmal Bone Cyst 146Melanotic Neuroectodermal Tumor of Infancy 147Juvenile Ossifying Fibroma 148Cherubism 149Hemangioma 150Vascular Malformation 151Verrucous Vulgaris and Condyloma Acuminatum 152References 15313 Diagnosis and Management of Salivary Gland Pathology 157Introduction 157Management of Sialolithiasis 158Bacterial Salivary Gland Infections 159Viral Sialadenitis 160Granulomatous Disease of the Salivary Gland 160Autoimmune Diseases 161Warthin Tumor 162Conclusion 163References 16314 Odontogenic Cysts and Odontogenic Tumors 167Introduction 167Developmental Odontogenic Cysts 168Odontogenic Keratocyst (Keratocystic Odontogenic Tumor) 169Lateral Periodontal Cyst and Botryoid Odontogenic Cyst 171Gingival Cyst 172Orthokeratinized Odontongenic Cyst 173Ameloblastoma 174Clinical Presentation 175Histologic Features 176Squamous Odontogenic Tumor 177Histologic Features 178Histologic Features 179References 18015 Osteomyelitis of the Jaw 183Classification 183Laboratory Analysis 184Microbiology 186Treatment 187Case Presentations 188Osteomyelitis of the Maxilla 188Osteomyelitis of the Mandible 189References 19216 Obstructive Sleep Apnea 193Introduction 193Symptoms 194Surgical Procedures 195Uvulopalatopharyngoplasty 196Genial Tubercle Advancement 197Conclusion 198References 19817 Temporomandibular Disorders: A Clinician’s Guide for Nonsurgical and Surgical Interventions 201Introduction 201Nonsurgical Treatment Approaches 204Methods of Therapy 205Maxillary and Mandibular Full-Arch Splints 206Surgical Approaches 207Case Presentation 214Conclusion 216References 21618 Postoperative Complications in Oral Surgery 219Complications Arising During the Procedure 219Root Fracture and Displacement 220Nerve Injury 221Complications after Oral Surgery 222Infection 223Pain, Swelling, and Trismus 224References 22519 Odontogenic Infections: Anatomy, Etiology, and Treatment 227Introduction 227Physical Examination 228Radiographic Imaging 229Pain Control 230Treatment Techniques 231Method 231Palatal Abscess 232Method 233Buccal and Midfacial Abscess 234Method 235Methods 236Pterygomandibular Space 237Pericoronitis 238Antibiotic Therapy 239References 240Part VI Pain Control 24320 Approaches to the Management of Facial Pain 245Introduction 245Diagnostic Approach to Facial Pain Patients 246Neuropathic Pain 248Episodic Neuropathic Pain 249Continuous NP 250Neurovascular Pain 253Topical NSAIDs 254Injection Therapy 255Complications of Injection Therapy 256Summary and Future Directions 257References 25721 Local Anesthesia: Agents and Techniques 261Local Anesthetics 261Nerve Block Techniques 262Greater Palatine Approach 263Sigmoid Notch Approach 264Halstead Method 265Akinosi Technique (Figure 21.6) 266Auxilliary/Supplemental Techniques 267Intrasulcular Infusion 268Trigger Point Injections 270Nasal Spray 271References 27222 Nitrous Oxide 275History 275Use and Administration 275Contraindications 276Safety Mechanisms 277References 278Part VII Oral Medicine 28123 Antibiotic Prophylaxis in Oral and Maxillofacial Surgery: Recent Trends in Therapeutic Applications 283Introduction 283Infective Endocarditis 285Additional Considerations about Infective Endocarditis Antibiotic Prophylaxis (When Indicated) 286Third Molars/Extractions 287Cleft lip and palate 289Dental Implants 290Trauma 291Conclusion 292References 29224 Management of Patients on Anticoagulation 295Introduction 295Heparins 296Antiplatelet Agents 297Conclusion 299References 29925 Burning Mouth Syndrome 301Introduction 301Etiology and Risk Factors 302Diagnosis 303Treatment 304Primary Burning Mouth Syndrome 305Conclusion 306References 307Index 311

The editors Harry Dym, DDS, FACS, is Chairman of the Department of Dentistry and Oral and Maxillofacial Surgery at the Brooklyn Hospital Center and Clinical Professor of Oral and Maxillofacial Surgery at Columbia University College of Dental Medicine, in New York City, New York, United States. Leslie Halpern, DDS, MD, PhD, MPH, FACS, is Section Chief and Program Director of Oral and Maxillofacial Surgery, Clinical Professor at New York Medical College/Metropolitan Hospital in New York City, New York, United States. Orrett Ogle, DDS, is Former Chief of the Oral and Maxillofacial Surgical Service at Woodhull Hospital in Brooklyn, New York, United States.

• Contributors xviiPreface xixPart I Basics 11 Patient Evaluation and Management of Medical Problems in the Oral Surgery Patient 3Risk Assessment 3Documentation 4Management of Patients with Medical Problems 5Cardiovascular Disease 6Hypertension 6Angina Pectoris 7Myocardial Infarction 8Stroke/Cerebrovascular Accident 9Cardiac Arrhythmias 9Heart Failure 10Treatment Guidelines 10Endocrine Disorders 11Diabetes Mellitus 11Thyroid Disease 12Adrenal Insufficiency 13Hepatic Disease 13Renal Disease 15Dialyzed Patients 15Pulmonary Disease 15Asthma 15Chronic Obstructive Pulmonary Disease 15Pregnancy 16Conclusion 18References 182 Risk Reduction Strategies 21Methods of Risk Reduction 21Faulty Record Keeping 21Informed Consent 21Conclusion 23Reference 233 Preparing the Dental Office for Medical Emergencies: Essentials of an Emergency Kit 25Staff 25Equipment 26Oxygen 26Airway Adjuncts 26Automated External Defibrillators (Figure 3.2) 26Vitals Monitoring 27Intravenous Kits 27Emergency Drug Kit 27Oxygen 27Aromatic Ammonia 27Aspirin 28Albuterol 28Glucose 28Nitroglycerin 28Diphenhydramine 29Epinephrine 29Sedation-Specific Emergencies 29Summary 29References 29Part II Dentoalveolar Surgery 314 Surgical Management of the Impacted Canine 33Etiology 33Diagnosis 33Treatment and Management of the Impacted Canine 35Goals 35Interceptive Treatment to Prevent Impactions 35Surgical Management of the Impacted Canine 35Open vs Closed Surgery 35Palatal Maxillary Impactions 36Labial Maxillary Impactions 36Mandibular Impactions 37Complications 37References 385 Crown Lengthening 39Biologic Width 39Indications for Crown Lengthening [3] 39Contraindications for Crown Lengthening [1] 40Procedures Carried Out Prior to Crown Lengthening [4] 40Bone Sounding [2] 40Sequence of Treatment for Crown Lengthening 40External Bevel Gingivectomy 40Internal Bevel Gingivectomy 40Flap Surgery with Osseous Surgery 41Apically Positioned Flap With or Without Osseous Surgery 42Combined with Orthodontic Extrusion 42Classification of Esthetic Crown Lengthening [2] 42Postoperative Care [3] 43References 43Part III Implantology 456 Bone-Grafting Techniques and Biomaterials for Alveolar Ridge Augmentation 47Bone Graft Materials and Healing Physiology 47Introduction 47Bone Graft and Tissue Engineering Materials – Outline 47Autogenous (Natural) 47Allograft (Natural) 47Xenograft – Bovine, Porcine, Equine, Marine Coral, or Algal Sources 47Alloplast 47Other Synthetic Sources (Engineered) 48Autologous Platelet Concentrate 48Bone Graft and Tissue Engineering Materials 48Autograft 48Allograft 48Mineralized Freeze-Dried Bone Allograft 49Demineralized Freeze-Dried Bone Allograft 49Particulate Cortical, Cancellous, and Corticocancellous Allograft 49Xenograft 49Natural Hydroxyapatite 49Bio-Oss – Bovine Derived 49Natural Hydroxyapatite – Marine Coral Derived 49Calcium Carbonate – Biocoral 49Fluorohydroxyapatite (FHA) – Natural Sea Algae Derived 50Alloplast (Synthetic Sources) 50Hydroxyapatite Based (Synthetic HA) 50Marine Coral Derived (Hydroxyapatite) 50Coralline Porous Hydroxyapatite – Interpore (Synthetic HA) 50Coralline Porous Hydroxyapatite – Pro Osteon (Synthetic HA) 50Nanocrystalline Hydroxyapatite (Synthetic HA) 51Tricalcium Phosphate (Synthetic) 51Biphasic HA and B-TCP Material (Synthetic Combination) 51Calcium Sulfate – Gypsum Based (Synthetic) 51Calcium Sulfate – Nanocrystalline (Synthetic) 51Biphasic Calcium Sulfate (Synthetic) 51Bioactive Glass Ceramics (Synthetic) 52Other Synthetic Sources – Recombinant Bone Morphogenetic Protein (rhBMP) 52Autologous Platelet Concentrates (See Table 6.1 for Complete Formulations) 52Platelet-Rich Plasma 52Platelet-Rich Fibrin 52Ridge Preservation 54Ridge Preservation Indications 54Ridge Preservation Algorithm 54Ridge Preservation Surgical Technique 55Ridge Preservation Surgical Complications 57Ridge Preservation Implant Survival and Success Rates 57Ridge Preservation Conclusion (Box 6.4) 58Guided Bone Regeneration (GBR) 59Guided Bone Regeneration Indications 59Nonabsorbable Membrane 59Titanium Mesh 59e-PTFE [51, 52] 59Nonexpanded d-PTFE (Osteogenics Biomedical) [6, 49–51, 53] 59Titanium-reinforced PTFE [51, 54] 60Absorbable Membrane 61Collagen Base (Bovine, Porcine, or Human Tendon, Dermis, Skin, or Pericardium) 61Polymeric Membrane (Manufactured Synthetic Membrane) 61Tuberosity Harvest Technique (Figures 6.9–6.11, Box 6.5) 62Guided Bone Regeneration 62Surgical Technique for Three Wall Defect (Figures 6.15–6.18) 62Surgical Technique for Moderate-to-Severe Defect 62Particulate Graft Resorption Post Grafting 64Guided Bone Regeneration Complications 65Guided Bone Regeneration Implant Survival and Success Rates 65Guided Bone Regeneration Conclusion (Box 6.6) 65Intraoral Onlay Graft 66Indications (Particulate and Block Graft) 66Subperiosteal Tunneling Technique with Absorbable Membrane 67Autogenous Onlay Corticocancellous Grafts Healing 68Surgical Harvest Technique: Intraoral Lateral Ramal Shelf and Symphysis (Figure 6.8) 68Autogenous Intraoral Block Grafts – Surgical Complications 70Allogeneic Block Bone (Cadaver Bone) 70Block Graft Implant Survival and Success Rate 70Block Graft Conclusion (Box 6.7) 70Ridge Split 71Indications 71Ridge Split Surgical Technique 71Ridge Split Complications 71Ridge Split Implant Survival and Success Rates 72Ridge Split Conclusion (Box 6.8) 72Interpositional Bone Graft or “Sandwich Osteotomy” 73Indications 73Interpositional Bone Graft Surgical Technique 73Interpositional Bone Graft Complications 74Interpositional Bone Graft Implant Survival and Success Rates 74Interpositional Bone Graft Conclusion (Box 6.9) 74Distraction Osteogenesis 75Indications 75Distraction Osteogenesis Surgical Technique 77Distraction Osteogenesis Complications 77Distraction Osteogenesis Implant Survival and Success Rates 77Distraction Osteogenesis Conclusion (Box 6.10) 77Postoperative Instructions 77Conclusion 78Horizontal Augmentation Recap (Tables 6.5 and 6.6) 78Horizontal Augmentation Complication Recap 78Vertical Augmentation Recap (Tables 6.5 and 6.6) 79References 817 Maxillary Sinus Augmentation 85Introduction 85Maxillary Sinus Anatomy 85Indications, Contraindications, Limitations 85Lateral Window Approach 86Transalveolar (Crestal) Approach 86Bone-Grafting Material 87Complications 87References 898 Technologic, Material, and Procedural Advancements in Dental Implant Surgery 91Introduction 91Three-Dimensional Imaging 91Computerized Implant Planning Technology 92Intraoral Optical Impressions and Integration with CBCT, CAD/CAM, and Stereolithography 92Surgical Drilling Guide Integration and Fabrication 94Guided Navigation in Osteotomy Preparation and Implant Placement 94Membranes for Bone Grafting 95BMP, PRGF, and PRP 96Implant-Supported, Full-Arch, Fixed Prostheses with Immediate Loading and “All-on-Four” 97Zygomatic Implants 98Lasers 99Conclusion 100References 100Part IV Trauma 1019 Diagnosis and Management of Dentoalveolar Trauma 103Introduction 103Evaluation 103History 103Physical Examination 103Radiographic Studies 104Diagnosis and Management of Dentoalveolar Injuries 104Injuries to the Dental Hard Tissue and Pulp 104Crown Infraction 104Crown Fracture 104Crown-Root Fracture 105Root Fracture 105Injuries to the Periodontal Tissues 105Concussion 105Subluxation 105Intrusion 105Extrusion 106Lateral Luxation 106Avulsion 106Dentoalveolar Injuries in the Primary Dentition 107Splinting 108Injuries to the Gingiva or Oral Mucosa 108Injuries to Supporting Bone 108Follow-Up 109Conclusion 109References 109Part V Pathology 11310 Biopsy Technique: When, Where, and How? 115Introduction 115Patient Evaluation: Health History, Medications 115Lesion History 116Clinical Examination 117Indications for Biopsies 120Precancerous Lesion: “Potentially Malignant Disorders” 120Biopsy Techniques 123Incisional Biopsy 123Excisional Biopsy 124Punch Biopsy 124Adjunctive Techniques 124Lugol’s Iodine 126Toluidine Blue 126Brush Biopsy/Cytology 128References 12811 Diagnosis and Management of Recurrent Lesions of the Oral Mucosa 131Introduction 131Aphthous Lesions and Recurrent Aphthous Stomatitis 131Presentation 131Etiology 131Diagnosis 132Treatment 132Herpetic Lesions 133Course of the Disease 133Diagnosis 133Treatment 133Candidiasis 134Clinical Presentation 134Diagnosis 134Treatment 134Lichen Planus 135Clinical Presentation 135Diagnosis 135Treatment 135Pemphigus Vulgaris 136Clinical Presentation 136Etiology 136Diagnosis 137Treatment 137Erythema Multiforme 137Clinical Presentation 137Diagnosis 138Treatment 138Fixed Drug Eruptions 138Clinical Presentation 138Etiology 138Diagnosis 139Treatment 139References 13912 Benign Pediatric Pathology: Diagnosis and Management 143Introduction 143Eruption Cyst 144Ameloblastoma 145Aneurysmal Bone Cyst 146Melanotic Neuroectodermal Tumor of Infancy 147Juvenile Ossifying Fibroma 148Cherubism 149Hemangioma 150Vascular Malformation 151Verrucous Vulgaris and Condyloma Acuminatum 152References 15313 Diagnosis and Management of Salivary Gland Pathology 157Introduction 157Management of Sialolithiasis 158Bacterial Salivary Gland Infections 159Viral Sialadenitis 160Granulomatous Disease of the Salivary Gland 160Autoimmune Diseases 161Warthin Tumor 162Conclusion 163References 16314 Odontogenic Cysts and Odontogenic Tumors 167Introduction 167Developmental Odontogenic Cysts 168Odontogenic Keratocyst (Keratocystic Odontogenic Tumor) 169Lateral Periodontal Cyst and Botryoid Odontogenic Cyst 171Gingival Cyst 172Orthokeratinized Odontongenic Cyst 173Ameloblastoma 174Clinical Presentation 175Histologic Features 176Squamous Odontogenic Tumor 177Histologic Features 178Histologic Features 179References 18015 Osteomyelitis of the Jaw 183Classification 183Laboratory Analysis 184Microbiology 186Treatment 187Case Presentations 188Osteomyelitis of the Maxilla 188Osteomyelitis of the Mandible 189References 19216 Obstructive Sleep Apnea 193Introduction 193Symptoms 194Surgical Procedures 195Uvulopalatopharyngoplasty 196Genial Tubercle Advancement 197Conclusion 198References 19817 Temporomandibular Disorders: A Clinician’s Guide for Nonsurgical and Surgical Interventions 201Introduction 201Nonsurgical Treatment Approaches 204Methods of Therapy 205Maxillary and Mandibular Full-Arch Splints 206Surgical Approaches 207Case Presentation 214Conclusion 216References 21618 Postoperative Complications in Oral Surgery 219Complications Arising During the Procedure 219Root Fracture and Displacement 220Nerve Injury 221Complications after Oral Surgery 222Infection 223Pain, Swelling, and Trismus 224References 22519 Odontogenic Infections: Anatomy, Etiology, and Treatment 227Introduction 227Physical Examination 228Radiographic Imaging 229Pain Control 230Treatment Techniques 231Method 231Palatal Abscess 232Method 233Buccal and Midfacial Abscess 234Method 235Methods 236Pterygomandibular Space 237Pericoronitis 238Antibiotic Therapy 239References 240Part VI Pain Control 24320 Approaches to the Management of Facial Pain 245Introduction 245Diagnostic Approach to Facial Pain Patients 246Neuropathic Pain 248Episodic Neuropathic Pain 249Continuous NP 250Neurovascular Pain 253Topical NSAIDs 254Injection Therapy 255Complications of Injection Therapy 256Summary and Future Directions 257References 25721 Local Anesthesia: Agents and Techniques 261Local Anesthetics 261Nerve Block Techniques 262Greater Palatine Approach 263Sigmoid Notch Approach 264Halstead Method 265Akinosi Technique (Figure 21.6) 266Auxilliary/Supplemental Techniques 267Intrasulcular Infusion 268Trigger Point Injections 270Nasal Spray 271References 27222 Nitrous Oxide 275History 275Use and Administration 275Contraindications 276Safety Mechanisms 277References 278Part VII Oral Medicine 28123 Antibiotic Prophylaxis in Oral and Maxillofacial Surgery: Recent Trends in Therapeutic Applications 283Introduction 283Infective Endocarditis 285Additional Considerations about Infective Endocarditis Antibiotic Prophylaxis (When Indicated) 286Third Molars/Extractions 287Cleft lip and palate 289Dental Implants 290Trauma 291Conclusion 292References 29224 Management of Patients on Anticoagulation 295Introduction 295Heparins 296Antiplatelet Agents 297Conclusion 299References 29925 Burning Mouth Syndrome 301Introduction 301Etiology and Risk Factors 302Diagnosis 303Treatment 304Primary Burning Mouth Syndrome 305Conclusion 306References 307Index 311