Study of articles: Importance of diet in the pre and post-operative period in oral and maxillofacial surgeries In major and minor oral surgeries , there are three stages: preoperative, intraoperative, and postoperative (before, during, and after the procedure, respectively). Often, the most significant complications occur during the postoperative phase , including localized and diffuse pain, swelling, bruising, hyper and hypoglycemic episodes, lowered immunity, and, in extreme cases of neglect, patients may suffer from malnutrition , and, later on, fatal consequences. With this in mind, the quicker and less painful the healing process of intentional traumas caused by oral and maxillofacial surgeries, the better the patient's recovery. A suitable, nutritious diet with proper professional guidance can reduce healing time and contribute to postoperative success. This is possible because of cellular repair processes, which work better with a source of proteins and amino acids, the...
Furcation Lesion:
Furcation is the root area where there is a separation between two or more roots. A highly sensitive region to perforate, as it can potentially split the tooth in half.
Furcation lesions are situations where there is a horizontal bone loss between the roots, due to periodontitis or endodontic problems, root fractures, and occlusal trauma. We classify furcation lesions into 3 classes: I, II, III.
When the furcation lesion is class I, it means that the Nabers probe has penetrated up to 3mm, which is less than half of the tooth.
If it's a class II furcation lesion, the Nabers probe reaches the middle of the furcation or goes beyond it, measuring between 6 and 9mm. Lastly.
If it's a class III case, the probe passes to the other side of the tooth.
Why is this detrimental to the patient's periodontal health? Because this is a location where a lot of food debris will accumulate, serving as a future food source for bacteria, and the gingival infectious-inflammatory process will never cease unless proper care is taken.
What are these precautions? It's quite simple! The dentist must perform thorough scaling in the lesion area, and if necessary, perform odontoplasty or tunneling to facilitate cleaning with an interdental brush and reduce the tooth's retention of food debris.
Odontoplasty: Enamel reduction to make the tooth less retentive of biofilm, minimize large bulges, or remove enamel pearls.
Tunneling: Using a Schluger file, grind the bone between the furcations to facilitate the passage of an interdental brush, improving local hygiene.
For scaling in these areas, it's common to flap the gingival tissue to have an open field and perform the best possible root scaling and planing. Root resection is also possible, where the procedure aims to remove one root, which has less supporting bone, and the tooth is supported by the remaining roots.
Finally, there is tooth hemisection, where half of the crown along with one root, the most compromised one, is removed, and a prosthetic premolarization is performed. This results in a crown resembling two premolars.
Indications for each procedure:
Furcation Lesions:
Grade I - Root planing and smoothing, flap for access (Odontoplasty, Osteoplasty).
Grade II - Flap for access (Odontoplasty, Osteoplasty), Regeneration, Resection/Hemisection, Tunneling, Extraction.
Grade III - Resection/Hemisection, Tunneling, Extraction.
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