개원의에게 꼭 필요한 구강 내 소수술 및 발치술

Chapter 1 전신질환 환자의 처치 (Management of medically compromised patients)

심혈관질환 (Cardiovascular disease) ............................................................................ 4
예방적 항생제 (Prophylactic antibiotics) ........................................................................ 8
당뇨 (Diabetes Mellitus) ................................................................................................... 10
간질환 (Liver disease) ..................................................................................................... 11
신장 질환 (Renal disease) .............................................................................................. 12
MRONJ (Medication Related Osteonecrosis of the Jaw) .......................................... 13
항암치료 및 방사선치료 (Anticancer treatment) ......................................................... 14
폐질환 (Pulmonary disease) .......................................................................................... 15

Chapter 2 구강내 소수술 및 발치술을 위한 기구 (Instruments for minor oral surgery and tooth extraction)

조직겸자 (Tissue forceps) .............................................................................................. 18
석션팁 (Suction tip) / Mouth prop / 지혈겸자 (Hemostat, mosquito) ..................... 20
소독 시린지 (Irrigation syringe) / 수술용 칼날 (Surgical blade) ............................... 22
칼대 (Blade holder) ........................................................................................................ 24
봉합침 (Suture needle) .................................................................................................. 26
봉합사 (Suture materials) ............................................................................................... 28
지침기 (Needle holder) .................................................................................................. 30
가위 (Scissors) ................................................................................................................ 32
견인기 (Retractor) ............................................................................................................ 33
수술용 큐렛 (Surgical curette) ...................................................................................... 34
골막 기자 (Periosteal elevator) ..................................................................................... 35
골겸자 (Bone rongeur) .................................................................................................. 36
본 파일 (Bone file) .......................................................................................................... 37
발치기자 (Extraction elevator) ....................................................................................... 38
발치겸자 (Extraction forceps) ....................................................................................... 42
고속 핸드피스 및 버 (High speed handpiece and bur) ........................................... 45
저속 핸드피스 및 버 (Low speed handpiece and bur) ........................................... 45

Chapter 3 구강내 소수술을 위한 절개 및 봉합술 (Incision and suture techniques for minor oral surgery)

절개의 기본 원칙 (Principle of incision) ........................................................................ 50
봉합의 기본 원칙 (Principle of suture) ......................................................................... 59
• 단순단속봉합 (Simple interrupted suture) ................................................... 60
• 단순단속봉합의 변형된 8자형 (Figure 8 modification of interrupted suture) . 63
• 수평누상봉합 (Horizontal mattress suture) .................................................. 66
• 수직누상봉합 (Vertical mattress suture) ...................................................... 68
• 연속병합 (Continuous suture) ....................................................................... 70
• 연속잠금봉합 (Continuous locking suture) .................................................. 72
• 골막봉합 (Periosteal suture) .......................................................................... 75

Chapter 4 낭 (Cyst) 및 양성 종양의 처치 (Management of intraoral cyst and benign tumor)

낭 (Cyst) ........................................................................................................................... 84
• 조직검사 (Biopsy) ........................................................................................... 84
• 낭 적출술 (Cyst enucleation) ........................................................................ 87
• 조대술 (Marsupialization) ............................................................................... 88
치근단 절제술 (Apicoectomy) ....................................................................................... 90
연조직의 양성종양 (Benign tumor of soft tissue) ....................................................... 97
• 섬유종 (Fibroma) ............................................................................................. 99
• 유두종 (Papilloma) ......................................................................................... 102
• 점액류 (Mucocele) ......................................................................................... 103
경조직의 양성종양 (Benign tumor of hard tissue) .................................................... 104
• 특발성골경화증 (Idiopathic osteosclerosis) ................................................ 105
• 치밀화골염 (Condensing osteitis) ............................................................... 106
• 백알질골화섬유종 (Cemento-ossifying fibroma) ..................................... 106
• 개화성골이형성증 (Florid osseous dysplasia) ........................................... 107
• 골종 (Osteoma) .............................................................................................. 107
• 단순골낭 (Simple bone cyst) ...................................................................... 109

Chapter 5 치성감염의 처치 (Management of odontogenic infection)

치성감염 (Odontogenic infection) ................................................................................. 114
절개 및 배농술 (I & D, Incision and Drainage) ......................................................... 122
• 간단한 치주농양 (Simple periodontal abscess) ........................................ 123
• 구강전정농양, 견치간극농양 (Vestibular abscess, Canine space abscess) 124
• 협부간극농양 (Buccal space abscess) ..................................................... 126

Chapter 6 발치술 (Extraction)

발치기자의 작용원리 (Action principle of extraction elevator) ................................ 130
발치겸자의 작용원리 (Action principle of extraction forceps) ................................. 134
사랑니 발치의 난이도 평가 (Evaluation of the level of difficulty in 3rd molar extraction)............. 138
발치를 위한 절개 (Incision for tooth extraction) ......................................................... 146
치조골 삭제 (Alveoloplasty for tooth extraction) ....................................................... 152
치아절제 (Odontectomy) ............................................................................................... 153
남은 치근의 발치 (Retained root extraction) .............................................................. 158
수직 및 원심경사 매복치아의 발치 (Vertical and distal impacted tooth extraction). 160
상악 매복 사랑니의 발치 (Maxillary impacted tooth extraction) ............................. 166
발치 후 발치와의 처리 (Socket management after tooth extraction) ..................... 168
사랑니 발치의 시기 (Timing of wisdom tooth extraction) ........................................ 170
잔존치근 및 난발치 (Retained root extraction) .......................................................... 172
발치 후 합병증 (Complications after tooth extraction) .............................................. 174
• 발치와의 감염 (Infection after tooth extraction) .......................................... 174
• 치조골 및 악골골절 (Alveolar and jaw fracture) ....................................... 176
• 발치와 주변의 날카로운 골편 (Bony spicule) ............................................. 177
• 건성 발치와 (Dry socket) .............................................................................. 178
• 근막 간극으로의 전위 (Displacement to intermuscular space) .............. 179
• 출혈 (Bleeding) .............................................................................................. 181
• 피하기종 (Subcutaneous emphysema) ..................................................... 182
• 상악동 점막 천공 (Maxillary sinus membrane perforation) ..................... 182
• 신경손상 (Nerve damage) ........................................................................... 186

Chapter 7 구강내 소수술 (Intraoral minor surgery)

과잉치 (Supernumerary tooth) ................................................................................... 190
매복치의 교정적 정출을 위한 외과적 노출 (Surgical exposure for orthodontic treatment of impacted tooth) ....... 197
소대 절제술 (Frenectomy) ........................................................................................... 200
치조골 성형술 (Alveoloplasty) ..................................................................................... 205