Jani Mira U et al.: Minor Oral Surgery in Pediatric Dentistry REVIEW ARTICLE Minor Oral Surgery in Pediatric Dentistry Jani Mira U1, AbhayMani Tripathi2, Sonali Saha3, Gunjan Yadav4, Kavita Dhinsa5, Apurva Mishra6 1 -Post Graduate Student, Sardar Patel Post Graduate Institute Of Dental And Medical Sciences , Uttar Pradesh. 2-Professor And Head, Sardar Patel Post Graduate Institute Of Dental And Medical Sciences, Uttar Pradesh. 3-Professor, Sardar Patel Post Graduate Correspondence to: Dr. Jani Mira U, Sardar Patel Post Institute Of Dental And Medical Sciences, Uttar Pradesh. 4- Professor, Sardar Patel Post Graduate Institute Of Dental And Medical Sciences, Uttar Pradesh. 5-Reader, Sardar Patel Graduate Institute Of Dental And Medical Sciences, Uttar Pradesh. Post Graduate Institute Of Dental And Medical Sciences, Uttar Pradesh. 6-Senior Lecturer, Contact Us: www.ijohmr.com Sardar Patel Post Graduate Institute Of Dental And Medical Sciences, Uttar Pradesh. ABSTRACT Minor oral surgery comprises of those surgical procedures, which can be comfortably completed by an operator in not more than 30 minutes. Minor surgical procedures will include carrying out complicated surgical extractions (a combination of tooth sectioning, mucoperiosteal flap reflection, bone removal prior to the use of a forceps or elevators), elimination of small lesions in the oral cavity, which are in the hard or soft tissues. It also comprises of oral surgical procedures of short duration which are carried out under local anesthesia. Oral surgical procedures in children are endeavors that demand expertise and skill. They involve unique consideration regarding behavior management, growth, and development, developing dentition, wound healing, and postoperative care. KEYWORDS: Odontogenic Infections, Unerupted and Impacted teeth, Supernumerary teeth, Lesions of the oral mucosa. detailed history of the general health status and medical AINTRODUCTIONASSSAAsasasss history of the patient is taken, which may or may not be related to the chief complaint, the management of the Pediatric patients deserve quality dental care of the patient, and the outcome of the treatment. The brief highest standards. Thus, in this respect, a pedodontist medical history questions / interview should include a strives to establish positive treatment experiences during detailed history of the following: an individual’s developmental years to help shape a 1. Cardiovascular disorders include hypertension, favorable outlook towards future dental and medical rheumatic heart disease, myocardial infarction, care.1 ischemic heart disease, angina, valvular septal defect, and congestive cardiac failure. Pedodontist can do a large number of surgical 2. Diseases of the respiratory system include bronchial interventions in the cases.. The term "Minor oral surgery" asthma, chronic obstructive pulmonary disease, refers to smaller operations and include removing pleuritis, bronchitis, pneumonia, and upper wisdom teeth, impacted teeth, and severely broken-down respiratory tract infections. teeth, as well as apicectomies, biopsies and other 2 3. Neurologic conditions such as and past history of procedures. head injury epilepsy, hemiparaplegia(also known as Brown-Sequard’s hemiplegia, Brown-Sequard’s PRE- AND POST-OPERATIVE paralysis, hemiparaplagic syndrome), and any CONSIDERATIONS TAKEN FOR medications taken for the same. 4. Endocrine system disorders including thyroid MINOR ORAL SURGERY disorders, adrenal pheochromocytoma, diabetes, and Metabolic management of children for surgery is more multiple endocrine neoplasias. complex and different than adults. That required special 5. Hematological disorders like anemias, leukemia, consideration like caloric intake, fluid and electrolyte hemophilia, platelet count abnormalities, etc. and the management, and blood replacement. Complete last available blood reports pertaining to the management of the pediatric patient for minor oral condition. surgery is accomplished by expertise and experience in 6. The bleeding tendency after the trauma the management of young patients.3 7. Tuberculosis, syphilis, viral hepatitis, herpes, and other sexually transmitted Infectious diseases that Taking Proper Personal And Family History: A adversely affect outcomes of surgery. detailed history of the personal habits as well as patient’s 8. Peptic ulcer, acidity problems, vomiting, and family taken. It include age, general health status, diarrhea are Gastric disorders. medical ailments (epilepsy, cardiac disorders, diabetes, 9. Glomerulonephritis, patients on dialysis, renal bleeding disorders, and tuberculosis), cause, and age at 4 failure, and nephrotic syndrome are Renal the time of death of any deceased member is recorded. pathologies. Taking Proper Past/Present Medical History: A 10. Liver Disorders such as alcoholic liver disease, How to cite this article: Jani MU, Tripathi AM, Saha S, Yadav G, Dhinsa K, Mishra A . Minor Oral Surgery in Pediatric Dentistry. Int J Oral Health Med Res 2019;6(4):29-32. International Journal of Oral Health and Medical Research | ISSN 2395-7387 | NOVEMBER-DECEMBER 2019 | VOL 6 | ISSUE 4 29 Jani Mira U et al.: Minor Oral Surgery in Pediatric Dentistry REVIEW ARTICLE hepatitis, and cirrhosis. It includes the red blood cell count, white blood cell 11. Autoimmune disorders including systemic lupus count, differential white blood cell count, platelet erythematosus, scleroderma, and patient long term number, and a description of blood smear.4 corticosteroid therapy. 12. Psychological disorders and treatment taken for the VARIOUS MINOR SURGICAL same. 13. Digestive system disorders including loss of appetite, PROCEDURES loss of weight, excessive thirst (polydipsia), and Minor surgical procedures will include carrying out the frequent urination (polyuria). elimination of small lesions in the oral cavity, which are 14. Drug allergy. in the hard or soft tissues. They include 15. Illness and trauma related to birth and childhood. 16. Detailed history of previous hospitalization, blood 1) Management of Odontogenic infections: Infections transfusions, and surgeries. of orofacial region may be odontogenic or non 17. Any medications (current/past) were taken. odontogenic in nature, and the most of odontogenic infections are caused by the endogenous bacteria present Any of the above conditions can alter the patient’s in the oral cavity. Odontogenic infections include response to surgical procedure, and influence both the periapical, and periodontal infections. In dentistry, anesthetic, and surgical management of the patient as odontogenic infections are one of the most difficult to 4 well as postoperative recovery and wound healing. treat and manage. These infections may range from low Dental Evaluation: It is important to perform a to high grade, and welllocalized infections that require only minimal treatment to severe life-threatening facial preoperative clinical and radiographic evaluation of the 6 dentition as well as soft tissues. Due to the presence of space infections. developing tooth follicles Surgery involving the maxilla Principles of treating the infection: To predict and mandible of young patients is complicated. Careful pathways of spread of infections and to drain these spaces evaluation and treatment planning carried out using proper knowledge of anatomy, anatomical landmarks and radiographs, tomography, cone beam computed vital structures of the face and neck is necessary. The tomography, and/or 3-D imaging techniques. It is cause should be removed (i.e. extract the tooth, open & important to minimize the negative / adverse effects of extirpate the pulp). To drain pus incision & Drainage 3 surgery on the developing dentition. performed. For treating the infections antibiotics use.7 Investigations: 2) Management of Unerupted and Impacted teeth: A) Radiological Examination Most commonly impacted teeth is third molars followed 1. Conventional radiography by permanent maxillary canines. Visual inspection, a) Intraoral Radiographs palpation, and radiographic examination are used for b) Extraoral Radiographs early detection of an ectopically erupting canine, and Orthopantomogram assessed abnormal angulation of cuspids. The treatment of choice is extraction of the impacted canines.3,8 Lateral oblique view of mandible Posteroanterior view or Water’s Position 3) Management of Supernumerary teeth: The Posteroanterior view of mandible additional teeth in to the normal dentition. Result from Lateral cephalogram view disturbances during the initiation and proliferation stages Posteroanterior view of skull of dental development. Supernumerary teeth can occur in Lateral skull view both primary or permanent dentition. Mesiodens is a Submentovertex view (Jug Handle view)— supernumerary tooth present in the midline between the 2. Specialized imaging two central incisors. Followed by the maxillary molar Magnetic Resonance Imaging area, known as a paramolar tooth. Complications of supernumerary teeth can include delayed the eruption of Sialography the permanent tooth or displaced the tooth from its Angiography 5 original position, crowding, resorption of adjacent teeth, Arthrography cyst formation (dentigerous cyst), pericoronal space B) Routine Hematological Investigations: The use of infection, and crown resorption. To prevent complete blood investigations before any minor surgery complications early diagnosis and treatment are is important for evaluation to determine fitness for pre- important. Depending on the size, shape, and number of anesthetic,