Types of Organization surgical Types of Organization surgical stomatologystomatology

HISTORY of SURGICAL STOMATOLOGY AND HISTORY of SURGICAL STOMATOLOGY AND JAW-FACIAL SURGERY in the World AND ON JAW-FACIAL SURGERY in the World AND ON

UKRAINE, THEIR OBJECT And TASK. An UKRAINE, THEIR OBJECT And TASK. An INSPECTION AND PREPARATION OF PATIENT INSPECTION AND PREPARATION OF PATIENT

IS TO OPERATION. ASEPSIS AND IS TO OPERATION. ASEPSIS AND ANTISEPTIKAANTISEPTIKA

Surgical stomatology - one of independent Surgical stomatology - one of independent clinical disciplines of stomatology, which clinical disciplines of stomatology, which

studies surgical diseases and damages of teeth, studies surgical diseases and damages of teeth, organs of cavity of mouth, person, neck, bones organs of cavity of mouth, person, neck, bones of facial skeleton of, which require the complex of facial skeleton of, which require the complex

methods of treatmentmethods of treatment

Surgical stomatology consists Surgical stomatology consists of such sections: (etiology, of such sections: (etiology, pathogeny, clinic, treatment. )pathogeny, clinic, treatment. )

• 1. Inflammatory diseases of teeth, jaws, soft fabrics 1. Inflammatory diseases of teeth, jaws, soft fabrics of person and neck, organs of cavity of mouth, for of person and neck, organs of cavity of mouth, for example: sharp and chronic periodontit, periostitis, example: sharp and chronic periodontit, periostitis, osteomielit, abscesses and phlegmons, limfadenit, osteomielit, abscesses and phlegmons, limfadenit, etc. On frequency they make the basic group of etc. On frequency they make the basic group of patients which treat oneself in permanent patients which treat oneself in permanent establishment.establishment.

• 2. Traumas of organs of cavity of mouth, bones of 2. Traumas of organs of cavity of mouth, bones of facial skeleton of facial skeleton of differentdifferent origin, combined origin, combined damages.damages.

• 3. Tumours and 3. Tumours and cancercancer similar diseases of person, similar diseases of person, jaws and organs of cavity of mouth, modern methods jaws and organs of cavity of mouth, modern methods of their diagnostics and treatment.of their diagnostics and treatment.

• 4. Born and purchased defects and deformations of 4. Born and purchased defects and deformations of person and jawsperson and jaws

History of development of jaw-History of development of jaw-facial surgery and surgical facial surgery and surgical stomatology is in Ukrainestomatology is in Ukraine • The department of surgical stomatology, one of the The department of surgical stomatology, one of the

oldest in our country, was organized in 1921 Headed oldest in our country, was organized in 1921 Headed her in 1921-1951рр. the figure of science and her in 1921-1951рр. the figure of science and technique, professor is deserved. Manufacturer. technique, professor is deserved. Manufacturer. Participant of four wars, he had large knowledges Participant of four wars, he had large knowledges and enormous scientific experience of travmatologii and enormous scientific experience of travmatologii and and recinstraktions recinstraktions surgery of surgery of jawjaw-facial area. In -facial area. In 1937. A manufacturer was select the honoured 1937. A manufacturer was select the honoured member of the World scientific association of member of the World scientific association of stomatologies. Numerous scientists of. A stomatologies. Numerous scientists of. A manufacturer was successfully protected by manufacturer was successfully protected by dissertations, some of them independently managed dissertations, some of them independently managed departments and departments and dental dental facial clinics: professors of facial clinics: professors of Lindenbaum,. Pravednikov,. Forest; associate Lindenbaum,. Pravednikov,. Forest; associate professor . Gutnik, Slutska, professor . Gutnik, Slutska,

• Guretska,. Shneyder, Korobkova, Gubenko, Guretska,. Shneyder, Korobkova, Gubenko, Zaslavskiy, Tarnovskiy and otherZaslavskiy, Tarnovskiy and other

• A department of surgical stomatology of the A department of surgical stomatology of the Ternopil state medical university is the name of Ternopil state medical university is the name of GorbachevskogoGorbachevskogo

• In obedience to a decision In obedience to a decision state akademik state akademik of of commission of Department of education and commission of Department of education and science of Ukraine vid April, 1З, 2004, science of Ukraine vid April, 1З, 2004,

• protocol № 50, and by the order of rectorprotocol № 50, and by the order of rector• № № 325 325 from from August, 26, 2004 on the August, 26, 2004 on the

Ternopil'skiy state medical academy the name of Ternopil'skiy state medical academy the name of Gorbachevskogo, openly stomatology faculty.Gorbachevskogo, openly stomatology faculty.

• April, 1З, 2004, April, 1З, 2004, • protocol № 50, and by the order of rector № 325 protocol № 50, and by the order of rector № 325

vid August, 26, 2004 on the Ternopil'skiy state vid August, 26, 2004 on the Ternopil'skiy state medical academy the name of . Gorbachevskogo, medical academy the name of . Gorbachevskogo, openly stomatology faculty.openly stomatology faculty.

• Inspection sick with surgical Inspection sick with surgical pathology of pathology of face face area is the area is the complex of researches, which are complex of researches, which are conducted for the exposure of conducted for the exposure of individual features of patient with the individual features of patient with the purpose of establishment of purpose of establishment of diagnosis and diagnosis and finding finding of rational of rational treatment, looking after motion of treatment, looking after motion of disease, determination of prognosis.disease, determination of prognosis.

If a patient grumbles about If a patient grumbles about pain, at first it follows to set:pain, at first it follows to set:• - possible reason of its origin (independent or - possible reason of its origin (independent or

appears after an action those or other irritants, at appears after an action those or other irritants, at swallowing, talk, related to the reception squeak or swallowing, talk, related to the reception squeak or by motion of jaw, language, dependency upon by motion of jaw, language, dependency upon position sick);position sick);

• - character (sharp or dull, burning, cutting, such - character (sharp or dull, burning, cutting, such which tears pulls);which tears pulls);

• - intensity (strong, middle, weak);- intensity (strong, middle, weak);• - duration (permanent or napadopodibna);- duration (permanent or napadopodibna);• - localization (poured out or local, presence of - localization (poured out or local, presence of

irradiation in tu or other area);irradiation in tu or other area);• - - time of daytime of day (nightly or daily pains, seasonality, (nightly or daily pains, seasonality,

etc.).etc.).

Inspection sick begin from a Inspection sick begin from a general review and general review and determination of his state . A determination of his state . A doctor carries out a review in doctor carries out a review in surgical gloves and uses the surgical gloves and uses the followings instruments (that followings instruments (that are in a sterile tray): are in a sterile tray): • 1. Spatula - for taking of lips, cheeks, language, at 1. Spatula - for taking of lips, cheeks, language, at

the review of cavity of mouth;the review of cavity of mouth;• 2. Pincers are stomatology or anatomic - for 2. Pincers are stomatology or anatomic - for

determination of degree of mobility of teeth and determination of degree of mobility of teeth and perkusperkusionsions;;

• 3. Stomatology mirror - for the review of teeth, back 3. Stomatology mirror - for the review of teeth, back surface of language, surface of language, lingya lingya area and sky area and sky of oral of oral cavity cavity

• 4. Dental probe - for determination of depth of 4. Dental probe - for determination of depth of dentsdents-gingival pockets and defects of -gingival pockets and defects of toothtooth , conduct , conduct pepercusionrcusion of teeth the handle of probe; of teeth the handle of probe;

Method of palpatMethod of palpationion

• back and neck limfovuzliv of subjaws a doctor back and neck limfovuzliv of subjaws a doctor inclines a chairman sick one hand downward, and inclines a chairman sick one hand downward, and by other hand, consistently, feels them three by other hand, consistently, feels them three fingers. limfovuzli is felt in tomu position an index fingers. limfovuzli is felt in tomu position an index finger. Cheeks, finger. Cheeks, nose and lipsnose and lips, bimanual, bimanual must be must be palpatonpalpaton under limfovuzli of jaws - by the fingers under limfovuzli of jaws - by the fingers of one hand from the side of cavity of mouth, and of one hand from the side of cavity of mouth, and other - outwardly. Parotid lymphatic knots other - outwardly. Parotid lymphatic knots pal'ppal'pechonechon two-three fingers in the projection of two-three fingers in the projection of branch of lower jaw or in after to the jaw area of branch of lower jaw or in after to the jaw area of area, and also bimanual - on the cutting edge of area, and also bimanual - on the cutting edge of parotid glandparotid glandss. At feeling of . At feeling of understern understern lymphatic lymphatic knots (located in large and small nadklyuchichnikh knots (located in large and small nadklyuchichnikh pits) a doctor becomes behind patient and feels pits) a doctor becomes behind patient and feels them three fingers, concluded on a collar-bone.them three fingers, concluded on a collar-bone.

The inspection of cavity of The inspection of cavity of mouth consists in mouth consists in determination of opening of determination of opening of mouth, review of pre-wall and mouth, review of pre-wall and actually cavity of mouthactually cavity of mouth• In a norm, opening of mouth must be In a norm, opening of mouth must be

approximately 5 see or on three transversal II, III, IV approximately 5 see or on three transversal II, III, IV fingers of entered between central chisels. fingers of entered between central chisels. Determine freely it, whether there is not a crunch in Determine freely it, whether there is not a crunch in joining, as a change of lower jaw aside. joining, as a change of lower jaw aside. Inflammatory processes with bringing in of Inflammatory processes with bringing in of masticatory muscles do opening of mouth difficult masticatory muscles do opening of mouth difficult and sickly. There is inflammatory kontraktura of and sickly. There is inflammatory kontraktura of jaws de bene esse parted on 3 degrees:jaws de bene esse parted on 3 degrees:

• I a degree is small limitation of opening of mouth;I a degree is small limitation of opening of mouth;• II degree - a mouth is opened on 1 see;II degree - a mouth is opened on 1 see;• III degree - jaws are densely taken, the III degree - jaws are densely taken, the

independent opening of mouth is impossible a independent opening of mouth is impossible a patient.patient.

computercomputer tomografiya - tomografiya - • the new, the new, notinvasivnotinvasiv method of method of

diagnostics on principle, that allows diagnostics on principle, that allows vizualivizualizatoinzatoini interrelation of separate i interrelation of separate organs of fabrics in a norm and at the organs of fabrics in a norm and at the different pathological states. He is different pathological states. He is based on the use of principle of based on the use of principle of mathematical design of x-ray mathematical design of x-ray photography image with a subsequent photography image with a subsequent construction by COMPUTER, according construction by COMPUTER, according to information received horizontal to information received horizontal “cuts” of parts of human body on the “cuts” of parts of human body on the screen of display.screen of display.

An asepsis is a complex of An asepsis is a complex of measures, measures, entering entering on warningon warning of of entering entering of microorganisms of microorganisms in a wound, organs and fabrics in a wound, organs and fabrics of patient in the process of any of patient in the process of any medical manipulations. medical manipulations.

An asepsis in surgical An asepsis in surgical stomatology includes for itself:stomatology includes for itself:• preparation of cabinet;preparation of cabinet;• special treatment of hands of surgeon;special treatment of hands of surgeon;• disinfection of the operating field; sterilization of disinfection of the operating field; sterilization of

instruments of stomatologies; sterilization of instruments of stomatologies; sterilization of bandaging material and linen; sterilization of stitch bandaging material and linen; sterilization of stitch material; sterilization of fabrics and matters which material; sterilization of fabrics and matters which enter a patient in fabrics;enter a patient in fabrics;

• an observance of the special receptions is during an observance of the special receptions is during medical manipulations in surgical stomatology, medical manipulations in surgical stomatology, which warn the which warn the air air way of passing to the way of passing to the infection;infection;

• organization of work of personnel in relation to organization of work of personnel in relation to realization of the special hygienical and realization of the special hygienical and organizational measures in a surgical cabinet.organizational measures in a surgical cabinet.

An asepsis consists of two An asepsis consists of two basic moments: disinfections basic moments: disinfections and sterilizations.and sterilizations.• Disinfection is a complex of receptions and Disinfection is a complex of receptions and

methods, directed on complete, partial or methods, directed on complete, partial or selective elimination potentially of pathogenic for selective elimination potentially of pathogenic for a man microorganisms on the objects of external a man microorganisms on the objects of external environment with the purpose of break of ways of environment with the purpose of break of ways of transmission of exciters of infectious diseases vid transmission of exciters of infectious diseases vid the sources of infection to the receptive people. the sources of infection to the receptive people. The necessity of conducting of disinfection of all The necessity of conducting of disinfection of all objects is dictated possibility of transference of objects is dictated possibility of transference of infections patients in the hidden form in default of infections patients in the hidden form in default of information about such features in their state of information about such features in their state of health and way of life.health and way of life.

• Sterilization is a process of complete elimination Sterilization is a process of complete elimination of microorganisms, including their forms of of microorganisms, including their forms of spores, by application of chemical and physical spores, by application of chemical and physical methods of influencing.methods of influencing.

A stomatology help behaves to A stomatology help behaves to one of popylar types of one of popylar types of medicaremedicare • . In the structure of general the dideses . In the structure of general the dideses

populations of our country of illness of cavity populations of our country of illness of cavity of mouth and teeth take third seat. Thus in of mouth and teeth take third seat. Thus in 99 % cases patients is establishments of 99 % cases patients is establishments of ambulatory policlinics. In the structure of ambulatory policlinics. In the structure of diseases which require hospitalization diseases which require hospitalization (about 1% patients), leading seat is taken by (about 1% patients), leading seat is taken by odontogenni inflammatory diseases and odontogenni inflammatory diseases and traumasAmbulatory stomatology help traumasAmbulatory stomatology help appears an urban population in specialized appears an urban population in specialized hospital and in the cabinets of stomatologies hospital and in the cabinets of stomatologies and separations of teritorial and medical and separations of teritorial and medical establishments of departments.establishments of departments.

To them belong:To them belong:

• 1) policlinics of stomatologies (for adults 1) policlinics of stomatologies (for adults and children);and children);

• 2) separations (cabinets) of stomatologies 2) separations (cabinets) of stomatologies in territorial hospital, at mediko-sanitarnikh in territorial hospital, at mediko-sanitarnikh partsparts

• 3) cabinets of stomatologies are in 3) cabinets of stomatologies are in hospitals, dispensaries, at schools and hospitals, dispensaries, at schools and preschool establishments, in the higher and preschool establishments, in the higher and middle special educational establishments.middle special educational establishments.

During organization of work of establishments of During organization of work of establishments of stomatologies in towns not obkhidno to connect stomatologies in towns not obkhidno to connect the known principles of centralization and the known principles of centralization and detsentrali-zatsii in giving stomatology assistance detsentrali-zatsii in giving stomatology assistance a population. At the centralized form, adopting a a population. At the centralized form, adopting a population is conducted bezpose-redne in population is conducted bezpose-redne in stomatology or to the policlinic in the stomatology stomatology or to the policlinic in the stomatology separation (cabinet) of territorial policlinic of jaw-separation (cabinet) of territorial policlinic of jaw-faci he policlinics of stomatologies differentiate:faci he policlinics of stomatologies differentiate:

• 1. After the level of service: republican, regional, 1. After the level of service: republican, regional, city, district.city, district.

• 2. On subordination: territorial, departments.2. On subordination: territorial, departments.• 3. On the source of financing: budgetary, self-3. On the source of financing: budgetary, self-

supporting.supporting.• 4. On categories: in dependence on power, that 4. On categories: in dependence on power, that

the number of visits in a changethe number of visits in a change

For the best organization For the best organization and planning of stomatology and planning of stomatology helping at every level of helping at every level of management of health a management of health a guard from a number guard from a number dentistredentistre-stomatologies of -stomatologies of ditch the most experimental ditch the most experimental doctor-stomatolodoctor-stomatologg

The structure of poli-klinik of The structure of poli-klinik of stomatologies is traditionally stomatologies is traditionally formed contains the followings formed contains the followings subsections:subsections: • 1) register office;1) register office;• 2) separation: therapeutic stomatology, surgical 2) separation: therapeutic stomatology, surgical

sto-matologii, to orthopaedic stomatology sto-matologii, to orthopaedic stomatology • child's stomatology;child's stomatology;• 3) cabinet of primary review;3) cabinet of primary review;• 4) cabinet of the first stomatology aid;4) cabinet of the first stomatology aid;• 5) cabinet of physiotherapy;5) cabinet of physiotherapy;• 6) cabinet of rentgenodiagnostiki.6) cabinet of rentgenodiagnostiki.In addition in a policlinic can be organized viddi-In addition in a policlinic can be organized viddi-

lennya and. cabinets on a grant strictly specialized lennya and. cabinets on a grant strictly specialized stomatology gy which executes the functions of stomatology gy which executes the functions of main specialist on stomatologii is selected.al areamain specialist on stomatologii is selected.al area

MethodMethodss of pal'patsi of pal'patsion on

Lymphatic nodesLymphatic nodes

Submandibular nodesSubmandibular nodes

Submental nodesSubmental nodes

Palpation of limphatic nodes Palpation of limphatic nodes behind uper jaw behind uper jaw

Substernalis nodesSubsternalis nodes

Circulation of limphatic blood Circulation of limphatic blood on the facial arenaon the facial arena