Oral and Maxillofacial Surgery
Core concepts
Cover exodontia principles (elevators, forceps, flap design, sectioning), complications (dry socket, hemorrhage, nerve injury, oroantral communication), and management of impacted third molars. Learn odontogenic infection spread, fascial spaces, and when to drain versus prescribe antibiotics. Understand maxillofacial trauma (Le Fort fractures, mandibular fracture sites), temporomandibular joint disorders, and basic implant surgery. Know biopsy principles and the management of medically compromised patients (anticoagulants, bisphosphonates, radiotherapy).
Traps
Antibiotics are adjuncts to drainage, not substitutes. Dry socket is managed by irrigation and dressing, not antibiotics routinely. Oroantral communication management depends on size and timing; large defects need closure. Beware Le Fort levels: I (low), II (pyramidal), III (craniofacial). Mandibular fracture common sites: angle, condyle, body, symphysis. Bisphosphonate-related osteonecrosis is a risk after extractions; conservative management is preferred.
Worked example
Rule of thumb: "Pus under pressure needs drainage; antibiotics alone will not cure an abscess." A patient with trismus, dysphagia, and floor-of-mouth swelling suggests Ludwig's angina - a surgical emergency requiring airway management and drainage. For a small (<2 mm) fresh oroantral communication, conservative management with avoidance of nose-blowing and follow-up may suffice.