MINISTRY OF PUBLIC HEALTH OF REPUBLIC OF MOLDOVA STATE MEDICAL UNIVERSITY «NICOLAE TESTEMITANU»

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1 MINISTRY OF PUBLIC HEALTH OF REPUBLIC OF MOLDOVA STATE MEDICAL UNIVERSITY «NICOLAE TESTEMITANU» Department of Oral and Maxillofacial Surgery and Oral implantology Arseny Gutan ANALYTICAL PROGRAM FOR STUDENTS OF THE STOMATOLOGICAL DEPARTMENT Title of course: clinical course (inflammatory processes, trauma in maxilla-facial area, oncological diseases in MFA, reconstructive surgery in MFA) Course code: S.0.O.0, S.0.O.09, S.07.O.080, S.08.O.084, S.09.O.100, S.10.O.10 The quantity of credits for course: 0 Names of authors names reading the lecture course: Professor Valentin Topalo Professor Dmitrii Scherbatyuk Lecturer Teodor Popovich Lecturer Andrew Doruk Lecturer Dmitrii Hitu Lecturer Dmitrii Sirbu Lecturer Natalya Rusu Doctor of Medicine Mihail Radzikevich Teaching assistant Alexei Palarie Teaching assistant Liliana Nastas Chisinau 013

2 The object of Maxillo-Facial Surgery discipline study: The discipline Maxillo-Facial Surgery is a part of general Surgery and in the same time is a part of Stomatology. This is the study of topographic anatomy peculiarities, surgical peculiarities in MFA, peculiarities of organization of the dental health care in the Republic of Moldova as well as the study of surgical anatomy in the maxilla-facial area. Academic content: A. Lecture III rd year: Nr. Subject Hours OMF infections: definition, classifications, frequency, etiology, pathogenesis and pathologic anatomy Acute and chronic apical paradontitis, etiology, classification, clinical picture and Suppurations around maxillary bones (odontogenic periostitis), etiology, pathogenesis, clinical picture and Odontogenic osteomyelitis. Classification, etiology, pathogenesis, clinical picture, diagnosis, 3.1. Eruption diseases of the teeth Abscesses and phlegmons of superficial spaces around maxillary bones (etiology, pathogenesis, topography) Abscesses and phlegmons of superficial spaces around maxillary bones (clinical picture, diagnosis, treatment) Abscesses and phlegmons of deep spaces around maxillary bones (etiology, pathogenesis, topography, clinical picture, diagnosis, treatment) General complications of OMF infections Anatomy and classification of inflammatory diseases of cervico-facial lymphatic system. Acute and chronic lymphangitis. 3.. Lymphadenitis, etiology, pathogenesis, clinical forms, symptoms, treatment, 4 prevention Adenophlegmon, etiology, pathogenesis, clinical picture, treatment, prevention Furuncles (boils) and carbuncles of the face and neck Cervical and facial specific infectious diseases: actinomycosis. 3.. Cervical and facial specific infectious diseases: syphilis, tuberculosis Acute odontogenic sinusitis: etiology, pathogenesis, clinical forms, symptoms, diagnosis, treatment, complications, prevention. Chronic odontogenic sinusitis: pathogenesis, symptoms, diagnosis, surgical and conservative 4

3 3..8 Perforative sinusitis. Surgical treatment of oro-sinusal communications Diseases of the salivary glands, clinical forms. Sialodochitis. Acute sialoadenitis: etiology, pathogenesis, clinical forms, symptoms, diagnosis, Chronic sialoadenitis: etiology, pathogenesis, clinical forms, symptoms, diagnosis, Specific and allergic chronic sialoadenitis Salivary lithiasis (sialolithiasis): classification, etiology, pathogenesis, clinical picture, diagnosis, treatment, complications. Medical rehabilitation (recovery) of the patients. Prognostication Salivary fistulas. Benign lymphoepithelial lesions of the salivary glands. Sialosis. A. Lecture IV rd year: OMF traumatisms, general information. Soft tissues damages Temporal-mandible joint dislocations. Mandible fractures. Treatment of the mandible fractures (immediate, at transportation, bone synthesis) Maxilla fractures. Treatment of the maxilla fractures. Dental-paradontal traumas Fractures of the zygomatic-orbital complex. Fractures of the nasal bones. Complications of OMF traumatisms Subject and object of military stomatology. Organization of care delivery to the maxillofacial injured. General characteristic, clinical course, the diagnostic of ballistic wounds and face and jaws affections. 4.. Battle damages of soft tissues and facial bones. Burns of the face and their 4..3 Combined affections (X-ray sickness) MFR Diseases and affections of temporomandibular joint. Diseases and affections of facial nerves. Medical examination. A. Lecture V rd year:.1.1 Types of the maxilla-facial tumors. International classification of the tumors by WHO. Main diagnostic methods. Strained oncologic attention, dispensary basis for patients with OMF tumors..1. Soft tissue benign tumors of maxillo-facial region. Osteogenic tumors, benign nonosteogenic and pseudo tumors of maxillary bones. Odontogenic benign tumors. 3

4 .1.3 Epithelial maxillary cysts. Pre- malignancies of the face skin, lips, lingual mucosa and of the oral cavity..1.4 Malignant epithelial tumors (carcinomas) of the lips, tongue, oral cavity, face skin and cervical region. Malignant epithelial tumors of the maxillary bones. Malignant tumors of the salivary glands...1 Tasks and peculiarities of reconstructive maxillo-facial surgery. Clinicosurgical classification of maxillo-facial deformities and defects. Planning the restorative.. Plastic surgery using local tissues with pediculate flaps. Plastic surgery using tubular flaps Filatov, Gillis...3 Free transplantation of tissues. Microsurgical techniques, possibilities to use them in facial surgery...4 Surgical treatment of jaw deformities. Surgical treatment of paradontal diseases. Preprosthetic surgery. Contemporary methods of oral implantology. B. Skills building session(practise) III rd year: Nr. Subject Hours OMF infections: definition, classifications, frequency, etiology, pathogenesis 3 and pathologic anatomy Acute and chronic apical paradontitis, etiology, classification, clinical picture 3 and Suppurations around maxillary bones (odontogenic periostitis), etiology, 3 pathogenesis, clinical picture and Inflammatory diseases and complications of the wisdom tooth eruption. 3 Eruption diseases of all the teeth Definition and classification of odontogenic osteomyelitis, pathogenesis, 3 pathologic anatomy, importance of microflora, anatomical peculiarities of the jaws during the evolution of osteomyelitis Evolution according to the stages of odontogenic osteomyelitis. Clinical 3 picture of acute osteomyelitis Subcutaneous and chronic odontogenic osteomyelitis Local and general treatment of the patient with acute odontogenic 3 osteomyelitis Local and general treatment of subcutaneous and chronic odontogenic 3 osteomyelitis. Medical recovery of the patients with odontogenic osteomyelitis Role of head and neck interfascial and intermuscular spaces in the infection 3 spreading(diffusion) into the soft maxillary-facial tissues. Ways of infection diffusion General and local clinical picture, top-anatomy of the infection processes 3 4

5 around maxilla (abscess and phlegmon of infraorbital, palatine, zygomatic and temporal regions). Diagnosis and General and local clinical picture, top-anatomy of abscesses and phlegmons 3 of subtemporal, pterigo-maxillary and orbital regions. Diagnosis and Local and general clinical picture, top-anatomy of abscesses and phlegmons 3 around mandible: submandible, submenton, sublingual and cheek spaces. Diagnosis and Local and general clinical picture, top-anatomy of abscesses and phlegmons 3 of messeter, parotid-messeter, pterigo-mandible and tongue spaces. Diagnosis and Local and general clinical picture, top-anatomy of abscesses and phlegmons 3 of lateral pharyngeal space. Diagnosis and Local and general clinical picture of hemifacial phlegmon and Liudvig 3 Angina. Surgical and conservative treatment of suppurations around maxillary bones. Peculiarities of anaesthesia and causative tooth extraction. Tools Local and general clinical picture top-anatomy of buccal plate (floor) 3 (Liudvig Angina). Diagnosis and 3..1 Local complications of OMF inflammatory processes General complications of OMF inflammatory processes. Medical rehabilitation (recovery) of the patients with inflammatory processes Anatomy and classification of inflammatory diseases of cervico-facial 3 lymphatic system. Acute and chronic lymphangitis Lymphadenitis, etiology, pathogenesis, clinical forms, symptoms, treatment, prevention Adenophlegmon, etiology, pathogenesis, clinical picture, treatment, 3 prevention. 3.. Furuncles (boils) and carbuncles of the face and neck Cervical and facial specific infectious diseases: actinomycosis, syphilis, 3 tuberculosis Acute odontogenic sinusitis: etiology, pathogenesis, clinical forms, 3 symptoms, diagnosis, treatment, complications, prevention Chronic odontogenic sinusitis: pathogenesis, symptoms, diagnosis, surgical 3 and conservative Perforative sinusitis. Surgical treatment of oro-sinusal communications Diseases of the salivary glands, clinical forms. Sialodochitis. Acute 3 sialoadenitis: etiology, pathogenesis, clinical forms, symptoms, diagnosis, 3..1 Chronic sialoadenitis: etiology, pathogenesis, clinical forms, symptoms, 3

6 diagnosis, Specific and allergic chronic sialoadenitis Salivary lithiasis (sialolithiasis): classification, etiology, pathogenesis, 3 clinical picture, diagnosis, treatment, complications. Medical rehabilitation (recovery) of the patients. Prognostication Salivary fistulas Benign lymphoepithelial lesions of the salivary glands Sialosis Credit 3 B. Skills building session(practise) IV rd year: Nr. Subject Hours Traumatic lesions in OMF region. Classification by the types of trauma. Etiology and pathogenesis, statistics. Basic principles of medical assistance organization for the patients with OMF trauma. Damages of soft tissues and oral cavity. Anatomy-clinical aspects. Treatment Dental and paradontal traumas, etiology, classification, clinical picture and The fractures of the mandible, etiology, frequency. Causative mechanisms, classification, symptoms, clinical forms, evolution. Treatment of the mandible fractures. Temporarily immobilization. Methods of orthopedic and surgical Dislocations of temporal mandible joint. Etiology, symptoms and Fractures of the maxilla. Etiology, causative mechanism, clinical forms, symptoms and 4.1. Fractures of the zygomatic-maxillary complex. Etiology, pathogenesis, anatomy - clinical forms, diagnosis, evolution and 4.1. Traumas of nasal bones. Etiology, pathogenesis, anatomy-clinical forms, diagnosis, evolution, Complications of the soft tissue damages, of the dental-paradontal traumas, of the mandible and maxilla fractures. Immediate complications (urgent). Treatment Complications of the soft tissue damages, of the dental-paradontal traumas, of the mandible and maxilla fractures. Secondary complications. Complications of the soft tissue damages, of the dental-paradontal traumas, of the mandible and maxilla fractures. Belated complications. Anaesthesic peculiarities in the OMF traumas 4..1 Organization and delivery of surgical care to maxillofacial injured. The general characteristic, clinical treatment, diagnostic of ballistic wounds and

7 face and jaws affections. Battle damages of soft tissues. Affection of the mandible and maxilla and facial bones (nasal and zygomatic bones) teeth affections. 4.. Affection of the mandible and maxilla and facial bones (nasal and zygomatic bones) teeth affections. Facial burns and their 4..3 Combined maxilla-facial affections Organization of the maxilla-facial injured treatment on the stages of medical evacuation. Medical examination of injured with the jaws, face and neck affections. Temporomandibular dislocations and inflammatory processes of these joints (etiology, symptomology, diagnostics, treatment, aggravation). 4.. Osteoarthrosis and syndrome of temporomandibular pains. Anchylosis and jaws contracture: etiology, clinical picture, pathogenesis, treatment, prognosis. 4.. Diseases and affections of facial nerves: etiology, clinical picture, pathogenesis, treatment, prognosis The peculiarities of the care of patients with trauma in maxilla-facial region. Dressing, drainage, mouth cavity hygiene, food ingestion Correct filling of the patient history of subject patients. B. Skills building session(practise) V rd year: Nr. Subject Hours.1.1 Medical service organization of the patients with oral and maxillofacial (OMF) tumors. Epidemiology. Principles of the international classification of tumors, methods of patients exploration with OMF tumors and pre-tumors..1. Pre- malignancies of the skin and lips border, and pre-malignancies of the oral mucosa. Non odontogenic epithelial cysts of maxillary bones. Cervicalfacial congenital cysts and fistulas. Odontogenic pseudo tumors of maxillary bones..1.3 Odontogenic epithelial cysts of maxillary bones. Odontogenic tumors of maxillary bones..1.4 Benign cutaneous tumors of the maxillo-facial region. Benign epithelial tumors of the oral cavity..1. The benign primary osteogenic epithelial tumors of the maxillary bones. Pseudo tumors of the maxillary bones..1. Benign tumors and pseudo-tumors of the salivary glands..1.7 Malignant tumors of the skin and lower lip. Malignant epithelial tumors of the oral cavity organs. Malignant tumors of the soft facial tissues..1.8 Malignant primary tumors of the maxillary bones. Malignant tumors of the salivary glands. Dispensary of the patients with oro-maxillo-facial tumors and 7

8 pre tumors...1 Reconstructive maxillo-facial surgery: definition, classifications, history, goals, connection with general surgery, dentistry and other medical specialties. Operative techniques, instruments, suture materials and methods, anesthesia. Planning reconstructive interventions: analysis (examination) of defect, deformity, plane stages, sources and reserves of plastic material. Preoperative care and preparation of patient and operative field. Indications and contraindications... Defects and deformities of maxillo-facial tissues (organs): etiology, frequency, classification...3 Mathematical substantiation in planning and performing reconstructive intervention: Z plasty, N plasty. Plastic surgery using flaps from neighbouring regions. Plastic surgery of labial and perioral defects using flaps from the immediate neighbourhood of the defect...4 Free transplantation of skin and mucous membrane, dermoplasty. Free transplantation of cartilage and bone, osteoplasty... Surgical treatment of sagittal anomalies and maxillary deformities. Surgical treatment of vertical and transversal dento-maxillary anomalies and deformities... Principles and methods of contemporary oral implantology...7 Treatment methods and reconstructive paradontal surgery. Methods of prophylactic (preventive) paradontal surgery. Surgical methods of oral cavity preparation for dental prosthesis (preprosthetic surgery)...8 Medical rehabilitation, physiotherapy and curative physical education of patient with surgical OMF disease. Medical expertise. 8

SYLLABUS OF ORAL AND MAXILLOFACIAL SURGERY

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