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Principles of Surgery
Make a Diagnosis
 Know   your patient
 Examine your patient
 Look at the data
 Consider the alternatives
 Is picking up a knife the best thing to
  do?
Be Prepared for
Surgery
 Proper instrumentation and supplies
 Surgical access
   Mouth  opening
   Good visibility
   Lighting
   Suction
   Flaps

 Good   assistants
Be Aseptic
 Try not to make the patient worse than
  before he came to see you!
 Don’t contaminate your environment
A Chance to Cut is a Chance to
Cure
  Buy a new knife
  Be assertive
  Watch where you are going
  Consider closure
Principles of Flap
     Design
Types of Flaps
 Split thickness
 Full thickness
Indications for Flaps
Design Principles
Size
Anatomical Landmarks
Base-Margin
Relationships
Thickness
Location of Margins
Relieving Incisions
Dental Papillae
Suturing
Sample Flaps
Maxillary Flaps
Mandibular Flaps
Apicoectomy Flaps
Palatal Flaps
Maxillary Third Molar
Flaps
Mandibular Third Molar
Flaps
Mandibular Third Molar
Flaps
The Goal in Flap
Design
Three Prinicples of Tissue
Handling
 Gentle
 Gentle
 Gentle
But it’s Bleeding
 Tamponade
 Indirect   pressure
 Cautery
 Ligation
 Hemostatics
   Gelfoam
   Surgicel
   Collagen
Dead space
 What  about it?
 Can I prevent it?
   Proper suturing
   Pressure dressings
   Drains
   Packing
Sew?
 When
 Resorbable or non-resorbable
 Swaged or tied
 Size
 Needle
 Material
Have a nice day

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Principles of oral surgery