「1」Oral and maxillofacial anatomy and physiology
Overview
Main physiological functions
Oral and maxillofacial anatomy and physiology
deciduous and permanent teeth
Maxillofacial Anatomy and Physiology
Surface markings and coordination relationships
nerve
Trigeminal nerve
maxillary nerve
sphenopalatine nerve
middle palatine nerve and retropalatine nerve
through the palatal foramen
superior alveolar nerve
superior retroalveolar nerve
facial nerve
temporal branch
Distributed in frontalis muscle (damaged frontal lines disappear)
Zygomatic branch
Distributed in the upper part of the orbicularis oculi muscle and the frontalis muscle (the damaged eyelid cannot be closed)
buccal branch
Distributed in the buccinator muscle, laughing muscle and orbicularis oris muscle (air leakage when the cheek is damaged)
marginal mandibular branch
Distributed in the muscles of the lower lip (paralysis of the damaged lower lip, distortion of the corners of the mouth)
「4」Dental endodontic disease
Dental disease
caries
Cause: Susceptibility ➕Bacteria (Streptococcus mutans) ➕Substrate ➕Time
Classification
According to the rate of progress
Acute caries/wet caries (violent caries/rampant caries/radiation caries)
Chronic caries/dry caries (quiescent caries)
Press the damaged anatomy
Osteoarthritis (pit and fissure caries)
Classification by lesion depth
treat
Surgical treatment (hole making classification)
Non-caries
dentin hypersensitivity
Sensitivity to mechanical stimuli
acid erosion
Exogenous origin is more common on the labial surface of the anterior teeth
Endogenous is more common on the lingual and palatal sides of the teeth
hereditary dentin disorders
congenital syphilis teeth
Fusion teeth, twin teeth, combined teeth
Endodontic disease
Classification
irreversible pulpitis
chronic pulpitis
chronic ulcerative pulpitis
chronic proliferative pulpitis
periapical disease
Cause - mostly developed from endodontic disease
Classification
acute apical periodontitis
chronic periapical periodontitis
chronic periapical abscess
periapical dense osteitis
Emergency treatment for toothache
Incision and drainage of pus
Anti-inflammatory and analgesic
「5」Periodontal disease
gum disease
Chronic gingivitis (main)
Cause: Initiation - dental plaque
Drug-induced gingival hypertrophy
acute necrotizing ulcerative gingivitis
periodontitis
chronic periodontitis
Cause: Dental plaque, tartar
Pathogenic bacteria: Porphyromonas gingivalis
Four characteristics
periodontal pocket formation
「6」Common diseases of oral mucosa
oral herpes simplex
primary herpes simplex virus
secondary herpes simplex virus
Oral candidiasis
Candida stomatitis
Acute pseudomembranous candidal stomatitis
Acute erythematous candidal stomatitis/antibiotic stomatitis
Chronic erythematous (atrophic) candidiasis/denture stomatitis
chronic proliferative candidiasis
Candida angular cheilitis
recurrent aphthous ulcer
Aphthous ulcer herpetiformis
Oral Manifestations of Sexually Transmitted Diseases
Oral mucosal manifestations of other common systemic diseases
Hand, foot and mouth disease
Behcet's disease/Behcet's syndrome
discoid lupus erythematosus
「7」Oral local anesthesia
Local anesthesia
Commonly used anesthetic drugs
Oral local anesthesia method
block anesthesia
maxillary nerve block anesthesia
Pterygopalatine canal injection
Greater palatine foramen (the midpoint of the line connecting the palatal gingival margin of the maxillary third molar to the palatal midline arcuate concave surface, the middle and outer 1/3 of the plane)
extraoral injection
Zygomatic bone and mandibular notch
Upper retroalveolar nerve block anesthesia
Distal buccal oral vestibular groove of maxillary second molar
Infraorbital nerve block anesthesia
extraoral injection
Infraorbital foramen (about 1cm next to the nose on the same side)
intraoral injection
Infraorbital foramen (in the oral vestibular groove of the maxillary lateral incisors)
Anterior palatine nerve block anesthesia
Greater palatine foramen (the midpoint of the line connecting the palatal gingival margin of the maxillary third molar to the arcuate concave surface of the midline of the palate)
Nasopalatine nerve block anesthesia
Anterior palatine foramen (incisive foramen)
mandibular nerve block anesthesia
Foramen ovale (zygomatic arch and mandibular notch)
Inferior alveolar nerve block anesthesia
Pterygomandibular space (tip of buccal fat pad)
Lingual nerve block anesthesia
1cm anterior and medial to the inferior alveolar nerve
Buccal nerve block anesthesia
Pterygomandibular space (tip of buccal fat pad)
Complications and prevention of oral local anesthesia
「14」 Maxillofacial nerve diseases
trigeminal neuralgia
Classification
primary trigeminal neuralgia
secondary trigeminal neuralgia
Functional check (the original does not affect the function)
sensory function
Pain and temperature sensations are lost but touch is present
Spinal tract nucleus damage
corneal reflex
The unaffected side can still cause bilateral reactions
No reaction on either side of the affected side
palatal reflex
The reaction disappears on one side
Damage to the retropalatine nerve or sphenopalatine nerve on that side
Motor function
Paralysis of masticatory muscles (relaxation when clenching, relaxation when swallowing)
Differential diagnosis
Toothache and other odontogenic diseases
Temporomandibular joint disorder
glossopharyngeal neuralgia
Similar symptoms but different parts
treat
primary
Semilunar ganglion radiofrequency temperature-controlled thermocoagulation
microvascular decompression
Facial nerve palsy
Bell's palsy (recoverable)
treat
acute phase
Glucocorticoids➕antiviral drugs
permanent facial nerve paralysis
「13」Oral and maxillofacial tumors
Oral and maxillofacial cysts
soft tissue cyst
sebaceous cyst
Puncture: white curd-like sebaceous gland secretions
Dermoid or epidermoid cyst
Puncture: Milky white tofu-like discharge
thyrohyoid cyst
Puncture: transparent, slightly turbid yellow thin or viscous liquid
branchial cleft cyst
Puncture: Yellow-green liquid containing cholesterol crystals
Tumor-like lesions and benign tumors
tumor-like lesions
Gingival tumors (non-true tumors)
benign tumor
Vascular malformations
Venous malformation (cavernous hemangioma)
Postural shift test positive
Arteriovenous malformation (penduloid hemangioma or botryoid hemangioma)
Feeling of tremor on palpation
Auscultatory blowing murmur
lymphatic malformation
Microcystic type (capillary type and cavernous lymphangioma)
Macrocystic type (cystic hygroma or cystic hygroma)
The body movement test is negative but the light transmission test is sometimes positive
mixed vascular malformation
Oral and maxillofacial malignant tumors
tongue cancer
Deep cervical lymph node metastasis
gum cancer
submandibular lymph nodes
cheek cancer
submandibular lymph node metastasis
「12」Common diseases of salivary glands
salivary gland inflammation
chronic obstructive mumps
Sialolithiasis and submandibular adenitis
salivary gland mucocele
mucocele
Most commonly occur on the ventral side of the lower lip and tongue tip
salivary gland tumors
benign salivary gland tumors
Pleomorphic adenoma/mixed tumor
Predilection: parotid gland > submandibular gland, minor salivary gland is most common in the palate
Warthin's tumor/adenolymphoma/papillary lymphocystadenoma
Salivary gland malignant tumors
mucoepidermoid carcinoma
Predilection: parotid gland > palate > submandibular gland
Adenoid cystic carcinoma/cylindroma
Prevalent: minor salivary glands and parotid glands in the palate
「11」Common diseases of temporomandibular joint
Temporomandibular joint anatomy and function
Soft tissue
Blood vessels and nerve distribution of the temporomandibular joint
sports
opening and closing movements
Temporomandibular joint disorder (TMD)
Masticatory muscle disorders
structural disorder
Restorable predisplacement
Irreducible predisplacement
degenerative joint disease
temporomandibular joint dislocation
acute anterior dislocation
recurrent anterior dislocation
Temporomandibular joint ankylosis
Intra-articular ankylosis/true ankylosis
Fibrous ankylosis (no pain, restricted opening)
Bone ankylosis (complete inability to speak)
Common causes: Suppurative otitis media (secondary infection from adjacent tissue sources) and trauma
Extra-articular ankylosis/pseudoarthrosis/intermaxillary contracture
other illnesses
temporomandibular joint infection
temporomandibular joint injury
Congenital or developmental malformations of the temporomandibular joint
「10」Oral and maxillofacial injuries
First aid treatment of oral and maxillofacial injuries
Oral and maxillofacial soft tissue injuries
Characteristics of treatment of soft tissue injuries in several special parts of the face
Eyebrow and eyelid injuries
Parotid gland and parotid duct injury
Oral and maxillofacial firearm injuries
Tooth and alveolar bone injuries
Zygomatic bone and zygomatic arch fractures
「9」Oral and maxillofacial infection
Pericoronitis of mandibular third molar
Maxillofacial space infection
Infraorbital space infection
Maxillary anterior teeth and first premolar
Masseter space infection
Pericoronitis of mandibular third molar
Pterygomandibular space infection
Apical infection or pericoronitis of mandibular third molar
submandibular space infection
Apical infection of mandibular molars and pericoronitis of third molars
cellulitis of floor of mouth
Ludwig's Angina (Ludwig's Angina)
Purulent or gangrenous apical periodontitis of mandibular teeth or third molar pericoronitis
osteomyelitis of the jaw
Suppurative osteomyelitis of the jaw
borderline
Pericoronitis of mandibular third molar
Maxillary osteomyelitis in infants and young children
Radiation osteomyelitis of the jaw
Bisphosphonate-related osteonecrosis of the jaw
Purulent lymphadenitis in infants and young children
facial nerve
V trigeminal nerve
Fiber properties
general somatosensory fibers
Special visceral motor fiber
branch
Ocular nerve
act
Entering the orbit through the supraorbital fissure
branch
lacrimal gland nerve
distributed
Tear gland (only concerned with feeling, not moving)
maxillary nerve
act
Enter the pterygopalatine fossa through the round foramen
branch
sphenopalatine nerve
anterior palatine nerve
greater palatine foramen penetration
middle palatine nerve and retropalatine nerve
Palatal foramen penetration
superior alveolar nerve
superior retroalveolar nerve
into maxillary tuberosity alveolar foramen
mandibular nerve
act
Through fossa ovale to infratemporal fossa
branch
lingual nerve
distributed
Front 2/3 mucous membrane of tongue
after injury
Paralysis and atrophy of masticatory muscles on the affected side
When opening the mouth, the mandible points to the affected side
Loss of sensation in ipsilateral facial skin and oral and nasal mucosa
VII facial nerve
Fiber content
Special visceral motor fiber
Controls facial muscle movements
General visceral motor fibers
control gland secretion
nasopalatine mucosal gland
Special visceral sensory fibers
The taste buds in the front 2/3 of the tongue
act
Pass through the bone wall into the facial nerve canal
Exits the skull through the stylomastoid foramen
branch
branches within facial nerve canal
Drumline
Fiber content
Special visceral sensory fibers
Distributed in the front 2/3 of the tongue, taste buds
parasympathetic fibers
Distributed in submandibular and sublingual glands
stapedius nerve
Innervates the stapedius muscle
after injury
Symptoms of facial paralysis
Loss of taste in the front 2/3 of the tongue
Branches outside the facial nerve canal
after injury
(Symptoms of facial paralysis)
Forehead wrinkles disappear
Nasolabial folds become shallower
The corner of the mouth is tilted to the healthy side
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