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Treatment of Lon’g-Stariding Communications
Successful treatment and closure of the oroantral communication requires extensive surgery. Aggressive antibiotic treatment is lso necessary. If the fistula has developed’ next to the root of an adjacent tooth, closure is further complicated and, to be successful, removal of the tooth may be necessary. Surgeons use various techniques to close oroantral f
Surgicai Staff Preparationa
The preparation of the operating team for surgery differs
according to the nature of the procedure being performed
and the location of the’ surgery. The two basic types of
personnel asepsis to be discussed are (1) the clean technique
and (2) the sterile technique. Antiseptics are used
during each of the techniques, so th.ey are discussed firs.
Iodophors, such as polyvinylpyrrolidon
Operatory Disinfection
The various surfaces present in the dental opera tory have different requirements concerning disinfection that depend on the potential for contamination and the degree of patient contact with the surface. Any surface
that a patient or their secretions contact is a potential carrier of infectious organisms, In addition, when high-speed drilling equipment is used, patient blood and secreti
Maintenance of Sterility
Disposable material Materials and drugs use oral and maxillofacial surgery, such a as , scalpel blades, and syringes with needles are sterilization
TABLE 5-6
Methods of Sterilization or Disinfection ‘of Selected Dental Instruments
·Chemical disinfecting/ster+lizing solutions are not the method of choice for sterilization of any items used in the mouth. In some circum-.stances t~e
Techniques of Instrument Disinfection
Clicnticul disinfectants. Many dental instruments cannot withstand the temperatures required for heat sterilization. Therefore if gaseous sterilization is not available and absolute sterility is not required, chemical disinfection can be performed. Chemical agents-with potential disinfectant
capabilities have been classified as being high, intermediate, or low in biocidal
Techniques of Instrument Sterilization
Any means of instrument sterilization. to be used in office-based dental and surgical care must be reliable, practical, and safe for the instruments. The, three methods generally available for instrument sterilization are dry heat, moist heat, and ethylene oxide gas.
Sterilization with heat. HeatIs one of the ‘oldest means of destroying microorganisms. Pasteur used
Concepts
Chemical and physical agents are the two principal means of reducing-the number of microbes on a surface. Antiseptics, disinfectants, and ethylene oxide gas are the major chemical means of killing microorganisms on surfaces.
Heat, irradiation, and mechanical dislodgment are the primary physical means of eliminating viable organisms (Box 5-2).
BOX 5-2
General Methods of Reducing the Number of Viable O
ASEPTIC TECHNIQUES AND UNIVERSAL PRECAUTIONS
Terminology
Different terms are used to describe various means of preventing infection. However, despite their differing definitions, terms such as disinfection arid sterilization are often used interchangeably. This can lead to the misconception that a certain technique or chemical has sterilized an
object when it has merely reduced the level of contamination.
Ther
Mycobacterial Organisms
The only mycobacterial organism of significance to most dentists is sivcobncteruun tuberculosis. Although tuberculosis (TB) is an uncommon di ease in the United States and Canada, the frequent movement of people between countries inclucing those where Tll is common, continues
to spread M, tuberculosis organisms worldwide. In addition, some newer strains of M, tuberculosis have become r
Viral Organisms
Viruses are ubiquitous in the environment, but fortunately only a few poseerious threat to the patient and the surgical team. The viral organisms that- cause the most difficulty are. the hepatitis Band C viruses, and the
human immunodeficiencv virus (HIVi. These viruses have differences in their’ susceptibility to nation that are important to understand when attempting to
prevent their sp
