TMI - "Periodontal flap surgery" photos
Apr. 1st, 2009 01:45 am![[personal profile]](https://www.dreamwidth.org/img/silk/identity/user.png){kind=small}
pyesetzHere. The hairless ape female being operated on in these pictures is not me; I had the right side done today (upper and lower) rather than upper-left as shown.
Page 1:
The patient is prepared with appropriate protective glasses, and surgical cap and drapes.
I did not get these, just your typical dentistry towel hung around my neck. I wore my own spectacles. After I got sprayed with water from the ultrasonic scaler, the periodontist pulled out what looked like an ordinary bath towel from a drawer and draped it over my thorax. After the procedure, I was handed a wet after-dinner towel for wiping the blood out of my facial fur.
Page 2:
Two percent lidocaine with 1:100,000 concentration of vasoconstrictor is slowly injected into the buccal mucosa.
After the first half-dozen shots, I got heart palpitations, so I asked the periodontist about epinephrine (some dentists have used epinephrine-free shots when working on my mouth). He quoted the same 1:100,000 figure as mentioned here. I didn't have further problems with the remaining shots, so perhaps he accidentally hit a blood vessel with one of them and I got a bolus dose of vasoconstrictor. The adverb "slowly" cannot properly be applied to the shots I received.
There is evidence of 6mm pockets in the interproximal regions
I had several 7mm pockets. I think there was an 8mm also. That's deep, man.
there appears to be an adequate with [sic!] of keratinized tissue along the entire buccal surface, with no significant gingival recession or mucal-gingival problems.
Spelling error. This patient sounds marginal to me; did she really need the procedure?
There is evidence of interproximal crater formation interdentally between the first molar and premolar. Also, there is angular bone loss between the premolars and on the mesial of the first premolar. We shall now used [sic!] an organized instrument by instrument approach
Okay, so maybe she really did need it. And another typo...
Page 3:
The incision is continued forward to include the premolars
Not applicable. My premolars were removed over 30 years ago for orthodontic purposes.
This blade is used with an up-and-down motion that allows for precise cutting.
Unless I'm mistaken, the procedure involves large quantities of these big-blade up-and-down motions, which are perceptible despite anaesthesia.
The same instrument is used to remove the thin tissue covering of the periosteum so that at least 3mm of the bone margin can be seen
Well, so they say, but I don't really know what I'm looking at with the tiny photo they present—and the following photo shows the entire area covered in blood, with zero mm of visible bone.
Page 4:
A sulcular incision is made beginning at the posterior tooth and proceeds forward with the blade cutting with an up-and-down motion.
Androtomy requires that human bodies be described as if they were zombies, standing vertically but with the limbs in the positions they would have on an autopsy table.
The Goldman Fox periosteal elevator allows for atraumatic flap elevation.
I saw the other end of this instrument, in the periodontist's hand.
The buccal interproximal tissues are removed in large pieces
This text makes it seem like they're removing something that I would want to keep.
An ultrasonic scaler is now used to remove smaller pieces of granulation tissue along the bone margins.
No, I don't think I want anything that an ultrasonic scaler can remove. Granulation tissue is like scar tissue; it's leftovers from old injuries.
The tip of this instrument is applied directly to the bone and clumps of tissue are removed.
Problem: this causes bone conduction of the non-ultrasonic noise that the ultrasonic scalar makes! Especially noticable when cleaning the wisdom teeth, which feel like they're directly connected to the eardrum.
Page 5:
One of the most important parts of periodontal surgery is root planing.
Also one of the most important reasons why I agreed to pay vast quantities of unreimbursable money for this procedure. I have had periodontal root planings several times; they make my teeth feel much younger! But the procedure works for only about ten years or so.
Use of a slow speed handpiece with an ultrafine diamond bur is a valuable technique to smooth root surfaces that are still rough or which have calculus. A high speed handpiece with ... a #8 round bur is applied to those areas of the alveolar process where the bone is thick and irregular.
One of these instruments creates a horrible "burning" odour and the feeling on the teeth is unpleasant.
Page 6:
For the first week the patient has been given appropriate analgesic tablets and instructed not to brush or floss in the area of the dressing.
No, I was given nine regular-strength ibuprofen tablets and told to take all of them during the first 24 hours. Also I got a prescription for Toradol (ketorolac) but told not to fill it unless necessary. I am supposed to brush "carefully, as needed to feel fresh", which reminds me of ads for vaginal douche bags (sorry).
[after 1 week] the sutures are removed. The patient will be given oral hygiene instruction and seen again in 1 week.
Nobody told me about coming back for a second return visit. My sutures are self-dissolving.
Page 1:
The patient is prepared with appropriate protective glasses, and surgical cap and drapes.
I did not get these, just your typical dentistry towel hung around my neck. I wore my own spectacles. After I got sprayed with water from the ultrasonic scaler, the periodontist pulled out what looked like an ordinary bath towel from a drawer and draped it over my thorax. After the procedure, I was handed a wet after-dinner towel for wiping the blood out of my facial fur.
Page 2:
Two percent lidocaine with 1:100,000 concentration of vasoconstrictor is slowly injected into the buccal mucosa.
After the first half-dozen shots, I got heart palpitations, so I asked the periodontist about epinephrine (some dentists have used epinephrine-free shots when working on my mouth). He quoted the same 1:100,000 figure as mentioned here. I didn't have further problems with the remaining shots, so perhaps he accidentally hit a blood vessel with one of them and I got a bolus dose of vasoconstrictor. The adverb "slowly" cannot properly be applied to the shots I received.
There is evidence of 6mm pockets in the interproximal regions
I had several 7mm pockets. I think there was an 8mm also. That's deep, man.
there appears to be an adequate with [sic!] of keratinized tissue along the entire buccal surface, with no significant gingival recession or mucal-gingival problems.
Spelling error. This patient sounds marginal to me; did she really need the procedure?
There is evidence of interproximal crater formation interdentally between the first molar and premolar. Also, there is angular bone loss between the premolars and on the mesial of the first premolar. We shall now used [sic!] an organized instrument by instrument approach
Okay, so maybe she really did need it. And another typo...
Page 3:
The incision is continued forward to include the premolars
Not applicable. My premolars were removed over 30 years ago for orthodontic purposes.
This blade is used with an up-and-down motion that allows for precise cutting.
Unless I'm mistaken, the procedure involves large quantities of these big-blade up-and-down motions, which are perceptible despite anaesthesia.
The same instrument is used to remove the thin tissue covering of the periosteum so that at least 3mm of the bone margin can be seen
Well, so they say, but I don't really know what I'm looking at with the tiny photo they present—and the following photo shows the entire area covered in blood, with zero mm of visible bone.
Page 4:
A sulcular incision is made beginning at the posterior tooth and proceeds forward with the blade cutting with an up-and-down motion.
Androtomy requires that human bodies be described as if they were zombies, standing vertically but with the limbs in the positions they would have on an autopsy table.
The Goldman Fox periosteal elevator allows for atraumatic flap elevation.
I saw the other end of this instrument, in the periodontist's hand.
The buccal interproximal tissues are removed in large pieces
This text makes it seem like they're removing something that I would want to keep.
An ultrasonic scaler is now used to remove smaller pieces of granulation tissue along the bone margins.
No, I don't think I want anything that an ultrasonic scaler can remove. Granulation tissue is like scar tissue; it's leftovers from old injuries.
The tip of this instrument is applied directly to the bone and clumps of tissue are removed.
Problem: this causes bone conduction of the non-ultrasonic noise that the ultrasonic scalar makes! Especially noticable when cleaning the wisdom teeth, which feel like they're directly connected to the eardrum.
Page 5:
One of the most important parts of periodontal surgery is root planing.
Also one of the most important reasons why I agreed to pay vast quantities of unreimbursable money for this procedure. I have had periodontal root planings several times; they make my teeth feel much younger! But the procedure works for only about ten years or so.
Use of a slow speed handpiece with an ultrafine diamond bur is a valuable technique to smooth root surfaces that are still rough or which have calculus. A high speed handpiece with ... a #8 round bur is applied to those areas of the alveolar process where the bone is thick and irregular.
One of these instruments creates a horrible "burning" odour and the feeling on the teeth is unpleasant.
Page 6:
For the first week the patient has been given appropriate analgesic tablets and instructed not to brush or floss in the area of the dressing.
No, I was given nine regular-strength ibuprofen tablets and told to take all of them during the first 24 hours. Also I got a prescription for Toradol (ketorolac) but told not to fill it unless necessary. I am supposed to brush "carefully, as needed to feel fresh", which reminds me of ads for vaginal douche bags (sorry).
[after 1 week] the sutures are removed. The patient will be given oral hygiene instruction and seen again in 1 week.
Nobody told me about coming back for a second return visit. My sutures are self-dissolving.
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Date: 2009-04-01 02:22 pm (UTC)no subject
Date: 2009-04-01 05:05 pm (UTC)