Total Joint Replacement Draping Shoulder roll Head drape Scrub and prep, towels on face Scrub and prep, towels on abdomen (Fat graft) Ioband Second mayo stand (abdomen?) Urology drape Really large tegederms/opsite (for the mouth – central supply) Peanut for the ear (after prep/drape) Mark and inject off the field or on the field? Accessories […]
Total Joint Replacement (TJR) Read Post »
Bovie Feel lateral ramus Layer by layer. Stay next to mucosa on your medial dissection Peel with periosteal, when you peel, go to the start of your incision Sharp then flat Seldon all the way back Must get gonial angle attachment off Strip post border with j hook The front end of the hook on
Gonial Angle Reduction Read Post »
Deglove Don’t need to see nerve Use raytech and broad periosteal Guide in Screw Score cut Score midline Score verticals Remove guide Put vertical plate in. Do your hole so you know your vertical length of your plate placement Do your vertical osteotomy first Then your lateral. Feel the inf border. Get both cortices Connect
Armamentarium #9 Periosteal elevator #15 Scalpel blade 26 gauge wire Appropriate sutures Bauer retractors Curved Freer elevator Langenbeck retractors Local anesthetic with vasoconstrictor Oscillating saw, 11.5 × 7-mm blade Rotary handpiece, 4-mm round bur
Intraoral Vertical Ramus Osteotomy Read Post »
With renal failure there is decreased glomerular filtration which results in an increased level of serum phosphate. This tends to cause serum calcium to be deposited in bone leading to a decrease serum calcium level. In response to low serum calcium the parathyroid glands are stimulated to secrete parathormone (PTH) which results in secondary hyperparathyroidism.
Nephrotic syndrome is a glomerulonephropathy causing severe proteinuria precipitating a large decrease in intravascular osmotic pressure and fluid loss to the interstitial tissue. While peripheral edema is a prominent symptom, intravascular volume depletion occurs and jugular venous distension is therefore not observed.
Nephrotic and Nephritic Syndrome Read Post »
Tertiary anticholinenergic drugs (atropine and scopolamine) can cross the blood brain barrier and lead to postoperative delirium. Glycopyrrolate is a quarternary agent and does not cross the blood brain barrier. Propofol is associated with rapid recovery and euphoria. Long acting benzodiazpines may also contribute to disorientation on emergence. In young healthy patients recovery from midazolam
Emergence Delirium Read Post »
Phenylephrine is an alpha agonist. It will increase SVR and may cause a reflex bradycardia, which would be beneficial for cardiac function. Ephedrine and epinephrine would both increase heart rate due to their beta stimulation and given this patients medical history that would not be desirable. Atropine is an anticholinergic drug, would increase heart rate
Intra-Op Management of Heart Rate and Blood Pressure Read Post »
Vertical bone height may be a consideration in the treatment planning phase of simultaneous sinus lifting and implant placement. In general 4 mm of vertical bone height will provide a situation that may allow for simultaneous placement however, the true determinate is primary implant stability.
Immediate Implant Placement Read Post »
Peri-implantitis is defined as radiographically detectable peri-implant bone loss occurring after initial successful osseointegration combined with soft tissue inflammation lesion that demonstrates suppuration and probing depths of 6mms or more. The process begins at the coronal aspect of the implant, whereas the more apical portion remains clinically stable (osseointegrated).
