Lesson 1Setting selection rationale: criteria for office, ambulatory surgery center, or hospital operating room useThis part outlines rules for picking office, day surgery center, or hospital room, thinking about patient health issues, sleep needs, infection risk, tools available, and emergency readiness for safe, smooth care.
Office setting indications and limitationsWhen to use an ambulatory surgery centerHospital operating room indicationsAssessing medical risk and ASA statusEmergency preparedness and equipment needsLesson 2Flap design options for mandibular molar surgery: envelope, triangular, and vertical releasing incisions with pros/consThis part checks flap design rules for lower molar surgery, comparing envelope, triangle, and side release cuts, stressing blood flow, reach, tension control, and how each affects after-surgery pain and ridge keeping.
Biologic principles of mucoperiosteal flapsEnvelope flap indications, pros, and consTriangular flap design and clinical usesVertical releasing incisions and limitationsFlap tension management and repositioningLesson 3Anesthesia level decision: indications for local anesthesia alone, local with IV sedation, or general anesthesiaThis part reviews patient, procedure, and body risk factors guiding sleep choice, comparing local alone, local with IV calm, and full sleep, including watch needs, air way thoughts, and legal notes.
Assessing patient anxiety and medical comorbiditiesIndications for local anesthesia aloneWhen to add IV sedation to local anesthesiaCriteria for choosing general anesthesiaMonitoring, recovery, and documentation needsLesson 4Formulating the final diagnosis: chronic periapical infection with buccal cortical thinning and proximity to inferior alveolar nerveThis part explains how to combine clinic, X-ray, and CBCT info to confirm long-term root tip infection, check cheek bone thinning, and judge link to lower jaw nerve for safe surgery planning and outlook.
Key clinical signs of chronic periapical infectionRadiographic and CBCT features of cortical thinningMapping proximity to the inferior alveolar nerveDifferential diagnosis and endodontic vs surgical careRisk stratification and prognosis documentationLesson 5Ridge preservation techniques: socket graft materials (autograft, allograft, xenograft, alloplast), membrane types, and choice considerations given infection and cortical defectsThis part looks at ridge keeping after infected molar pull, comparing socket graft stuff and membrane kinds, timing with infection and bone gaps, and choice paths to keep space for future implants.
Assessing socket walls and defect morphologyAutograft, allograft, xenograft, and alloplast choicesResorbable versus nonresorbable membranesTiming of grafting in infected extraction sitesStrategies to maintain ridge width and heightLesson 6Tooth sectioning strategies: root separation patterns for mandibular molars, instrumentation, and minimizing torque on nerveThis part covers root shape check, best root split lines for lower molars, tool and instrument pick, controlled cut steps, and ways to cut twist pass and machine stress near lower jaw nerve.
Radiographic evaluation of root morphologyDesigning root separation patterns by molar typeInstrumentation choice for precise sectioningTechniques to minimize torque on the nerveManaging fractured roots and difficult segmentsLesson 7Bone removal and access techniques: osteotomy planning, use of rotary instruments vs piezoelectric surgery, minimizing cortical lossThis part details pre-cut bone design, pick and order of spinning vs piezo tools, water and cool plans, and ways to cut bone shell loss while getting good reach and sight for safe tooth removal.
Principles of osteotomy design and planningChoosing rotary versus piezoelectric devicesHandpiece control, irrigation, and heat reductionPreserving buccal and lingual cortical platesIntraoperative assessment of access and visibilityLesson 8Debridement of periapical lesion: curettage technique, removal of granulation tissue, culture/biopsy indicationsThis part describes orderly cleaning of root tip spots, including scrape method, removal of growth tissue, handling cyst spots, and when to take samples or biopsies to guide germ-killing treatment and tissue check.
Instrumentation for periapical curettageStepwise removal of granulation tissueHandling cystic and fibrous lesionsIrrigation protocols and hemostasisIndications for culture and biopsy samplingLesson 9Managing proximity to the mandibular canal during extraction: gentle traction, controlled apical curettage, and use of intraoperative CBCT or navigationThis part focuses on spotting high-risk canal nearness, using soft pull and loosen, controlled tip scrape, and signs for during-surgery CBCT or guide systems to dodge nerve harm and handle surprise canal show safely.
Preoperative mapping of the mandibular canalAtraumatic luxation and traction techniquesControlled apical curettage near the canalUse of intraoperative CBCT and navigationManagement of suspected nerve exposureLesson 10Soft tissue management and closure: primary closure vs open healing, use of collagen membranes, suturing techniques to maintain ridge contourThis part deals with soft tissue handling around pull and graft spots, comparing main close vs open heal, use of collagen sheets, flap move, and stitch methods that guard grafts and keep ridge shape and tough tissue.
Criteria for primary closure versus open healingFlap advancement and releasing techniquesUse of collagen membranes for coverageSuture selection and tension controlPostoperative soft tissue remodeling review
