Validity of the Indication for Minor Oral Surgery Procedures Performed under Local Anesthesia in Special Needs Outpatients at Our Oral Health Center

Abstract

It is difficult to evaluate the success of implementing a minor oral surgery （MOS） protocol in facilities lacking equipment for general anesthesia or intravenous sedation for special needs patients for whom MOS is indicated. We adapted and implemented an MOS protocol for such patients using the following four criteria：parental consent was provided；the patient could maintain a posture for a specified period of time；this posture could be maintained through behavior management；and the MOS procedure could be completed within 30 min.

We used the adapted MOS protocol for 62 patients with an indication for MOS. The procedure was completed in 61, but was discontinued in the remaining patient. The most frequent indication for MOS was surgical extraction, of which 39 procedures were performed. Apicoectomy, intraoral inflammation surgery, and benign tumor removal were among the other procedures performed. The most frequent postoperative complication was swelling of the cheek. Restraining by assistants and use of a restrainer were adopted as methods of behavior management. The extracted impacted lower third molars were categorized asⅠA,ⅠB,ⅡA, andⅡB, according to the classification proposed by Pell and Gregory. Neither ClassⅢnor Position C molars were extracted. One MOS case was discontinued due to difficulty in securing an operative field due to cheek puckering.

Our results suggest that an MOS protocol can be adapted to and implemented in special needs patients in whom an operative field can be successfully secured. Furthermore, extraction of Pell and Gregory classⅠA,ⅠB,ⅡA, andⅡB impacted lower third molars can be performed successfully using this protocol.