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Excision of lesion or tumor (except listed above), dentoalveolar structures; with complex repair

CPT4 code

Name of the Procedure:

Excision of lesion or tumor, dentoalveolar structures; with complex repair
(Common names: Tumor Removal, Lesion Excision with Reconstruction)

Summary

This surgical procedure involves removing a lesion or tumor from the dentoalveolar structures, which include the teeth and the bone that supports them. The procedure also includes a complex repair of the affected area to restore function and appearance.

Purpose

The procedure addresses the presence of abnormal growths or tumors in the jawbone and dental structures. The goals are to eliminate potentially harmful lesions, restore normal function, and improve aesthetic outcomes.

Indications

  • Presence of benign or malignant tumors in the jawbone or dental structures
  • Persistent pain or discomfort due to a lesion
  • Swelling or deformity in the dentoalveolar area
  • Problems with chewing, speaking, or other oral functions due to the growths

Preparation

  • Patients may need to fast for a certain period before the procedure.
  • Adjustments to current medications may be necessary, especially blood thinners.
  • Preoperative imaging studies like X-rays or CT scans are often required.
  • Routine blood tests and health assessments will be conducted.

Procedure Description

  1. Anesthesia: General anesthesia or local anesthesia with sedation is administered.
  2. Incision: A precise incision is made to access the lesion or tumor.
  3. Excision: The lesion or tumor is carefully removed from the dentoalveolar structure.
  4. Complex Repair: The area is reconstructed possibly with grafts or other reparative techniques to restore function and appearance.
  5. Closure: The incision site is sutured closed, ensuring minimal scarring.

Tools used can include scalpels, dental drills, and microsurgical instruments.

Duration

The procedure typically takes between 1 to 3 hours, depending on the size and complexity of the lesion and the extent of repair needed.

Setting

This procedure is usually performed in a hospital, surgical center, or outpatient clinic with appropriate surgical facilities.

Personnel

  • Oral and Maxillofacial Surgeon
  • Surgical nurses or assistants
  • Anesthesiologist (if general anesthesia is used)
  • Possibly a reconstructive specialist, depending on the extent of the repair

Risks and Complications

Common risks:

  • Infection
  • Bleeding
  • Swelling and bruising

Rare risks:

  • Nerve damage leading to numbness or altered sensation
  • Fracture of the jaw
  • Complications from anesthesia

Benefits

  • Removal of harmful or discomforting lesions
  • Restoration of normal jaw function
  • Improved oral and facial aesthetics
  • Reduced risk of lesion recurrence

Benefits can often be seen immediately, though complete healing and functional restoration might take time.

Recovery

  • Patients are advised to rest and avoid strenuous activity for a few days.
  • Pain management may include prescribed or over-the-counter pain relief medication.
  • Follow-up appointments are necessary to monitor healing.
  • Dietary restrictions may include soft foods initially.
  • Full recovery typically takes a few weeks, with some cases healing within a few months.

Alternatives

  • Laser removal (less invasive but may not be as thorough)
  • Radiation therapy (primarily for malignant tumors)
  • Observation and regular monitoring (if the lesion is benign and symptom-free)

The alternatives vary in invasiveness, recovery time, and suitability based on the specific condition.

Patient Experience

During the procedure, the patient will be under anesthesia and won't feel pain. Post-procedure, some discomfort, swelling, and bruising are expected. Pain management measures, including medications and cold compresses, will help. Emotional support and clear communication from healthcare providers further ease recovery.

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