Cool-Headed, Dr.Yousra El-Kady

Bilateral Palatally Impacted Canines Exposure For Orthodontic Traction...

Alveoloplasty Procedure (Removal Of Bony Exostosis).
A 50 Yr old Male Patient Was Referred From The Prosthesis Department For Removal Of Bony Exostosis Related to his upper left quadrant Causing him Irritation & Pain While Using His Partial Denture.

Steps:
1) Gingival Incision using 15 c Scalpel.
2) Mucoperiosteal Flap Reflection using Mucoperiosteal Elevator.
3) Removal Of Bony Exostosis Using Carbide Bur ( Straight Hand piece) With Copious Saline Irrigation.
4) Continuous With Lock Suture Using black silk 4/0.
5) Follow up & Suture Removal after 1 week.

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Contact Us : 01005528213

It's Always My Pleasure To Watch My Interns Develop Surgical Passion & Start Working On It Hard Day After Day After Day...♥️

A Very Lovely Ending To A Very Hectic Week By One Of My Most Amazing, Skillful & Favourite Interns .. 😊♥️
Teaching Surgery With Passion Has Always Been The Goal & Reason Behind The Long Path Of Learning & Advancing Day After Day After Day....

Made My Day 😊♥️
Tues. 10/10/2023

Back To Work 🩵💙

Bilateral Palatally Impacted Canines Case ♥️

A 36 yr old female patient presented to clinic seeking esthetic restorations to her bilateral missing canines.

Dental History :
Past History Of Orthodontic Treatment of only her upper arch without canines traction !!!

Clinical Examination:
- Missing Bilateral Canines.
- Grade 2 mobility in her teeth due to faulty orthodontic treatment planning.

Treatment Planning :
- Implant placement & Implant Crown restorations After Canines' Surgical Extraction.
- Splinting Of Teeth.

Radiographic Examination:
- Revealed the presence of bilateral Palatally Impacted canines demanding their Surgical Removal first before Implant Placement.
- Upper Left Canine Is More Superficial Than The Upper Right One.
- Extension from the upper lateral incisors to the upper second premolars.

Surgical Technique:
- Local Anesthesia.
- Palatal Gingival/ Sulcular flap extending from the upper right 5 to the upper left five.
- Hanging Suture for visibility.
- Bone Guttering & Crown exposure.
- UL3 (More Superficial) Removal as follows :
By Wedging using curved apexos then Delivery using Bayonet Forceps
- UR3 (Deeper) Removal as follows:
By Decuspation then Wedging using curved apexos then Delivery using Bayonet Forceps.
- Bone Filing & Saline Irrigation.
- Multiple Interrupted Sutures.
- A surgical stent is preferred to avoid any sagging.

Freelancing Oral Surgery ♥️♥️

Bilateral Palatally Impacted Canines Case ♥️

A 36 yr old female patient presented to clinic seeking esthetic restorations to her bilateral missing canines.

Dental History :
Recent Orthodontic Treatment of only her upper arch without canines traction !!!

Clinical Examination:
- Missing Bilateral Canines.
- Grade 2 mobility in her teeth due to faulty orthodontic treatment planning.

Treatment Planning :
- Delayed Implant placement & Implant Crown restorations After Canines' Surgical Extraction.
- Splinting Of Teeth.

Radiographic Examination:
- Revealed the presence of bilateral Palatally Impacted canines demanding their Surgical Removal first before Implant Placement.
- Upper Left Canine Is More Superficial Than The Upper Right One.
- Extension from the upper lateral incisors to the upper second premolars.

Surgical Technique:
- Local Anesthesia.
- Palatal Gingival/ Sulcular flap extending from the upper right 5 to the upper left five.
- Hanging Suture for visibility.
- Bone Guttering & Crown exposure.
- UL3 (More Superficial) Removal as follows :
By Wedging using curved apexos then Delivery using Bayonet Forceps
- UR3 (Deeper) Removal as follows:
By Decuspation then Wedging using curved apexos then Delivery using Bayonet Forceps.
- Bone Filing & Saline Irrigation.
- Multiple Interrupted Sutures.
- A surgical stent is preferred to avoid any sagging.

Freelancing Oral Surgery ♥️♥️

Impactions & Matching With My Lovely Interns ♥️♥️

A 37 yr old famale patient complaining of Repeated Inflammation & pain related to her lower posterior areas especially the left side.

Clinical Examination:
Revealed the presence of an operculum related to her lower Left 8.

Radiographic Examination :
Revealed a Disto-Angular Impacted Lower 8 With Fused Roots & in Close Proximity To Lower 7 Distal Root.
CBCT was requested to check for any fusion between the roots which revealed only a close proximity with no fusion.

Surgical technique:
Surgical Extraction Of Lower 8 Using Gingival Flap, Disto-Buccal bone gutter And Atraumatic Luxation & Delivery By More Disto-Buccal Application & Minimal Mesio-Buccal Application Of Straight Elevator To avoid traumatizing the Lower 7 Distal Root.

Freelancing Oral Surgery ♥️
WhatsApp No. : 01005528213

من أحب الأدعية لي قبل ما اشتغل اي حاله و بإذن الله الدنيا بتمشي احسن بكتير مما أتخيل ❤️💙

"اللهم إن يدك سابقة ولاحقة ومحيطة بأيدينا فاجعل الشفاء يجري عليها
اللهم لا تؤاخذه بذنبي ولا تؤاخذني بذنبه
اللهم أصلح ما بين أيدينا" 🍂

"اللهم بك أستعين وعليك أتوكل، اللهم ذلل لي صعوبة أمري، وسهَلْ لي مشقته، وارزقني الخير كله أكثر مما أطلب، واصرف عني كل شر رب اشرح لي صدري ويسر لي أمري يا كريم. اللهم إني توكلت عليك فأعنّي، ووفقني، واجبر خاطري، جبرا أنت وليّه. يا رب، أدعوك بعزتك وجلالك، ألا تصعّب لي حاجة، ولا تعظم علي أمرًا، ولا تحنِ لي قامة." ♥️

When We Practice Oral Surgery, We Feel So Good, but
When We Practice & Teach Oral Surgery, We Feel So Alive and that we'll always have a good reason to show up every day! ♥️

In Love With Freelancing Oral Surgery That Gets Me Involved With Beautiful Doctors & Amazing Teamworks 🥰❤️

Management Of A Symptomatic Eruption Cyst causing pressure & pain to a very co-operative 8 & Half Yr Old Female Patient Delaying The Eruption Of UR1.

P.S.
- Eruption cysts do not require treatment;. however, if the cyst is symptomatic, it should be treated with simple surgical excision.
- Periapical X ray was taken but isn't available for documentation...

Tues. 15/8/2023

"أنا استحاله انزل اشتغل يوم اجازتي!!"
انا و شنطة ادواتي ايام اجازاتي 😂😅
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My Beautiful Morning Texts From Lovely Interns 🥰♥️
فضل من الله و نعمه ♥️

"Life Is Short... Smile While You Have Teeth."😊 💙
Celebrating My Birthday At Clinic 🎉🥳
Freelancing Oral Surgery ♥️
Enjoying Our Little Achievements Is The Key For Optimism & Bigger Achievements..
اللهم لك الحمد حمداً كثيراً طيبا مباركا فيه 💙❤️
اللهم إني أسألك علما نافعا و رزقا طيبا و عملا صالحا متقبلا ♥️
Sat. 15/7/2023

Eid El-Adha Referral 😂😅
A Case Of Lower Left 8 R.Rts was referred by a dentist who tried to extract the tooth using Straight Elevator without separation of those wide roots which ended up with a fractured Crown & Two Sub-bony Roots..
Management Of Such Cases Could be Closed Or Open Accordingly!
1) Closed/ Flapless Extraction demands a very good visibility of the outline of the roots, Complete Separation of the two roots & accessible point of application of your elevator ( preferred to be a root tip elevator ).
2) Open/ Trans Alveolar Extraction is done in cases with no visibility or accessibility (as in this case) due to the need of slight bone gutter, complete separation & the use of elevators (root tip elevators / Curved apexos).

If you have any comments, plz let me know..

Mon. 3/7/2023

Dunkin Donuts From Lovely Students ♥️

أسرة Cool-Headed تتمنى لكم عيد فطر سعيد 😂🎉🎉🎉
كل سنه و حضراتكم جميعاً بخير و صحه و سعادة ♥️

Cool-Headed Case 24, Upper Left 8 Soft Tissue Impaction..
All we need to do is a very small sulcular incision deep to the occlusal surface, resembling the socket opening, that doesn't need to be sutured in addition to a very good Mesiobuccal wedge using your Curved Warwick James or Curved Apexo!

ERU Innovative DNT Event..
"WHAT WE PLAN IS WHAT WE GET" 🙏♥️
Implant Planning Basics Seminar
Tues. 21/3/2023

Ramadan Gifts From My ERU Students 🥰♥️
Cause Allah Has Blessed Me With The Passion Of Teaching To See Those Amazing Students...♥️

Mon.20/3/2023

Cool-Headed Case #23 , Bilateral Impacted Horizontal Wisdom Teeth Extractions..
A 24 yr old Male Patient Was referred By his orthodontist for extraction of his Lower Right & Left Horizontally Impacted Wisdom Teeth...

Extraction of His Wisdom Teeth On Both Sides Was Done In The Same Manner as Follows;
1) Gingival / Sulcular Incision.
2) Disto-buccal Bone guttering.
3) Decapitation / Coronectomy In Two Pieces.
4) Luxation & Delivery Of Roots Using Straight Elevator.
5) Bone Filing.
6) Curettage & Removal Of Tooth Follicle.
7) Irrigation Using Saline.
8) Multiple Simple Interrupted Sutures Using Vicryl 5/0.

If You Have Any Comments, Plz Let Me Know..
♥️

Cool-Headed Case 22, Upper Wisdom Tooth Extraction..
A 27 yr old female patient came with the chief complaint of Slight buccal cheek biting and discomfort related to her upper left posterior area!
Clinical & Radiographic Examinations revealed a partially soft tissue impacted upper 8 with the distal cusp causing friction against cheek upon biting ..

Extraction Steps:
1) A Small Crestal incision related to the mesial cusp & Reflection to gain access for luxation.
2) Mesiobuccal Wedge using your curved apexo / Curved Warwick James.
3) Delivery Using Jockey after being fully luxated.

P.S. Upper Right Wisdom Tooth should also be removed since its over eruption leading to cheek biting problem as well!

If you have any comments, plz let me know!😊

Sharing my very humble knowledge & Experience with my dearest Interns has always been my biggest passion & Motive To Continue ...
"Teaching Is The Greatest Act Of Optimisim!" ♥️

Cool-Headed Case #21, Impacted Wisdom Teeth..
Lower Left 8 Horizontal Impaction

According to the Principles Of Minimally Invasive Surgery as follows:
ACT LIKE A BURGLAR;
1- Break In Quietly (Least Trauma).
2- Complete The Task As Quickly & Professionally As Possible.
3- Leave No Traces Behind (Complete closure by Suturing with no tension).

1 January 2023 🤍✨

Cool-Headed 20, Lower Wisdom Teeth Extractions..
Mesio-Angular Lower 8 With Mesially Curved Roots..
A 52 yr old female patient came with a repeated complaint of dull aching pain related to lower right posterior area.

Clinical Examination Revealed;
Deep Periodontal Pocketting related to distal aspect of lower 7.

Radiographic (Panoramic) Examination Revealed ;
1) Mesio-Angular Lower 8 With Mesially Curved Roots.
2) Radiolucency related to the mesial aspect of lower 8 (Periodonal Pocket & Bone Resorption)

Cause of Periodontal Pocket : Food Entrapment & Inaccessible Frequent hygiene measures between lower 7&8 due to Mesio-Angular Position Of Lower 8.

Surgical Planning:
Gingival Sulcular flap Elevation & Bone guttering Bucco-Distal aiming for better accessibility for two Surgical Steps;
1) Decapitation & Safe Delivery of the mesial part.
2) Delivery Of the distal part By Disto-Buccal Application Of Straight Elevator To avoid Fracturing of the apical 1/3 of the Mesially Curved Roots.

Please Let Me Know if you have any comments 😊

♥️🥰

Hayat Dental Education Event ..
Thurs. 14.4.2022

Cool-Headed Case #12,
Lower Right 8 Impaction

- A 22 yr old female patient was referred by her orthodontist for lower impacted 8 extractions (as they cause lower anterior teeth crowding)…

A- Killey, Kay (1965) Classification According To;
1) Angulation / Winter’s Classification : Mesio-angular.
2) State Of Eruption: Unerupted.
3) Number Of Roots: Fused Roots.

B- Pell, Gregory (1933) Classification According To;
1) Relation of the tooth to the Ramus of the mandible: Class I
2) Relative Depth in Bone: Position B (Highest Point of Lower 8 is between the occlusal plane & Cervical margin of lower 7).
3) Position in relation to the long axis of 2nd Molar: Mesio-Angular, Lingoversion.
4) Complications/ Difficulties: Lack of Accessibility & Proximity or closeness to the mandibular canal.

- Impactions Instrument Used:
1) Bard Parker Blade Handle no. 3.
2) Blade .
3) Thin Mucoperiosteal Elevator/ Papilla Elevator/ Buser.
4) Thicker Mucoperiosteal Elevator/Pritchard Elevator.
5) Long shank surgical bur (High Speed).
6) Straight Elevator (groove 3mm).
7) Bone File.
8) Bone Curette.
9) Tissue Forceps.
10) Needle Holder.
11) Scissors.
12) Sterile Gauze.
13) Non Resorbable Polypropylene blue Stitch 4/0.

- Impaction Steps Include:
1) Clinical & Radiographic Examination.
2) Planning of surgical approach.
3) 2-line Incision Flap is made (Releasing line mesial to lower 7).
4) Flap Reflection buccaly & lingually (gently).
5) Lingual flap protection by your assistant using Mucoperiosteal elevator.
6) Bone Guttering buccodistally.
7) Slight luxation at the bifurcation area using straight elevator.
8) Decapitation in 2 pieces (to avoid friction or injury at the distal aspect lower 7).
9) Delivery of fused roots.
10) Curettage & removal of the tooth follicle to avoid occurrence of residual cyst.
11) Suturing.
12) Post-operative instructions & medications.

Please Let Me Know if you have any comments ☺️

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