made.  If  the  lesion  is  not  malignant,  it  is  allowed  to heal without further surgery. If a laboratory test shows the tissue is malignant, complete removal is indicated. Excision Method The   excision   method   involves   removal   of   the entire lesion along with some adjacent normal tissue. This  procedure  is  done  on  small  lesions  where complete removal would not create significant esthetic or  functional  impairment. FOREIGN  BODY  REMOVALS This is the removal of any foreign body, such as a needle,  metallic  restoration,  or  pieces  of  elevators, forceps, or even bullets. Such a removal is considered a surgical procedure. It is not always indicated, and is often  left  up  to  the  judgment  and  discretion  of  the dentist. SEQUESTRECTOMY Sequestrectomy  procedure  involves  the  removal of devitalized portions of the bone that have separated from the adjacent bone. Often the devitalized portion of bone will work its way partially through the tissue and be sharp and rough. ALVEOLAR  OSTEITIS After  the  extraction  of  a  tooth  from  its  alveolus, healing begins immediately when blood oozes into the alveolus and forms a clot. The clot is later replaced by scar tissue and ultimately bone as healing progresses. The blood clot also protects the alveolus from food, air, and fluids. If the blood clot does not form or dislodges from  the  tooth  socket,  a  painful  condition  called alveolar  osteitis  (also  known  as  a  dry  socket)  may occur  from  2  to  4  days  after  the  removal  of  a  tooth. With  the  clot  missing,  healthy  granulation  is  absent and  the  tissue  within  the  socket  appears  grayish  in color  and  often  presents  a  foul  odor.  The  patient  is usually  in  severe  and  persistent  pain  because  of  the exposed   bone   in   the   open   socket.   In   Dental Technician,  Volume  1,  chapter  6,  we  describe emergency treatment for this condition. PERICORONITIS The   procedure   for   pericoronitis   involves   the treatment of the gingival tissue surrounding a partially erupted   or   malposed   tooth,   that   develops   painful, localized   inflammation.   In   Dental   Technician, Volume  1,  chapter  6,  we  also  describe  emergency treatment for this condition. SURGICAL  INSTRUMENTS TRAUMATIC  WOUND  REPAIR Simple and complicated wounds of the facial and or oral soft tissues may be repaired and or sutured in oral surgery. INCISION  AND  DRAINAGE Incision   and   drainage   involves   surgical inter-vention   for   drainage   of   an   abscess,   cyst,   or hematoma. A surgical rubber drain can be sutured in the area to establish drainage. IMPLANTS There are several types of surgical implant devices and associated procedures. An endosseous implant is a device placed in the alveolar bone to support an oral or  facial  prosthesis.  A  transosteal  or  superiosteal implant is a device placed to support an oral or fixed prosthesis. A surgical abutment procedure involves uncovering   the   implant   and   connection   of   the abutment  used  in  the  prosthetic  reconstruction  of single or multiple teeth. Many  surgical  instruments  are  used  in  both  oral surgery  and  periodontic  procedures.  All  surgical instruments  are  made  of  high-grade  steel,  either stainless   or   chrome-plated.   Each   instrument   has   a particular  purpose  and  should  be  handled  with  extreme care. The instruments with cutting edges must be kept sharp to prevent slippage. Hinged instruments should be lubricated with a milk bath and sterilized in the wide open position to keep them in good operating condition and to prevent rusting. MISCELLANEOUS  SURGICAL INSTRUMENTS No  matter  what  kind  of  dental  surgery  is  being performed,   some   miscellaneous   instruments   will almost certainly be required. Among these are surgical suction,   retractors,   scalpels,   suture   needles   and materials,  and  surgical  scissors.  A  few  other instruments, such as mouth props, mouth gags, and a surgical  mallet,  will  also  be  included  with  the miscellaneous  surgical  instruments. 5-5