[Surgical treatment of the aging patient]

Surgery in the elderly patient calls for a particular approach, since the physical powers of older persons are generally compromised, age-induced pathological organ alterations are frequent and the structures of skin, mucosa and bone have undergone physiological changes. Regarding the use of anesthetics and premedication, impaired hepatic and renal function will often require considering drugs with a prolonged half life and selecting low dosages. Although the surgical procedures required are basically the same as in the younger age groups, these operations are often considerably complicated by sclerosing of the surrounding bone and the associated risk of a jaw fracture. The majority of the elderly patients treated by the oral surgeon present with painful TMJ arthroses or rheumatoid arthritides, fractures of the visceral cranium accompanied by soft tissue injuries, tumors, or conditions requiring preprosthetic surgery. In older persons all these procedures demand specific indications, operative techniques and aftercare.