1. Introduction to Oral Surgery

Question 1

Definition of non-surgical extractions

Answer 1

No flaps, no bone removal, no sectioning of teeth

Question 2

Definition of surgical extraction (3)

Answer 2

Incision in gingivae/mucoperiosteal flaps
Bone removal with drills/chisels
Tooth sectioning with drills

Question 3

Definition and use of coronectomy (3)

Answer 3

Removes crown of tooth
Leaves roots
Can be used when roots are close to nerves and where surgical removal carries a higher risk of damage to the nerve (lower third molars)

Question 4

Difference between OAC and OAF (2)

Answer 4

OAC - acute communication

OAF - chronic communication (epithelial lined tract)

Question 5

Types of soft tissue biopsies (3)

Answer 5

Excision – remove the whole lesion
Incision – take a sample of the lesion
Punch Biopsy – a core: punch a circle around the lesion (excision) or within the lesion (incision) – 4mm or 6mm

Question 6

When would incisional biopsies be used (3)

Answer 6

Squamous cell carcinoma
Lichen planus/lichenoid reaction
Leukoplakia

Question 7

Definition of mucoceles

Answer 7

Damaged minor salivary glands

Question 8

Removal of mucoceles (3)

Answer 8

Saliva gets trapped within the minor gland
Can increase and decrease in size – often burst then refill
Damage to sublingual salivary gland (major salivary gland) can result in a ranula – like a large mucocele in the floor of the mouth. Often marsupialised. If does not resolve requires more complex surgery for removal

Question 9

Definition of cyst

Answer 9

Epithelial lined fluid filled cavities in bone or soft tissue

Question 10

Definition of enucleation

Answer 10

Removal of entire cyst

Question 11

Definition of marsupialisation

Answer 11

Removal of part of cyst lining and leaving it open (de-roofing)

Question 12

Features of periradicular surgery (5)

Answer 12

Surgery around the root of the tooth
Failed root canal treatment/non-resolving infection/cyst
Root fractures
Post Crowned Teeth – post perforations
Can involve debridement (cleaning), sealing perforations, apicectomy (removal of root apex)

Question 13

Definition of pre-prosthetic surgery

Answer 13

Removal of denture induced hyperplasia

Question 14

Definition of haemangioma

Answer 14

Vascular lesion

Question 15

Features of cryosurgery (3)

Answer 15

Using liquid nitrogen/nitrous oxide to freeze abnormality, removing blood supply
Haemangiomas – risk of bleeding if excised
Trigeminal neuralgia – cryo the nerve involved (infraorbital nerve, mental nerve)

Question 16

Features of TMJ problems (5)

Answer 16

Problems with jaw joint
Pain associated with muscles of mastication
Combination of muscle and joint pain
Often related to tooth grinding/clenching habits
Can be treated with conservative advice and analgesia, occlusal splints/bite raising appliances