2. Basic Surgical Technique for Extraction Flashcards
What are the basic principles for surgical extractions ?
Risk assessment - MH and planning.
Aseptic technique.
Minimal trauma to hard and soft tissues.
What are key things to look for in radiological assessment prior to surgical extraction ?
Root morphology - how many.
Bone formation - dense, soft.
Nerve proximity - lingual nerve.
Adjacent structures - apical lesions ?
What should be carried out before starting any surgical treatment ?
Written consent.
Surgical safety checklist - mark tooth, check patient name and address, ask patient if they are clear on what is happening today.
Describe an envelope periodontal flap.
Incision with only one relieving incision - usually distal.
Describe a 3 sided periodontal flap.
Incision with two relieving incisions - distal and mesial. Preferred due to maximal access.
What is the difference between a normal handpiece and handpiece used for bone removal ?
Normal handpiece - angled air turbine.
Handpiece for bone removal - electrical motor driven straight handpiece.
What is surgical emphysema ?
Risk from using air turbine handpiece is used.
Air driven between bone and soft tissues causing swelling which can spread to neck and chest becoming airway risk and infective risk - sepsis.
What are the aims of suturing ?
Reposition tissues.
Cover bone.
Prevent wound breakdown.
Achieve haemostasis.
Encourage healing by primary intention.
When are non-absorbable sutures required ?
Closure of OAF.
Exposure of canine tooth.
- Extends retention period required.
What are the disadvantages of non-absorbable sutures ?
Must be removed post-operatively.
What is a disadvantage of polyfilament sutures ?
Prone to wicking and collecting bacteria as more along suture - greater infection risk.
When would monofilament sutures be used ?
Better for aesthetics i.e. lip lacerations.
What is a benefit of monofilament sutures ?
Less infection risk as single strand - resistant to bacteria colonisation.
Better aesthetics as it passes through tissues more easily.
What is the disadvantage of monofilament sutures ?
Difficult to handle.
What needle shape would be used in oral surgery for sutures ?
Curved - for best access in oral cavity.
Triangular cross section.
