37. Oral Surgery Flashcards
Contraindications for endodontic treatment
Grade III mobility (>2mm: with vertical displacement)
Vertical root fracture
External root resorption
Rx app of vertical root fractures
J shape radiolucency or Teardrop
Rx app of Ext root resorption
Moth eaten
Pearshape cyst
Globulomaxillary cyst
Cyst seen in crowns of impacted tooth; common in Impacted Mn 3rd molars
Dentigerous cyst
Other term for dentigerous cyst
Follicular cyst
Dentigerous cyst may transform into
Ameloblastoma
Ameloblastoma: benign or malignant?
Benign tumor but very aggressive
benign bec it cannot metastasize
Rx app of ameloblastoma
Unilateral soap bubble appearance
Presents: Angel like face 👼
Rx app: BILATERAL soap bubble appearance
Cherubism
BQ: Stage of dev - Supernumerary
Initiation
BQ: appositional stage, morphodifferentiation and histodifferentiation happens in what stage?
BELL STAGE
Most common supernumerary
Mesiodens
Tx for mesiodens
Extract asap
“4th molar”
Found distal to the 3rd molars
Distmolar
Supernumerary found on buccal or lingual of molars
Paramolars
Most common tooth extracted before ortho tx
1st PMs
When to extract C-D-4
C8
D9
4 asap
Space deficiency indicated for serial exo
8mm (boards)
Hallmark of malignancy
Anaplasia
Cancer cells - Anaplastic cells; rapidly multiplying
Radiation therapy may cause
Osteoradionecrosis of the Jaw (Mn most common)
Anti resorptive drugs; used for pxs with osteoporosis and hyperparathyroidism)
Bisphosphonates
Bisphosphonates causes
BIOJ - Bisphosphonate induced osteonecrosis of the jaw
Difference between BIOJ and ORN
Cause only
BIOJ - Bisphosphonates
ORN - radiation
How to manage BIOJ and ORN
Px is exposed to 100% Hyperbaric O2
If hindi effective = excise
Causative agent of acute endocarditis
Staph aureus
Causative agent of Subacute endocarditis
Strep viridans
Prophylactic antibiotic for pxs with risk of endocarditis
Amoxicillin 2000mg
If unable to swallow = Ampicillin
Dosage of clindamycin as prophylactic antibiotic
600mg
Clindamycin inhibits what ribosomal unit
50s
Aminoglycosides (bacteriostatic/30s)
Streptomycin
Gentamycin
Tobramycin
Neomycin
Adverse effects of tetracycline
Hepatotoxic
Photosensitivity
Resistance and superinfections
Tooth discoloration
Common immunosupressant drugs
Cyclosporins - gingival hyperplasia
Corticosteroids - mimics cortisol (zona fasciculata of adrenal cortex of adrenal gland)
When to schedule pxs with controlled diabetes
Morning
Tx for end stage renal disease
Kidney transplant
Hemodialysis: 3x/week (GFR=125ml/min)
BQ: Tooth extraction on pxs with end stage renal dse should be done when?
After dialysis
BQ: Px is under long term steroidal therapy and needs to have tooth exo. What pre-op procedure should be done?
Double the dose
Limit of epi for hypertensive pxs
0.04mg (2carpules)
Anes safe for hypertensive pxs
Mepivacaine
2 LA na hindi na nilalagyan ng vasoconstrictor
Mepivacaine - weak vasodilator
Cocaine - already a vasoconstrictor
All LA are vasodilators except
Cocaine
Doc for angina pectoris
Nitroglycerin - sublingual
Amyl nitrate - inhalational
Sign na magkaka heart attack (fist pressed on chest)
Levine’s sign
Wait for _____ months after heart attack management before tooth extraction
Wait for 6 months after management
BQ: Hemophilic pxs have problem with bleeding time or clotting time?
Increased clotting time (but normal bleeding time)
Normal clotting time= 8-15mins
Christmas dse
Hemophilia B
Normal bleeding time
1-3mins
PeT
9-13s
PiTT
25-35s
Normal calcium level
9-11
Inc Calcium levels
PTH (secreted by: chief cells)
Dec calcium levels
Calcitonin (parafollicular cells of thyroid)
What is secreted by the follicular cells of thyroid gland
T3/T4
Most common cause of hyperthyroidism
Graves dse
Most common cause of hypothyroidism
Hashimoto’s thyroiditis
Factor 8 deficiency
Hemophilia A (A8)
Factor 9 def
Hemo B (B9)
Factor 11 def
Hemo C (C11)
⬇️ platelets
Both clotting and bleeding time affected
Thrombocytopenia
Normal platelet count
150,000-450,000
Lifespan of platelets
10days
1st trimester of pregnancy
Organogenesis
Precaution for 3rd trimester of pregnancy bec
Baka manganak na
Uncimfortable lying in dental chair
Ideal time for tooth exo in pregnant
2nd trimester
BQ: What kind to drug is 5-fluorouracil?
“Anti metabolite drug” - prevents cellular division
BQ: How many days stop aspirin before tooth exo
7 days stop prior tooth exo
Other term for aspirin
Acetylsalicylic acid
- inactive drug
- inhibits COX
- blocks formation of thromboxane A2 (reduce blood clot)
BQ: dont give aspirin to child with
Viral infection / fever = may lead to: REYE’s SYNDROME
2 characteristic features of reye’s syndrome
Hepatotoxicity and encephalitis
Warfarin suppresses
Vit K
Vit K dependent CF
2/7/9/10
BQ: Vit K produced in the
Liver
BQ: Tx for severe pericoronitis (acute inflammation of tissue surrounding a partially erupted tooth)
Irrigation using NSS or chlorhexidine
No need for antibiotics