Assessing difficulty of XLA

Question 1

What 2 ethnic groups have denser bone = harder XLA?

Answer 1

asian, afro-carribean

Question 2

what causes abrasion and abfraction cavities?

Answer 2

abrasion = excessive forces (brushing, tooth picks etc)
abfraction = excessive forces on teeth causing flexure
both cause pits at gum line

Question 3

what forceps can be useful when difficult access i.e upper 8s?

Answer 3

Bayonets forceps

Question 4

what teeth are most commonly submerged? when does this often happen?
what causes submerged teeth?

Answer 4

deciduous molars - when no permanent molar
alveolus and surrounding permanent teeth change and grow and deciduous tooth stays put

Question 5

how does bone in children differ to adults - affecting XLA? root morphology?

Answer 5

more elastic bone in children so easier XLA - though often thin divergent roots prone to fracture

Question 6

what is cemento-osseous dysplasia? looks like?

Answer 6

tooth fused to sclerotic bone

benign lesion and often asymptomatic - requires no tx
looks like wite patch on x-ray

Question 7

give examples of osteolytic lesions - radiographic appearance

Answer 7

cysts, odontogenic tumours, primary & metastatic cancer

Question 8

how does internal & external root resorption affect xla?

Answer 8

external = easier
internal = harder

Question 9

how does periapical, peiriodontal and osteomylitis affect xla
what is osteomylitis?

Answer 9

make sit easier as bone lost around apex = mobile

osteomylitis = inflammation in the jaw bone after chronic infection (radiolucent) - can lead to blood loss to the bone

Question 10

is referral required for ankylosis?

Answer 10

yes - as tooth will be unerupted

Question 11

why should high speed never be used to section roots? what should be used?

Answer 11

high speed will introduce air causing emphysema (cellulitis) - use surgical hand piece

Question 12

where to refer cases?

Answer 12

oral surg department, oral surg specialist, maxfax