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LAST ACTUAL FINAL > B9 cysts and shit > Flashcards

B9 cysts and shit Flashcards

1
Q

basic surgical goals when managing b9 cysts

A

eradication of pathological condition

funcitonal rehab

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2
Q

what is imperative prior to definitive tx

A

histological diagnosis

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3
Q

PA cyst vs ameloblastoma…which would require more aggressive tx

A

tumor (ameloblastoma)

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4
Q

when should you plan reconstruction? what types of things should you plan for

A

plan while planning the excisions surgery

grafting, fixation, soft tissue, dental rehab, PATIENT PREPARATION

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5
Q

a true cyst….

A

contains an epithelial lining

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6
Q

types of inflammatory cyst (2)

A

periapical

residual

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7
Q

types of developmental cysts (5)

A 
dentigerous
OKC
lateral periodontal
glandular odontogenic cyst
calcifying odontogenic cyst
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8
Q

4 strategies for managing cysts

A
  1. enucleation
  2. enucleation and curettage
  3. marsupialization
  4. staged marsupialization and enucleation
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9
Q

what is the decompression technique

A

staged marsup/enucleation

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10
Q

what is the treatment of choice for cystic lesions

A

enucleation

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11
Q

define enucleation

A

remove entire cystic lesions without rupture

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12
Q

what allows a cleavage plane between lesion and bony cavity during enucleation

A

fibrous connective tissue

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13
Q

indication for enucleation

A

any cyst that can be removed in entirety and safely without harming adjacent structures

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14
Q

how would you treat a dentigerous or PA cyst

A

enucleation

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15
Q

advantages of enuc

A

history examination of entire cystic wall

initial biopsy/treatment is curative in certain situations

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16
Q

disadvantages of enuc

A

possible pathologic fracture

devitalization of teeth

injury to nerve

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17
Q

enuc technique

A

access

aspirate

use largest curette

visualize bony cavity for soft tissue remnants

smooth bony margins/obtain water tight primary closure

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18
Q

what type of curette/how should you use curette for enuc

A

largest curette that defect will allow

cleavage plane
concave surface toward bone

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19
Q

post op for enuc

A

modify diet/activity

OHI

panorex every 6 mos

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20
Q

how long will it take for bony fill after enuc, will this bone recontour over time?

A

6-12 mos

yes it will recontour

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21
Q

E&C steps

A

enucleate cyst

remove 1-2 mm of bone with burs on entire periphery of cavity

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22
Q

is outcome better with mechanical (burs) or curette during e&c

A

you can use curette aggressively, but burs are more effective

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23
Q

e&c indications

A

aggressive cyst with high recurrence (OKC)

secondary surgery after recurrence when 1st surgery (enucleation) was deemed curative

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24
Q

advantage of e&c

A

gets rid of all epithelial remnants, decreasing chance of recurrence

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25
Q

disadvantage of e&C

A

damage to neurovascular bundle

dental pulps stripped

26
Q

define marsupialization

A

open a cystic lesion and maintain latency to an adjacent cavity

decreases intracystic pressure (cyst shrinks, bone fills)

27
Q

what are examples of spaces that you can leave patency to during marsup

A

oral cavity, max sinus, nasal cavity

28
Q

is marsup a final treatment

A

not usually, normally have to enucleate later

29
Q

marsup indications

A

adjacent vital structures at risk with enuc

difficult surgical access to all portions of cyst (increasing recurrence)

medical compromise

30
Q

marsup advantages

A

simple to perform

spare vital structuers

either completely resolves lesion or makes it much smaller and easier to treat

31
Q

marsup disadvantages

A

can’t histo examine the entire cystic wall (stuff you leave behind might be more aggressive)

patient inconvenience with home care

occasional secondary infections

32
Q

marsup technique

A

aspirate
1 cm elliptical incision in soft tissue

create bony window

piece of cystic lining removed and submitted for path

cystic contents evacuated

keep window into cyst patent

33
Q

marsup: thick cystic lining?

A

to keep window open, suture to oral mucosa

34
Q

marsup: thin, friable cystic lining?

A

to keep window open, pack cavity for 10-14 days to prevent oral mucosa from healing over

35
Q

post op for marsup

A

pt responsible for irrigating cystic cavity

cavity might get infection

routine follow up with radiographs

36
Q

how long do you leave cavity open during marsup

A

until goals for choosing marsup have been met

37
Q

why do you marsup before enucleation in some cases

A

allow time for bony coverage of vital structures

increases strength of jaw

38
Q

indications for decompression

A

concern for injury to adjacent strucrures

size of lesion

marsup alone does not resolve

need to examine entire lesion histopatholgically

39
Q

advantages of decompression

A

thickened cyst lining

reduces morbidity, accelerates complete healing

(all the other same as marsup alone)

40
Q

disadvantages of decompression

A

same as marsup

41
Q

periodical cyst tx

A

remove underlying process (RCT or ext)

enucleate +/- curettage

abx if needed

42
Q

residual cyst tx

A

e&c

43
Q

dentigerous cyst tx

A

ext of affected tooth

e&c

if larger, consider decompression

44
Q

OKC tx

A

e&c with potential extraction

if large, consider decompression

45
Q

lateral periodontal cyst tx

A

enucleation with preservation of tooth

46
Q

glandular odontogenic cyst tx

A

e&c

some advocate resection

47
Q

calcifying odontogenic cyst (gorlins) tx

A

e&c

48
Q

epithelial jaw tumors (4)

A

ameloblastoma
adenomatoid odontogenic tumor
calcifying epithelial odontogenic (pindborg)
squamous odontogenic tumor

49
Q

mixed jaw tumors (3)

A

ameloblastic fibroma
ameloblstic fibroma-odontoma
odontoma

50
Q

ectomesenchymal jaw tumors (3)

A

odontogenic fibroma
odontogenic myxoma
cementoblastoma

51
Q

which has poorer prognosis: tumor in mx or mn

A

maxilla due to undetected growth

52
Q

t/f: tumors within bone have a better prognosis

A

true

53
Q

indications for E&C jaw tumors

A

slow growing, non aggressive tumors

most odontogenic tumors

medically compromised

54
Q

types of tumors tx with E&C

A

odontoma

ameloblstic fibroma/fibro-odontoma

AOT

cementoblastoma

odontogenic fibroma

55
Q

indications for resection for tx of jaw tumors

A

aggressive lesions either by histopath/clinical behavior

tumors that would be difficult to remove in entirety/by e&c alone

56
Q

types of jaw tumors indicated for resection

A

ameloblastoma

myxoma

CEOT

squamous odontogenic tumor

57
Q

resection technique

A

lesion is removed with a 1 cm margin of uninvolved tissue

58
Q

marginal resection

A

maintains continuity at inferior border

59
Q

segmental resection

A

full thickness portion removed

60
Q

total resection

A

remove entire jaw

LAST ACTUAL FINAL (2 decks)

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