BASIC SURGICAL TECHNIQUE Flashcards
what are the three main basic principles of oral survey techniques?
- Good risk assessment
- Aseptic technique
- Minimal trauma to hard & soft tissues
What are the stages of surgery?
- anaesthesia
- access
- bone removal (as necessary)
- tooth division (as necessary)
- debridement
- suture
- achieve haemostasis
- post-op instructions
- post-op medications
What is the most pre-op part of surgery?
CONSENT
- verbal & written consent
What is in place to ensure maximum safety of the patient during the procedure?
Pre-Op Surgical Checklist
- check patients name & DOB
- check the patient knows procedure
- check which tooth is being extracted
- ensure post-op instructions given
When raising a gingival flap, what is the goal?
Maximal access with minimal trauma
- (big flaps heal just as quickly as small flaps & makes it easier to see!!)
When achieving surgical access, what are some important to maintain health of tissue?
- Wide-based incision circulation
- Use scalpel in one firm continuous stroke
- No sharp angles
- Flap reflection should be down to bone & clean
- Keep tissue moist
Why is it important to avoid causing trauma to dental papillae?
The dental papillae will shrink after surgery causing black triangles
When raising a 3-sided flap, what must you ensure with the initial incision?
It should lie more bucally as opposed to lingually
What is used to remove bone during a surgical extraction?
Electrical straight handpiece with saline cooled bur (MOTOR DRIVEN, NO AIR)
What type of burrs are used for removal of bone?
Round or fissure tungsten carbide burs
Why are air driven handpieces avoided during oral surgery?
Drives air into the tissues known as SURGICAL EMPHYSEMA (can be life threatening)
If the tooth will not come out of the socket, what can you do to try & achieve this?
Divide the tooth (number of pieces dependant on roots of tooth)
What are the principles of use when using elevators?
- Avoid excessive force
- ALWAYS support the instrument to avoid injury to patient/operator (dont use adjacent tooth as support)
- Ensure applied force is away from major structures
- Always use elevators under direct vision
- Keep them sharp
What are the uses of elevators in oral surgery?
- Provide a point of application for forceps
- Loosen teeth prior to applying forceps
- Extract tooth without use of forceps
- Removal of roots/root stumps/retained roots/root apices
What are the three main actions of elevators?
- Wheel & axle
- Wedge
- Lever
What are the main modes of debridement used in oral surgery?
- Physical
- Irrigation
- Suction
How is physical debridement carried out?
- Bone file or handpiece to remove bony sharp edges
- Mitchell’s trimmer or Victoria curette to remove soft tissue debris
How is irrigation debridement carried out?
Sterile saline into socket and under flap
How is suction debridement carries out?
Aspirate under flap to remove debris
What are the 2 types of sutures used in oral surgery?
- Non-Absorbable
- Absorbable
At what area on suture needles do you hold them with the forceps?
on the body (shaft)
How can you achieve haemostasis peri-operatively?
- Pressure!
- LA with vasoconstrictors
- Artery forceps (rare)
- Diathermy (seal off blood vessels)
- Bone wax (packed into parts of bone that are bleeding)
What nerve is at risk when raising mandibular molar flap?
Lingual nerve
What nerves can be damaged during removal of third molars?
- lingual
- inferior alveolar
- mylohyoid
- buccal
What are the aims of peri-radicular surgery?
- establish a root seal at the apex of a tooth or at the point of perforation of a lateral perforation
- remove existing infection
What can be used to cut PDL to reduce trauma during tooth extraction?
Peristome
What are the three basic modes of action/mechanical principles for tooth elevation?
- wheel & axle (rotation)
- lever
- wedge
What elevator is good for removal of wisdom teeth?
Warwick James elevators
