Basic Surgical Technique Flashcards
Stages of surgery
Anaesthesia
Access
Bone removal as necessary
Tooth division as necessary
Debridement
Suture
Achieve haemostasis
POIG
Post op meds
Surgical access
Maximal access with minimal trauma
Bigger flaps heal just as quickly
Preserve adjacent soft tissues
Consider post operative aesthetics
Key points of surgical access
Wide based incision
Scalpel used in one firm continuous stroke
No sharp angles
Minimise trauma to dental papillae
No crushing
Tissue most
Ensure flap margins will lie on sound bone
What happens if wounds are closed under tension
Suturing will burst, flap should be passive
What instruments are used for soft tissue retraction
Howarth’s periostel elevator
Or
Rake retractor
What instrument used for bone removal
Electrical straight hand piece with saline cooled bur with round or fissure tungsten burs
Why should normal handpiece not be used
Air driven handpieces may lead to surgical emphysema
Three basic actions of elevators
Wheel and axle
Wedge
Lever
Elevator uses
To provide point of application for forceps
Loosen teeth
Extract tooth
Removal of multiple root stumps, roots or apices
Three types of debridement
Physical
Bone file or handpiece for bony edges
Mitchell’s trimmer or Victoria curette for soft tissues
Irrigation
Sterile saline into socket and under flap
Suction
Aims of suturing
Compress blood vessels
Reposition tissues
Cover bone
Prevent wound breakdown
Achieve haemostasis
Encourage healing
Two types of sutures
Non absorbable
Absorbable
Non absorbable suture
If extended retention periods required
Must be removed postoperatively
Closure of OAF or exposure of canine tooth
Absorbable sutures
Holds tissue edges together temporarily
If removal of suture not possible/desirable
Breakdown via absorption of water into filaments> polymer degradation
No review?
Polyfilament vs monofilament
Poly- several twisted together, easier to handle, prone to wicking
Mono- single strand, pass easily through tissue, resistant to bacterial colonisation
