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Oral Surgery > Basic Surgical Technique > Flashcards

Basic Surgical Technique Flashcards

1
Q

Stages of surgery (10)

A
  1. Consent
  2. Safety checklist
  3. Anaesthesia
  4. Access
  5. Bone removal as necessary
  6. Debridement/wound management
  7. Suture
  8. Achieve haemostasis
  9. Post op instructions + meds
  10. Follow up
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2
Q

When must we obtain written consent?

A

When tx involves conscious sedation or GA

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3
Q

how do we obtain surgical access?

A

Lifting a mucoperiosteal flap

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4
Q

What sits between the bone and the gum?

A

Periosteum

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5
Q

Why do we want a wide-based incision?

A

To allow the flap to maintain good circulation

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6
Q

What makes up a 3 sided flap?

A
  1. Distal relieving incision
  2. Crevicular incision around tooth
  3. Mesial relieving incision between 7 and 8
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7
Q

How should we position our distal relieving incision?

A

Bit more buccal so we dont damage lingual nerve

Follow the external oblique ridge of the mandible

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8
Q

What makes up an envelope flap? (2)

A
  1. Distal relieving incision
  2. Crevicular incision along gingival crevice
    - Extends midway along 7 or further
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9
Q

What instruments are used for soft tissue retraction (3)

A
  1. Ash
  2. Rake retractor
  3. Howarths periosteal elevator
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10
Q

Function of ash

A

Protecting and retracting lingual soft tissues

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11
Q

Function of rake retractor and howarths periosteal

A

Reflects light in and protects soft tissues/adjacent structures like nerves

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12
Q

Compare rake retractor to howarths periosteal

A

HOWARTHS - narrow + thinner

RAKE - reflects light + protects soft tissues

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13
Q

Why do we use electrical straight handpieces for bone removal instead of air driven?

A

Air driven may lead to surgical emphysema

  • driving air or gas underneath mucosa or skin
  • can lead to hospital admission
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14
Q

What major structures must we be wary of when using an elevator?

A
  1. Antrum - max sinus
  2. ID canal
  3. Mental nerve
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15
Q

Whats the exception for using the adjacent tooth as a fulcrum ?

A

Only if its to be extracted too

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16
Q

List some uses of elevators

A
  1. Loosen tooth before using forceps
  2. Extract tooth w/o forceps
  3. Removal of retained roots
  4. Removal of root apices
17
Q

3 ways that we can perform debridement following an extraction

A
  1. PHYSICAL
    - Bone file or handpiece to remove sharp bony edges
    - Mitchells trimmer or victoria curette to remove soft tissue debris
  2. IRRIGATION
    - Sterile saline into socket
  3. SUCTION
    - Aspirate under flap to remove debris
    - Check socket for retained apices
18
Q

Aims of suturing (5)

A
  1. Reposition of tissues
  2. Cover bone
  3. Prevent wound breakdown
  4. Achieve haemosasis
  5. Encourage healing by primary intention
19
Q

Different types of sutures

A

NON-ABSORBABLE

  • Removed post-operatively
  • used when need the wount to be supported + retained for a longer period of time

ABSORBABLE
- Hold tissue edges together temporarily

20
Q

What are monofilament sutures? (3)

A
  • Single stranded
  • Pass easily through tissue
  • Resistant to bacterial colonisation
21
Q

What are polyfilament sutures? (2)

A
  • Several filaments twisted together

- Easier to handle

22
Q

How is haemostasis achieved peri-operatively?

A
  1. LA with vasoconstrictor
  2. Artery forceps
  3. Diathermy
  4. Bone wax
23
Q

How is haemostasis achieved post-operatively?

A
  1. Pressure
  2. LA infiltration
  3. Diathermy
  4. Surgical
  5. Sutures
24
Q

What post op meds will patients take after an extraction?

A

Analgesia - ibuprofen + painkillers

Chlorrhexidine

25
Q

What nerves can be damaged from a surgical removal from 3rd molars (4)

A
  1. Lingual
  2. Inferior alveolar
  3. Mylohyoid
  4. Buccal
26
Q

List some complications of lower 3rd molar removal (7)

A
  1. Pain
  2. Swelling
  3. Bruising
  4. Bleeding
  5. Trismus
  6. Infection
  7. Dry socket
  8. Paraesthesia
27
Q

What is an excision of mucocele?

A

Flap based soft tissue procedure in removing a lump or sack of saliva (that is created in response to trauma) usually to the lower lip or from damage to the minor salivary glands

28
Q

What is an OAF? (2)

A

Communication from mouth into the sinus via an epithelial lined tract

Following the removal of an upper molar tooth which was close to the floor of the max sinus

29
Q

Function of peri-radicular surgery

A

Establish a root seal at the apex of the tooth/at the point of perforation, to remove existing infection

30
Q

What flap is used most commonly for periradicular surgery? (2)

A
  1. Triangular

2. Rectangular

31
Q

Why is a semilunar flap not as popular anymore?

A
  1. Reduced access
  2. Only good for apical lesions
  3. Scarring
32
Q

Post-op review (3)

A
  1. Review + ROS at 1 week
  2. Post op radiographs between 1-6wks
  3. Further review 3-6mths later
33
Q

List some reasons for failure (4)

A
  1. Inadequate seal
  2. Inadequate support
    - Perio pockets
    - Occlusal overload
    - Excessive root resection
  3. Split roots
  4. Soft tissue defect over apex post-op

Oral Surgery (6 decks)

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