Chapter 56: Oral and Maxillofacial Surgery Flashcards

1
Q

Indications for Oral and Maxillofacial Surgery

A
  • Extraction of decayed teeth that cannot be restored
    -Surgical removal of impacted teeth
  • Extraction of nonvital teeth
    -Preprosthesis surgery to smooth and contour the alveolar ridge
  • Removal of teeth for orthodontic treatment
  • Removal of root fragments
    -Removal of cysts and tumors
  • Biopsy
  • Treatment of fractures of the mandible or maxilla
  • Corrective jaw surgery
  • Surgery of the temporomandibular joint
  • Reconstructive surgery
  • Cleft lip and cleft palate repairs
  • Salivary gland surgery
  • Surgical implant procedures
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2
Q

Surgical procedures are invasive and in-depth, requiring the surgical assistant to have advanced knowledge and skill in:

A
  • patient assessment & monitoring

-use of specialized instruments

-surgical asepsis

-surgical procedures

-pain control techniques

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3
Q

Surgical Assistant’s Role in Oral Surgery

A

• Review patient record
• Have necessary consent forms signed
• Verify any information requested from the patient’s physician has been received.
• verification of final fabrications with dental lab
• surgical setups are prepared and sterilized.
• Contact the patient and provide preoperative instruction
• Instruct patient to have someone drive him or her and stay during the procedure.

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4
Q

Treatment Room Preparation

A

• placing protective barriers
• Keeping surgical instruments in their sterile wraps until ready for use.
• pain control medications ready for administration
• postoperative instructions fot the patient.

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5
Q

Surgical procedures are accomplished in two types of settings:

A

private dental practice
hospital or outpatient surgical suite.

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6
Q

room in a private practice that resembles an operating room, but on a much smaller scale

A

surgical suite

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7
Q

The patient who is receiving surgical care from an OMFS in an office setting is considered as having ____ surgery and is seen as an outpatient.

A

minor

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8
Q

specific items used only for surgical procedures in a private dental practice

A

-monitoring equipment
-mobile trays
- pain control units

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9
Q

To acquire permission from a hospital to use its clinical facility, the oral surgeon must apply for privileges to practice at an institution.

The hospital will then grant privileges to the oral surgeon based on his or her training, competency, and reference.

T or F

A

True

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10
Q

The environment is spacious enough to accommodate :

A

(1) operating table
(2)anesthesiology equipment
(3) mobile surgical trays, holding instruments, and supplies
(4) overhead lighting
(5) monitoring equipment
(6) standing room for the surgeon, surgical assistant, roving assistant, and anesthesiologist

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11
Q

_____ instruments are designed to separate the tooth from the socket, retract surrounding tissue, loosen and elevate the tooth within the socket, or extract the tooth from the socket

A

surgical

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12
Q

reflects (separate) and retract the periosteum from the surface of the bone.

Before a surgical forcep is placed around the tooth, the dentist uses a this instrument to detach the gingival tissues from around the cervix (neck) of the tooth.

A

periosteal elevators

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13
Q

are used to apply leverage against the tooth to loosen it from the periodontal ligament and ease the extraction

additional uses include removal of residual root fragments and removal of teeth that have been sectioned with a surgical handpiece and bur.

A

straight elevators

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14
Q

are instruments used for the removal of root tips or fragments that may break away from the tooth during the extraction procedure

A

root tip pick

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15
Q

are used after the extraction to scrape the interior of the socket to remove diseased tissue or abscesses.

A

surgical curette

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16
Q

used to trim alveolar bone. It is widely used after multiple extractions to eliminate sharp projections and to shape the edentulous ridge.

A

rongeurs

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17
Q

used with a push-pull motion to smooth the surface of the bone after the rongeur has removed most of the undesirable bone.

Can also be used to smooth rough margins of the alveolus after an extraction

A

bone file

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18
Q

. The most commonly used scalpel blade for oral surgery is:

A

a #15 blade

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19
Q

a surgical knife used to make a precise incision into soft tissue with the least amount of trauma to the tissue.

A

scalpel

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20
Q

are multipurpose instruments used to grasp and hold things.

During oral surgery,this is used to grasp a vessel, soft tissue, bone, and tooth fragments that have been removed during the procedure

A

hemostat

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21
Q

looks and operates like a hemostat. The difference is that the beaks have a cross-pattern serration on the surface, allowing the surgeon to grasp a suture needle firmly

A

needle holder

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22
Q

The handles of surgical scissors range in length from approximately 3 1/12 to 6 1/4 inches.

These fragile scissors are used to trim soft tissue.

A

surgical scissors

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23
Q

are used during surgical procedures to handle soft tissue as carefully as possible to prevent trauma that may delay healing.

A

tissue retractors

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24
Q

A patient who is receiving nitrous oxide/oxygen, intravenous sedation, or general anesthesia should use a ____ ___ to prevent involuntary closure of the mouth.

A

mouth prop

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25
Q

When there is a need to remove or reshape bone, a _______ and _____ are used

A

surgical chisel
mallet

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26
Q

what is required for cooling when rotary instruments are used.

A

sterile saline water

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27
Q

Establishing and maintaining the chain of asepsis for a procedure requires that the instruments, surgical drapes, and gloved hands of the surgical team must be _____

A

STERILE

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28
Q

Contact with _____ objects or surfaces breaks the chain of asepsis and contaminates the surgical area.

A

non sterile

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29
Q

The purpose of chain of asepsis is:

A

minimize the number of microorganisms that can enter the wound

30
Q

this is prepared to hold surgical instruments and accessories that will be used during a surgery.

A

sterile field

31
Q

Sterile setups are prepared just before OR after assistants prepare themselves and begin a procedure?

A

before

32
Q

what is the purpose of a surgical scrub

A

lessens the chance of infection

33
Q

When assisting in an invasive procedure, what kind of gloves must you wear?

A

sterile gloves

34
Q

Forceps extractions are often described as “routine” or ____ extractions.

Use of these terms implies that the extraction can be completed without ____ instrumentation.

A

simple
extensive

35
Q

this type of extraction is performed on a tooth that is fully erupted and has a solid, intact crown that is grasped firmly with forceps.

A

forceps extraction

36
Q

Will “most” routine forceps extractions require placement of sutures?

A

no

37
Q

procedure that is indicated when a patient will be receiving a partial denture, a full denture, or implants.

A

multiple extraction

38
Q

When several teeth have been extracted within the same quadrant, the alveolar crest remains intact, and the surgeon must perform an
________ to contour and smooth the affected area.

A

alveoplasty

39
Q

when conditions require additional skill, knowledge, and instrumentation to remove a tooth. The extraction of an impacted tooth is an example of a this type of extraction

A

complex extraction

40
Q

a tooth that has not errupted

A

impacted tooth

41
Q

Indicates that the tooth is loacted under the gingival tissue

A

soft tissue impaction

42
Q

Indicates that the tooth is partially or toally covered by tissue and bone

A

hard tissue impaction

43
Q

a process by which tissue is removed and examined to distinguish malignant (cancerous) from nonmalignant (noncancerous) lesions in the oral cavity

A

biopsy

44
Q

most common biopsy procedures used in dentistry:

A

-exfoliative cytology

-incisional biopsy

-excisional biopsy

-fine needle aspiration.

45
Q

diagnostic procedure in which cells are scraped from a suspect oral lesion for analysis.

A

exfoliative biopsy

46
Q

is indicated when the lesion is larger than 1 cm in all dimensions.

The surgeon will remove a small sample of tissue from the lesion, along with some normal tissue to be used for comparison.

Complete surgical removal of the lesion is not performed until a final diagnosis of the type of lesion is made.

A

incisional biopsy

47
Q

involves removal of the entire lesion plus some adjacent normal tissue. This procedure is ideal for localized lesions.

A

excisional biopsy

48
Q

involves using a thin needle to remove a small sample of cells from the lesion

This procedure is ideal for nodules or a lump located intraorally and extraorally.

A

fine needle aspiration

49
Q

this type of tumour dictates immediate treatment by a qualified specialist.

A

malignant tumour

50
Q

these type of tumors and cysts are removed if their size and location interfere with appearance and normal function.

If they do not interfere and do not pose a risk to the patient, removal may be postponed

A

nonmalignant (benign) tumours

51
Q

As a rule, if a scalpel has been used, ____ are placed to control bleeding and promote healing.

A

sutures

52
Q

Suture material is available in ______ and ______ varieties.

A

absorbable
non absorbable

53
Q

most common types of ABSORBABLE suture materials are

A

plain catgut

chromic catgut

polyglactin 910

54
Q

Nonabsorbable suture materials include

A

-Silk
-Polyester fiber (one of the strongest sutures)
-Nylon

55
Q

Nonabsorbable sutures require the patient to return to the office for removal. This type of suture is usually removed _ to _ days after surgery.

A

5-7

56
Q

the most commonly placed suture technique for a single tooth socket.

A

Interrupted sutures

horizontal mattress sutures

57
Q

are used for suturing two or more papillae together

A

The mattress suture

figure-eight suture

58
Q

An important step when removing sutures is to prepare the area of the suture placement by preparing the surface site with a____ cotton-tip applicator and _____solution.

A

sterile

antiseptic

59
Q

Immediately after an extraction is performed, _________ is folded and placed over the socket to control bleeding and to promote clot formation and healing.

A

sterile 2x2 2 inch gauze

60
Q

instructions for patients to control BLEEDING

A

after leaving office, keep gauze pack in place for 30-45 mins

do not disturb clot with tongue

restrict strenous physical activity

61
Q

instructions for patients to control SWELLING

A

• During the first 24 hours, use a cold pack on a cycle of 20 minutes on and 20 minutes off.

• After the first 24 hours, apply external heat to the area of the face to enhance circulation in the tissues and to promote healing.

• After the first 24 hours, begin gently rinsing the oral cavity with warm saline solution (1 tsp salt to 8 oz warm water) every 2 hours to promote healing.

62
Q

types of pain control for a patient

A

It can be an over-the-counter type of analgesic, or it may require a prescription.

63
Q

Common Analgesics for Postextraction Pain

Mild Pain

A

• Ibuprofen
• Acetaminophen

64
Q

Moderate Pain Situations (by Prescription)

A

•Acetaminophen with codeine
• Hydrocodone

65
Q

Severe Pain Situations (by Prescription)

A

• Oxycodone (Percocet)

66
Q

why is the clot important in wound healing

A

it protects the wound and is later replaced by granulation tissue and ultimately bone.

67
Q

Failure of the healing process can result in
________ also known as a dry socket.

A

alveolar osteitis

68
Q

alveolar osteitis This painful condition can occur _ to _ days after removal of the tooth.

A

2-4

69
Q

alveolar osteitis may occur for the following reasons:

A

• Not caring for the extraction site as instructed
• Not following home care instructions
• Smoking, sneezing, coughing, spitting, or drinking from a straw within the first 24 hours
• Women who take oral contraceptives (may be more susceptible)

70
Q

Treatment of dry socket focuses on reducing symptoms, particularly pain.

Dry socket treatment may include the following:

A

flushing out socket

medicated dressings

pain meds

self care

71
Q

(dry socket treatment)

A surgical dressing as either a paste or saturated gauze strips with a medicated dressing that includes an antibacterial and topical anesthetic is packed into the socket for up to _ days, providing immediate relief for the patient.

A

5

72
Q

equipments and supplies for Performing a Surgical Scrub

A

• Orangewood stick
• Antimicrobial soap (such as chlorhexidine gluconate)
• Sterile surgical scrub brush
• Sterile disposable towels