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Oral Surgery Exam > Exam 1 (Lectures 1-6) > Flashcards

Exam 1 (Lectures 1-6) Flashcards

1
Q

average formation of 3rd molar formation is ____

A

20-24 years

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2
Q

pathognomic indicating md fracture

A

sublingual hematoma

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3
Q

cleft lip with or without cleft palate is the failure of fusion between the

A

median nasal process and the maxillary process

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4
Q

osteomyelitis results in

A

ischemia and bone necrosis

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5
Q

skeletal defiency secondary to oligodontia

A

ectodermal dysplasia

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6
Q

option for intrusion

A

allow passive eruption (deciduous teeth) orthodontic traction stabilize 2-3 months

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7
Q

Name six indications for orthognathic surgery

A

skeletal discrepancy with masticatory difficulty impingement on palatal tissue speech difficulty OSA psychosocial problems esthetics

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8
Q

what procedure has low morbidity

A

Lefort 1

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9
Q

limited correction is possible for this type of movement

A

growth redirection

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10
Q

open apex of avulsed teeth (<2 hours) (7) steps KNOW FOR CLINIC

A
  1. reimplant immediately 2. transport in Hanks soln or milk 3. Doxycycline 4. LA, socket irrigation, Tetanus 5. Replant 6. Splint for 7-10 days 7. Apexification (Ca(OH)
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11
Q

why do we close in layers

A

to eliminate dead space

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12
Q

position of 3rd molars does not change substantially after _____

A

25 years

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13
Q

non-surgical treatment of fractures is indicated in which situations

A

fractures without malocclusion and a compliant patient

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14
Q

are vertical impacted md 3rds easy or hard according to winter’s classification?

A

generally easy

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15
Q

which type of healing has a little bit of movmenets

A

secondary healing

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16
Q

closed reduction requirements

A

good teeth

favorable fracture

min-mod displacement

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17
Q

palatal repair of cleft palate patients should be done when

A

12 months

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18
Q

velopharyngeal flap helps eliminate _____

A

nasal speech

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19
Q

the role of age in third molar surgery

A

  Surgery less complicated §  Healing process quicker

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20
Q

if pt has a fractured mandible they will have

A

malocclusion

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21
Q

attaches part of soft palate to posterior wall of pharynx

A

velopharyngeal flap

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22
Q

periodontal compromise

A

orthodontic camouflage

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23
Q

in orthognathic surgery what does the stent determine

A

AP and transverse

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24
Q

how long can an avulsed tooth last in milk

A

six hours

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25
Q

incidence of cleft lip with or without palate in african-american

A

1:2000

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26
Q

full bony impaction of 3rd molar

A

D7240

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27
Q

area between the mental foramina

A

symphysis

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28
Q

what winter’s classification is this

A

mesioangular

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29
Q

vertical maxillary deficiency

A

class 3

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30
Q

posterior to canine and anterior to mental foramen

A

parasymphysis

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31
Q

<2 hours closed apex tx of avulsed teeth

A
  1. Store in hank’s solution 2. Replant 3. Splint for 7-10 days 4. Perform endodontic cleansing and shaping of canal 5. fill canal with Ca(OH)2 (6-12 months) 6. perform gutta percha obturation (6-12 months)
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32
Q

fusion of facial structures occur at what week

A

week 7

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33
Q

how often do vertical impacted md 3rds occur (winter’s classification)

A

38%

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34
Q

disadvantages of extraoral approach for surgical

A

external scar

potential for facial n. damage

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35
Q

surgical procedures for mx

A

maxilla anterior segment, posterior segment, Lefort 1, high lefort 2 and 3

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36
Q

Principles of Management for Fractures

A
  1. Reduction
  2. Stabilization
  3. Immobilization
  4. Prevent Infection
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37
Q

why does osteomyelitis occur

A

Smokers
End-stage process of long wound healing
Immunocompromised

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38
Q

dentition used as the handle to reduce the fracture

A

closed reduction

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39
Q

orthognathic movements on cleft palate patients have to use what

A

distraction

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40
Q

big advantage of a BSSO (Saggital Split Ramus Osteotomy)

A

can advance the jaw without doing a bone graft

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41
Q

pt’s occlusion and teeth then wired together

A

maxillo-mandibular fixation

in closed reduction

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42
Q

fracture of the cheekbone

A

zygomaticomaxillary complex ZMC

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43
Q

most commonly selected time for alveolar bone graft for cleft lip/palate

A

mixed dentition grafting

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44
Q

what winter’s classification is this

easy or difficult?

A

horizontal

difficult

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45
Q

TMJ considerations for this type of movement

A

growth redirection

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46
Q

Class 2 bites have what percent occurrence

A

10%

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47
Q

what winter’s classification is this

A

vertical

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48
Q

which type of healing has no movements

A

primary healing

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49
Q

lacerations tx

A

return tissue to proper orientation

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50
Q

Class 2 bites need surgery what % of times

A

2%

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51
Q

Subperiosteal Abscess
occurs when

A

2 – 3 weeks post op

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52
Q

metallic sound upon percussion

A

intrusion

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53
Q

AAOMS / OMSF

•  7 year study

•  Advised that even most 3rds that are asymptomatic
and free of disease are at

A

Advised that even most 3rds that are asymptomatic
and free of disease are at risk for chronic oral infections

tooth decay and should be considered for removal in young adulthood

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54
Q

impacted/unerupted. FIll in blank Not all __________ teeth are ______

A

unerupted/impacted

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55
Q

high mortality rate and brain trauma resulting from this fracture

A

LeFort 3

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56
Q

extraction technique for mx third molars

A

Flap design

•  Approach

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57
Q

Name four advantages of orthognathic surgery

A

decreased treatment time improved esthetics improved occlusion increased esthetics

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58
Q

Based on inclination of impacted tooth to long axis of 2nd molar

A

Winter’s Classification

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59
Q

what is the easiest winter’s classification

A

mesioangular

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60
Q

Bleeding:
Intraopeatively from 3rd molar extractions

A

give local, bone wax, Gelfoam, Surgicel, pressure pack if needed

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61
Q

velopharyngeal flap complications

A

mouth breathing, OSA, complicates intubation for surgery

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62
Q

incidence of isolated cleft palate

A

1:2000

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63
Q

reimplanted tooth (mature) stabilization periods

A

7-10 days

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64
Q

tx of abrasions

A

DEBRIDEMENT 1) scrub with mild soapy water/irrigate with saline 2) cover with thin antibiotic ointment

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65
Q

advancement of set back of mandible

A

BSSO bilateral saggital split osteotomy

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66
Q

in orthognathic surgery the vertical position is determined by what

A

k-wire placed in the nasion

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67
Q

fratures involving upper, middle, and lower face

A

panfacial trauma

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68
Q

Treatment options for facial fractures

A

No treatment

Closed Reduction

Open Reduction with rigid internal fixation

Combination

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69
Q

what % of time does distoangular classifications occur for md molars

A

6%

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70
Q

general facial form is defined by what

A

Na-A-pg form

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71
Q

convex profile is usually what

A

skeletal and dental class 2

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72
Q

complex, full bony impaction of 3rd molar

A

D7241

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73
Q

fractures of medial orbital walls

A

ethmoid fractures

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74
Q

class 3 bites have what percent occurrence

A

2.5%

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75
Q

crown formation of thirds

A

14 years

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76
Q

frontal sinus fractures can lead to

A

brain abscess

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77
Q

continuous bleeding may lead to

A

hematoma

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78
Q

in cleft lip with or w/out cleft palate the lip/alveolous is contiguous without any

A

vestible

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79
Q

theories behind impacted thirds

A

Differential root growth between mesial & distal •  Inadequate arch space •  Dental development lags skeletal development •  Obstruction secondary to cyst, tumor, supernumerary teeth

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80
Q

mesioangular impacted md 3rds occur what % of time

A

43%

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81
Q

how to manage thirds in pt >40 yrs

A

Monitor with panoramic x-ray every 1-2 years

•  Surgical intervention for clinical symptoms or
radiographic signs

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82
Q

secondary to ____________, _______ remains open during speech and ______

A

velopharyngeal incompetence, nasal airway remains open during speech and air escpaes

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83
Q

treatment for extrusion and lateral displacement

A

reposition tooth fully at socket splint tooth for 1-3 weeks

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84
Q

move maxilla in all planes

A

Lefort 1

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85
Q

classify this

A

distoangular impaction of mx third molar

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86
Q

INTRAOPERATIVE COMPLICATIONS
•  Sinus Perforation what to do?

A
  •   Sinus Perforation
  •   Antibiotic
  •   Decongestants
  •   Afrin nasal spray
  •   Written & verbal instructions

•  Suture tight

•  Follow-up
(ADAWSF)

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87
Q

tooth not having perforated the oral muocsa

A

unerupted tooth

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88
Q

what has shown to remove 100% of the cpap in patients

A

maxillo mandibular advancements

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89
Q

recovery period of 3rd molar extractions

A

3-4 days

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90
Q

how long can an avulsed tooth last in Hanks solution

A

24 hours

91
Q

chief complaint of pts who have md fracture

A

malocclusion

92
Q

may not be stable when used for anterior open bite

A

BSSO (bilateral saggital split osteotomy) BSSO

93
Q

fracture common in fights

A

ZMC complex

94
Q

what makes the cleft palate patient different?

A

large maxillary AP defiencies scar tissue VP incompetence vascular compromise palatal and nasolabial fistulas

95
Q

stable treatment of anterior open bite

A

Lefort 1

96
Q

incidence of cleft lip with or without palate in whites

A

1:1000

97
Q

Alveolar fractures treatment

A

stabilization, reduction, RCT

98
Q

residual _______ at _______ and in _______ is common in palate repair

A

residual fistula at anterior of palate and in vestible is common

99
Q

what bacteria are we considered about in animal bites

A

pasteurella multocida (gram-negative rod)

100
Q

root fracture stabilization periods

A

2-4 months

101
Q

compression fracture of alveolus to accomodate new position

A

intrusion

102
Q

opposite movement of pre-surgical orthodontics

A

orthodontic camouflage

103
Q

what symptoms are associated with osteomyelitis

A

imflammation and edema

104
Q

pt has grossly displaced md fracture what tx to use?

A

open reduction with internal fixation (ORIF)

105
Q

lacerations management

A

cleaning/debridement/hemostasis/closure

106
Q

what winter’s classification is this

A

distoangular

107
Q

failure to fully erupt within the expected developmental time period

A

impacted tooth

108
Q

painful, owing to exposed nerve endings

A

abrasions

109
Q

classify this

A

mesioangular impaction of maxillary third molar

110
Q

Ideal Patient Selection for 3rd molar removal (5)

_____ root formation

______age

+ 3 others

A

2/3RD root formation

  •   18-25 year old
  •   Healthy
  •   No psychological contraindications
  •   No job restrictions to “numb lip”
111
Q

dentition is used as a handle to reduce the fracture

A

closed reduction

112
Q

between sigmoid notch and the top of the condylar head

A

condyle

113
Q

what type of movement has a possible periodontal compromise

A

orthodontic camouflage

114
Q

T or F

Most healthy 3rd molar patients benefit IVSA / GA

A

true

115
Q

for minimal discrepancy

A

orthodontic camouflage

116
Q

Nerve Injury

A
  •   Nerve Injury
  •   Follow
  •   Document, document, document
  •   Steroid dose pack
  •   Neurosensory testing
  •   When to refer?
  •   Malpractice
117
Q

results in multiple fractured segments

A

comminuted fracture

118
Q

extraoral approach for surgical approach

A

excellent access for reduction/fixation

119
Q

pt has facial fracture and has lung disease

A

open reduction with internal fixation (ORIF)

120
Q

Midface Fractures

A

LeFort 1,2,3

ZMC, ZOE

121
Q

partial bony 3rd molar impaction

A

D7320

122
Q

intraoral surgical approach disadvantages

A

oral contamination

fracture reduction can be difficult to reduce

123
Q

what is noticed with chronic osteomyelitis

A

> 1 month
Dull discomfort
Paresthesia
Moth eaten appearance of bone on film

124
Q

how common are mesioangular mx 3rd winter’s classifications

A

12%

125
Q

how common are horizontal mx 3rd winter’s classifications

A

1% -rarely seen

126
Q

most frequently used md procedure

A

BSSO (bilateral saggital split osteotomy)

127
Q

removes papillary dermis and epithelial layer

A

abrasions

128
Q

how common are distoangular mx 3rd winter’s classifications

A

25%

129
Q

when should lip repair be done in cleft palate/lip patients

A

Rule of ten

pt is 10lbs

WBC<10

HG>10

10 weeks

130
Q

what percentage of BSSO patients have IAN nerve damage

A

50%

131
Q

classification of soft tissue 3rd molar impaction

A

D7220

132
Q

between sigmoid notch and angle

A

ramus

133
Q

how often does horziontal md molar 3rd impactions occur

A

3%

134
Q

possible esthetic compromises

A

orthodontic camouflage

135
Q

allows segmentalization of maxilla

A

Lefort 1

136
Q

whole part of midface is fractured, most severe

A

LeFort 3

137
Q

what to do for bleeding vessels

A

clamp/tie/cauterize

138
Q

how long does post-surgical orthodontics take

A

6 months

139
Q

in mixed dentition graft in cleft lip/palate patients and lateral incisor is absent or pt is small or cleft is large, ___

A

delay until later

140
Q

what tooth is functionally missing in cleft lip/palate patients and what %

A

80% lateral incisor

141
Q

expose fractures and use direct visualization and dentition to manipulate segments into place then fixate with plates and screws

A

open reduction with internal fixation (ORIF)

142
Q

POSTOPERATIVE COMPLICATIONS
•  Secondary bleeding

A

Suction oral cavity

•  Examine site

  •   Apply pressure for 5 minutes
  •   Local
  •   Curettage
  •   Identify and control source of bleeding
  •   Monitor for 15 minutes before discharge
143
Q

bone healing in the wrong position

A

malunion

144
Q

stabilization periods for displaced tooth

A

3-4 weeks

145
Q

Contraindications to removal of 3rd molars

A

Extremes of age:
Yo u n g a g e : mandible may grow to accommodate 3rd molars Old age: most common contraindications for removal

146
Q

tx for pasteruella multocida

A

augmentin po for 7 days

147
Q

what is problem in speech evaluation of cleft lip/palate patients

A

nasal speech

148
Q

rarely need for intermaxillary fixation (wiring of the teeth together)

A

orthognathic surgery

149
Q

class 3 bites need surgery what percentage of time

A

40%

150
Q

pt has facial fracture and has seizures what treatment to use

A

open reduction with internal fixation

151
Q

direction of the fracture line is different then the muscle line

A

favorable

152
Q

classify this

A

vertical impaction of maxillary third molar

153
Q

how long is maxillo-mandibular fixation needed for in closed reduction

A

4-8 weeks

154
Q

layers of the lip

A

1) muocsa 2)orbicularis oris-muscle 3) skin

155
Q

incidence of cleft lip with or without cleft palate with male and females

A

male: female 2:1

156
Q

regions involved in panfacial trauma

A

frontal bone

ZMC
NOE region

maxilla and mandible

157
Q

how long does pre-surgical orthodontics take

A

12-18 months

158
Q

mandibular intraoperative complications of 3rd molar removal

A
  •   Root tip out lingual plate
  •   Submandibular, lingual
  •   Nerve injury
  •   Fracture
159
Q

indications for 3rd molar removal

A

Indications for 3rd molar removal

Therapeutic
To treat a currently active process/disease
Prophylactic
To prevent future disease or other problems

160
Q

what type of movement has a possible esthetic compromise

A

orthodontic camouflage

161
Q

incomplete fracture

A

greenstick

162
Q

how common are vertical mx 3rd winter’s classifications

A

63%

163
Q

possibly less stable

A

orthodontic camouflage

164
Q

name the maxilary winter’s classification

A

vertical

distoangular

mesioangular

horizontal

165
Q

must have remaining growth to work

A

growth redirection

166
Q

what may improve speech evaluation/therapy in cleft palate/lip patients

A

velopharyngeal flap

167
Q

stable rigid fixation possible

A

BSSO (bilateral saggital split osteotomy) BSSO Lefort 1

168
Q

a callous/cartilage involves which phase of healing

A

secondary phase

169
Q

which trauma to tooth has the worst prognosis

A

intrusions

170
Q

maxilary intraoperative complications of oral surgery

A

Infratemporal fossa
•  Tuberosity “tuberectomy”
•  Oroantral communication

171
Q

what is used for large AP discrepancies

A

distraction

172
Q

fracture line is allowing the bones to be displaced

A

unfavorable

173
Q

where are incisions made for orthognathic surgery

A

intraoral

174
Q

what to expect after 3rd molar surgery as far as pain/swelling

A

Expected mild-moderate pain

•  Expected mild-moderate swelling to peak at day 3 and
decrease after

•  Expected to feel lousy – dental surgery – makes talking,
eating, and social situations hard for a few days

175
Q

tx of subperiosteal abscess

A

Flap and irrigate • Antibiotics

176
Q

has potential for iAN nerve damage

A

bilateral saggital split osteotomy (BSSO)

177
Q

reimplanted tooth (immature)

A

3-4 weeks

178
Q

combined orthodontics and surgery are used to manage a skeletal malocclusion

A

orthognathic surgery

179
Q

incidence of isolated cleft palate in females: males

A

2:1

180
Q

single fracture line

A

simple fracture

181
Q

vertical maxillary hyperplasia

A

class 2

182
Q

stabilization periods for mobile tooth

A

3-4 weeks

183
Q

accentuate dental compensations

A

orthodontic camouflage

184
Q

bleeding under the skin

A

contusion

185
Q

what is the critical driving force in cleft palate repair

A

speech

186
Q

odontogenic bacteria invade bone marrow describes what process

A

osteomyelitis

187
Q

communication with the external environment

A

compound fracture (open)

188
Q

what percentage of patients are happy with BSSO even with IAN numbness

A

90%

189
Q

concave profile is usually what

A

skeletal and dental class 3

190
Q

advances the anterior pharyngeal palate and enlarges the mandible

A

maxillo-mandibular advancement

191
Q

◦ ____moved the envelope of discrepancy further out for the dental movements

A

TAD

192
Q

pyramidal fracture bc of shape

involving orbit

A

LeFort 2

193
Q

how long can an avulsed tooth last in ViaSPan

A

a week

194
Q

abrasions leaves what exposed

A

raw bleeding reticular dermis

195
Q

lacerations are a tear in what

A

epithelial and subcutaneous tissue

196
Q

just the fracture of the maxilla

A

LeFort 1 fracture

197
Q

patients occlusion established and teeth are then wired together

A

maxillo-mandibular fixation

198
Q

Three ways to treat skeletal malocclusion

A
  1. Growth Redirection 2. Orthodontic Camouflage 3. Orthognathic Surgery
199
Q

first treatment of avulsed tooth

A

put it back

200
Q

straight profile is usually what

A

skeletal and dental class 1

201
Q

indicating of a fractured mandible

A

floor of mouth hematoma

202
Q

what systemic problems are seen in cleft lip/palate patients

A

middle ear disease

cardiac disease

203
Q

Collection of purulence between periosteum of flap and
bone

A

Subperiosteal Abscess

204
Q

intraoral surgical approaches benefits

A

no external scar

no f. nerve damage

205
Q

what three signs are noticed with acute OM

A

Duration < 1 month
Pain
Minimal to no radiographic
changes

206
Q

root formation is approximately ____ by _____ years

A

Root Formation approximately 50% by 16 years

207
Q

compliance and burnout are possible for this type of movement

A

growth redirection

208
Q

pt has a condylar fracture

A

open reduction with internal fixation (ORIF)

209
Q

not healing, bone segments are still moving

A

nonunion

210
Q

in mixed dentition grafting if lateral incisor is present, consider grafting ____

A

early

211
Q

name the 4 winter’s classification

A

•  1. Mesioangular •  2. Distoangular •  3. Horizontal •  4. Vertical

212
Q

purpose of stannous fluoride in a RCT

A

prevents root resorption

213
Q

purpose of citric acid in a root canal

A

disinfects dentinal tubules

214
Q

stabilization period for mobile tooth

A

3-4 weeks

215
Q

stabilization periods for displaced tooth

A

3-4 weeks

216
Q

stabilization periods for roor fracture

A

2-4 months

217
Q

stabilization periods for reimplanted tooth (mature)

A

7-10 days

218
Q

stabilization periods for reimplanted tooth immature

A

3-4 weeks

219
Q

blunt trauma can cause this type of injury

A

contusion

220
Q

subcutaneous or submucosal hemorrhage wihtout breakage of the soft tissue

A

contusions

221
Q

treatment of contusions

A

surgical exploration if arterial involvement is involved

antiobiotic if contaminated

222
Q

removes epithelial layer and papillary dermis

A

abrasions

223
Q

soaps which enter a wound can cause

A

cellular damage and necrosis

Oral Surgery Exam (1 decks)

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