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Oral Surgery BDS3 > Extraction Complications 4 > Flashcards

Extraction Complications 4 Flashcards

1
Q

what is an OAC

A

oral antral communication

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2
Q

what is an OAF

A

oral antral fistula

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3
Q

how do you diagnose an OAC

A

size of tooth
radiographic position of roots
bone at trifurcation
bubbling of blood
nose holding test
direct vision
good light and suction
blunt probe

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4
Q

what do you do if a small OAC happens

A

encourage clot
suture margins
post op instructions
possible antibiotic

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5
Q

what do you do if a large OAC happens

A

close with buccal advancement flap
antibiotics, decongestants and nose blowing instructions

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6
Q

how do you manage a chronic OAF

A

excise sinus tract
buccal advancement flap
buccal fat pad with advancement flap
palatal flap
bone graft/collagen membrane

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7
Q

how do you retrieve a foreign body from the antrum

A

flap design
open fenestration with care
suction
small curettes
irrigation or ribbon gauze
close like OAC

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8
Q

what is the caldwell luc approach for root in antrum retrieval

A

go in through buccal sulcus/buccal window

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9
Q

what is osteomyelitis

A

infection of the bone

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10
Q

what do patients experience in osteomyelitis

A

systemically unwell/raised temperature
extraction site tender
altered sensation due to pressure on IAN

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11
Q

what is the progression of osteomyelitis

A

begins in medullary cavity in cancellous bone and spreads to cortical bone and then periosteum
soft tissue inflammation
increased tissue hydrostatic pressure
compromised blood supply so soft tissue necrosis

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12
Q

why is mandible more likely to experience osteomyelitis

A

poorer blood supply and more likely to become ischaemic and infected

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13
Q

what are the major predisposing factors of osteomyelitis

A

odontogenic infections and fractures of mandible
compromised host defence

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14
Q

what does chronic osteomyelitis look like

A

bony destruction in area of infection
increased radiolucency on radiographs

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15
Q

in osteomyelitis, why would there be an increase in radiodensity surrounding the radiolucent area

A

bone production is increased as a result of inflammatory reaction

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16
Q

how do you treat osteomyelitis

A

medical and surgical treatment
investigate host defences with blood and glucose levels

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17
Q

what antibiotic is prescribed for osteomyelitis

A

penicillin

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18
Q

what is the surgical treatment for osteomyelitis

A

drain pus
remove non-vital teeth in area
remove loose pieces of bone
remove any wires/plates
remove bony cortex
excise necrotic bone

19
Q

who do you refer osteomyelitis people to

A

local OS or OMFS

20
Q

who is ORN seen in

A

patients who have received radiotherapy of head and neck to treat cancer

21
Q

what happens to the bone with ORN

A

bone becomes non-vital and causes endarteritis
turnover of remaining bone is slow
gets worse with time and dose

22
Q

what jaw is more commonly affected for ORN

A

mandible

23
Q

how do you prevent ORN

A

scaling/chlorhexidine before extraction
careful extraction technique
antibiotics, chlorhexidine and review
hyperbaric oxygen before and after extraction
take advice/refer patient for extraction

24
Q

what does hyperbaric oxygen do

A

increase local tissue oxygenation and vascular ingrowth to hypoxic areas

25
Q

how do you treat ORN

A

irrigation of necrotic debris
loose sequestra removed
hyperbaric oxygen

26
Q

what do bisphosphonates do

A

inhibit osteoclast activity and bone resorption and therefore bone renewal

27
Q

what is the ending of bisphosphonate drugs to class them all together

A

dronate

28
Q

what are the 2 ways to give bisphosphonates

A

oral and IV

29
Q

apart from bisphosphonates, what other drugs cause MRONJ

A

antiresorptive
RANKL inhibitors
monoclonal antibodies

30
Q

when does MRONJ occur

A

post extraction/following denture trauma/spontaneous

31
Q

when is MRONJ risk higher

A

in patients with IV bisphosphonates

32
Q

what drugs are cancer patients treated with

A

anti-resorptive
anti-angiogenic

33
Q

what drugs are osteoporosis patients treated with

A

anti-resorptive

34
Q

what are the risk factors for MRONJ

A

dental treatment
duration of bisphosphonate drug therapy
dental implants
concurrent medication
previous drug history
drug holidays

35
Q

how do you manage symptoms of MRONJ

A

remove sharp edges of bone/chlorhexidine mouthwash
prevent invasive treatment

36
Q

what are the 2 groups of patients that are grouped in MRONJ

A

initial management
continuing management

37
Q

what is actinomycosis

A

rare bacterial infection

38
Q

what does actinomycosis present like

A

multiple skin sinuses and swelling
thick lumpy pus

39
Q

what is treatment for actinomycosis

A

incision and drainage of pus accumulation
excision of chronic sinus tracts
excision of necrotic bone and foreign bodies
high dose antibiotics
long term antibiotics to prevent recurrence

40
Q

what antibiotics are used for actinomycosis

A

penicillin
doxycycline
clindamycin

41
Q

what patients are specifically at risk for infective endocarditis

A

problems affecting structure of heart (replacement valve)
previous IE

42
Q

name some invasive dental procedures

A

placement of matrix band
anything which manipulates gingival mucosa
sub gingival restorations
full perio exams
PMPR

43
Q

name some non-invasive dental procedures

A

BPE
supra gingival scaling/restorations
radiographs
removal of sutures

44
Q

what antibiotics can you prescribe for IE prophylaxis

A

amoxicillin - 3g
azithromycin - 500mg
clindamycin - 600mg

Oral Surgery BDS3 (8 decks)

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