Final Flashcards
Define osteoinduction.
New bone formation from differentiation of osteoprogenitor cells into osteoblasts
_________ is a cytokine that acts on progenitor cells to initiate osteoinduction.
BMP
T/F: BMP is higher in cortical bone than in cancellous bone.
True
T/F: Osteoconduction involves the production of bone.
False
Creates a scaffolding that conducts bone forming cells from the host
__________ is the formation of new bone from osteoprogenitor cells.
Osteogenesis
Which type of graft possesses osteogenic properties?
Autogenic grafts
During phase I of osteogenesis, transplanted cellular bone produces new __________.
Osteoid
What determines the quantity of bone that the graft will form?
Number of bone cells that survive phase I
Which phase of osteogenesis determines the quality of bone?
Phase II
Initial woven bone replaced by lamellar bone. BMP released by matrix as graft is resorbed
What is the gold standard of bone grafts?
Autograft
Most frequently used in OMFS, from same individual
__________ are osteoconductive and are harvested from human cadaver.
Allograft/homograft
___________ are transplanted between individuals fo different species.
Xenografts
T/F: Recombinate grafts are approved for children.
False
What are some common reasons for compromised would healing?
Medication, radiotherapy, infection, systemic disease
What are some diseases associated with bone healing problems?
- Medication related osteonecrosis of the Jaws (MRONJ)
- Osteo-radio-necrosis
- Osteomyelitis
What drugs are associated with MRONJ?
- Bisphosphonates
- Anti-resorptive agents
- Anti-angiogenic medications
T/F: Bisphosphonates inhibit osteoclasts and have a high affinity for calcium.
True
T/F: Patients with multiple myeloma take oral bisphosphonates.
False
IV
What are the parameters for diagnosis of MRONJ?
- Current or previous bisphosphonate treatment
- Exposed bone for more than eight weeks
- No hx of radiation to jaws
What are the three stages of osteo-radio-necrosis?
- Superficial (cortical bone)
- Localized (cortical and medullary bone)
- Diffuse (including inferior border)
_________ is an inflammatory process of bone marrow that involves cancellous and cortical bone with a tendency of progression.
Osteomyelitis
T/F: Osteomyelitis is more common in the mandible.
True
What is the antibiotic of choice for osteomyelitis?
Clindamycin
T/F: Dry socket can last for over 1 week.
False
If this long think osteomyelitis
What qualities should the temporary prosthesis have after grafting?
Non-load bearing
Limit wear
What are the advantages of distraction vs grafting vertical defects?
Minimal relapse, bigger movements possible, soft tissue comes with bone, low morbidity
Which of the grafting materials is ready more quickly than the others for sinus lift? Which is most expensive?
Autograft; BMP
How much bone can you achieve with indirect sinus lift?
4mm
T/F: A histological diagnosis is imperative prior to definitive treatment of pathology.
True
T/F: A true cyst has an epithelial lining.
True
What is the treatment of choice for cystic lesions?
Enucleation
What common cysts are often removed via enucleation?
Dentigerous and periapical cysts
How long will it take for bone to fill in an enucleation defect?
6-12 months
Which types of cyst require curettage after enucleation?
Aggressive cysts with common recurrence (OKC)
What is marsupialization?
Open a cystic lesion and keep it patent to an adjacent cavity. Cyst will shrink over time to allow for removal.
What is also known as the decompression technique?
Staged marsupialization and enucleation
T/F: Tumors in the maxilla have a worse prognosis.
True
Often go longer undetected
T/F: Lesions must be removed with a 1 cm margin of uninvolved tissue.
True
What does it mean if a resection is segmental?
Full thickness all the way to inferior border removed
T/F: Bone-on-bone grinding of the condyle is a critical finding.
False
Why is posterior dentition important for proper jaw function?
Helps stabilize the joint
How should the clinical TMJ exam be done?
Multiple different movements should be done. Must pay attention to what hurts where when doing movements.
T/F: Patients with mechanical or inflammatory joint disease will benefit from TMJ surgery.
True
What is the typical sequence of surgical therapies for TMJ disorders?
Arthrocentesis -> arthroscopy -> open surgery
What is the most common indication for arthrocentesis?
Acute closed lock
Which part of the joint are you in during arthroscopy?
Superior envelope
___________ is an incision into the joint.
Arthrotomy
__________ is repair, revision, and/or reconstruction of joint tissue.
Arthroplasty
____________ is removal of the disk.
Meniscectomy/discectomy
T/F: Preauricular incision for open surgery is anterior to the ear.
True
T/F: If you remove the disk you must replace it with graft.
False
What is the most common graft for replacing the condyle?
Costochondral graft (rib)
T/F: Materials for total joint replacement can last a lifetime.
False
15 years is current estimate
What are the goals of TMJ reconstruction?
- Restore and maintain jaw function
- Restore and maintain facial symmetry
- Long-term skeletal and occlusal stability
Alleviate pain-secondary
T/F: Pain is often eliminated in total joint replacement.
False
Decreased but not eliminated
