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Oral Surgery > FINAL > Flashcards

FINAL Flashcards

1
Q

Osteoinduction is _ from _, derived from _

A

New bone formation from differentiation of osteoprogenitor cells derived from mesenchymal cells into osteoblasts

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2
Q

Differentiation is induced by _ from _

A

Bone inductive proteins from bone matrix

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3
Q

BMP does what

A

Initiates osteoinduction. Acts on progenitor cells to induce diff into osteoblasts

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4
Q

BMP is higher in _ than _

A

Cortical bone than cancellous

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5
Q

Osteoconduction is formation of new bone from _ or _ along a _

A

Host derived or transplanted osteoprogenitor cells

Along a biologic framework

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6
Q

T/F osteoconduction produces new bone

A

FALSE, conducts bone forming cells from host into the scaffolding

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7
Q

Osteogenesis is formation of new bone from _

A

Osteoprogenitor cells. It’s both inductive and conductive

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8
Q

Two phase theory of osteogenesis.
Phase I is what:
What does it determine

A

Transplanted cellular bone produces new osteoid.

Determines QUANTITY of bone that the graft will form

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9
Q

Two phase theory of osteogenesis.
Phase II is what
Determines what

A

Fiber and blood vessel proliferation, then osteogenesis. Woven bone replaced by lamellar. Graft resorbed, BMP released.

Determines QUALITY

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10
Q

5 types of grafts and definition

A 
Autograft - tissue from yourself
Allograft - other human
Xenograft - animal graft
Alloplast - synthetic (HA)
Recombinate graft - BMP
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11
Q

How do Allografts and xenografts work

A

Osteoconduction

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12
Q

1 reason BMP is not effective

A

Cost

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13
Q

Tough issue when putting implants into grafted bone

A

Crown to root ratio

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14
Q

Osteoclasts come from _

Osteoblasts come from _

A

Hematopoietic stem cells

Mesenchymal stem cells

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15
Q

4 reasons for poor wound healing

A

Medications
Radiotherapy
Infection
Systemic disease

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16
Q

3 types of drugs associated with MRONJ

A

Bisphosphonates
Anti-resorptive agents
Anti-angiogenic medications

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17
Q

How do bisphosphonates work

A

Inhibit osteoclasts by binding to Ca2+

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18
Q

Who would take bisphosphonates

A

Osteoporosis/osteopenia
Paget’s disease
Osteogenesis imperfecta

Solid tumors with bone metastasis
Hypercalcemia of malignancy
Multiple myeloma

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19
Q

What makes the jaws unique for bone remodeling

A 
Increased turnover (10 x long bones)
Thin overlying oral mucosa
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20
Q

MRONJ
Stage 1
Stage 2
Stage 3

A

1: asymptomatic exposed bone, no infection
2: exposed bone, pain, infection
3: exposed/necrotic bone, pain, infection

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21
Q

Osseus surgery if on IV BP

A

Avoid if at all possible

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22
Q

PO BPs needing EXT

A

Informed consent, medical consult to see about drug holiday

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23
Q

Three hypos of ORN

A

Hypoxia
Hypovascularity
Hypocellularity

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24
Q

Osteomyelitis:

A

Bone infection.

Inflammation of bone marrow involving cancellous and cortical bone that tends to progress.

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25
Q

Steps of osteomyelitis

A 
Bacteria
Inflammation
Vascular compression
Ischemia
Necrosis
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26
Q

Osteomyelitis is found more in the _ than the _

A

Mandible

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27
Q

Why is osteomyelitis more common in mandible

A

Cortical bone more prone to damage on ext

Blood supply of max is better

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28
Q

Radiographic findings of osteomyelitis

A

Moth eaten

Islands of non-resorbed bone

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29
Q

Antibiotic for osteomyelitis

A

Clindamycin

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30
Q

How long does dry socket last

A

A week

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31
Q

3 ways to restore lost tissue volume

A

Grafting
Distraction
Ortho eruption

32
Q

GBR

A

Horizontal augmentation, flap, prepare site, place bone, membrane, primary closure

33
Q

Block grafting:

A

Horizontal alveolar graft, shaped like a block

Cortical w or w/o cancellous

Block maintains space while remodeling

34
Q

Pros/Cons of iliac crest donor site

A

P: lots of bone, no rejection

C: need gen anesthesia, two surgeons, scar on hip

35
Q

Diet modification after block graft

A

Non chew (scrambled eggs at most) for 12 days

36
Q

T/F vertical augmentation is easily achieved

A

FALSE. No got way to do it currently

37
Q

3 reasons not to do grafts for vertical gain

A

Risk of graft exposure

Bad adaptation of graft to ridge

Higher resorption rates

38
Q

Advantages to distraction for vertical gain

A

Controlled
New bone in gap
Soft tissue envelope expands

39
Q

Phases of distraction and length of each

A

Latency (4-7 d)
Distraction (1 mm/day)
Consolidation (2-3 months)

40
Q

Two disadvantages of distraction

A

Distractor arm

Long consolidation phase

41
Q

Sinus augmentation timeline for autograft vs allograft

A

Autograft in 4 months

Also in 6-8 months

42
Q

Post op for sinus augmentation with perf

A

Nasal decongestant

Mucolytic

43
Q

4 requirements for good implants

A

Healthy gingival collar
Thick biotype gingiva
No perio
Adequate bone

44
Q

T/F immediate implant should fill socket

A

FALSE

45
Q

T/F Most people have enough bone for mand ant implants

A

True

46
Q

Patient wants max ant implants, not a lot of bone, can’t do sinus augmentation

A

Angle implants/implants in nasal bones

47
Q

Why are long angled implants usually not done

A

If patient can’t do sinus augmentation, they can rarely do general anesthesia

48
Q

_ is needed before definitive removal of a pathological condition

A

Histological diagnosis

49
Q

Reconstruction should be planned when

A

While planning excisional surgery

50
Q

A true cyst contains a _

A

An epithelial lining

51
Q

4 ways to manage cysts

A

Enucleation
Enucleation and curettage
Marsupialization
Staged marsupialization and enucleation

52
Q

When to do E&C

A

Removing known aggressive cyst like OKC

Or 2nd surgery after the first was supposed to cure it

53
Q

When to do marsupialization

A

Adjacent vital structures at risk
Difficult surgical access to all portions of cyst
Medical compromise

54
Q

T/F marsupialization alone is done more frequently than other treatments

A

FALSE. Staged marsupialization and enucleation is done more

55
Q

Advantages of marsupialization and enucleation

A

Thickened cystic lining
Reduces morbidity
Same as marsupialization

56
Q

Cysts that probably require extraction

A

Dentigerous

OKC (potentially)

57
Q

Management of jaw tumors depends on what 3 things

A

Lesion behavior
An atomic location
Desired reconstruction results

58
Q

E&C indications

A

Slow growing, non-aggressive
Most odontogenic tumors
Medically compromised

59
Q

Jaw tumor resection indications

A

Aggressive lesions either path or clinically

Difficult to remove by E&C alone

60
Q

Most important part of workup

A

History

61
Q

Pain history

A 
Location
Intensity
Quality
Onset
Radiation
Associated symptoms
Alleviating factors
Aggravating factors
62
Q

Pts that will benefit from TMJ surgery

A

Mechanical or inflammatory joint disease
Failed non-surgical therapy
Muscle disorders are not only problem
Invasive treatment will correct mechanical dysfunction

63
Q

Why do arthroscopy instead of arthrocentesis

A 
Long duration of symptoms
History of failed steroid injection
Long history of late, hard, painful pop
Can’t get MRI
Obesity
64
Q

Pros/cons of arthroscopy

A

P: minimally invasive, excellent success
C: not for advanced disease, failure requires open surgery, can injure middle ear or nerve

65
Q

Arthrotomy:

A

Incision into joint

66
Q

Arthroplasty

A

Repair, revision and or reconstruction of joint tissues

67
Q

Meniscectomy or discectomy

A

Removal of disk

68
Q

Main reason for arthrocentesis

A

Acute closed lock

69
Q

Arthrocentesis affects _ space

A

Superior joint space

70
Q

Arthroscopy benefits

A

Allows examination under anesthesia

Doesn’t reposition disk

71
Q

T/F a healthy joint should be avascular and show bone and fibrocartilage

A

FALSE. Should be avascular and no bone, with fibrocartilage

72
Q

Most common graft material for discectomy

A

Temporal fascia

73
Q

Best material for condyle graft

A

Rib

74
Q

Most common joint reconstruction for kids?

A

Costochondral rib, grows with patient

75
Q

Indications for total joint replacement

A

Severe degeneration of condyle
Recurrent fibrous or bony ankylosis
Failure of other reconstructive procedure

76
Q

Why not do total joint replacement

A

Expensive
May not improve pain
Treatment of last resort

Oral Surgery (2 decks)

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