Final Exam Questions Flashcards
6 signs of right body mandibular frature
Orofacial derangement
Numbeness of lower lip
Bleeding
Facial Asymmtery
Devaition of mandible
AOB
Mobile teeth
2 radiological views for mandibular fracutre
OPT
PA
What casues a fracture to become displaced
opposing occlusion
intact soft tissue
angualtion of fracture line
magnitiude of force
pull of attached muscle (unfavourable)
3 managemetns of mandiblar fracture
open reduction and internal fixation
closed reduction and fixation
do nothing
control of pain and infection
Symptoms of TMD
Headaches
clicking sound from jaw
crepitus
pain on opening
tongue scalloping
linea alba
toothwear
unable to open mouth fully
What muscles do you palpate for TMD
masseter
temporalis
Advice to manage TMD conservatively
soft diet
reduce stress
reassure
stop habits - nail biting
assisting jaw when opening
hot and cold compresses
analgesics
cut food into small pieces
How does a bite splint work
acts as a habit breaker to stop parafunctional habit
reduces load on tmj
decreass abnormal activity and stabilises occlusion
What is arthosentetisis
when sterile saline is injected into the jont space and breaks fibrous adhesion and flushes away inflammatory exudate
How to manage bleeding that won’t stop
Take quick history
LA with vasoconstrictor
Apply pressure with damp gauze
Sutures
Diathermy
Local risk factors for delayed onset of healing
LA with vasoconstrictor wears off
Pt prodes area with finger/tongue
smokes - damages clot
suture becomes lose
Why do you need to get written consent before sedation
as pt does not have capacity once sedation and procedure has started
Drug used for IV sedation
midazolam 5mg5ml IV
3 vital signs monitored during sedation
heart rate
blood pressure
O2 levels
Drug used to reverse effect of drug
Flumazenil
Advice to pt after sedation
no driving
no signing legal docs
don’t look after children unattended
Indications for inhalation sedation
phobia
anxiety
gagging
trauamatic procedures before
asthma
epilepsy
Advatnages of inhalation over midazolam
quicker onset and recovery
no needles
no amnesia
less side effects
no adult chaperone required
safer
Contraindications of inahaltion
serve COPD
1st trimester of pregancy
unable to nose breath
Stages of anesthesia
inhalation
excitment
surgical anesthesia
overdose
What is conscious sedation
use of drugs to depress CNS to allow treatment
pt must remain verbal contact, remain conscious, retain protective relfexes
GABA
Gamma-aminobutric acid
1/2 life of midazolam
90-150mins
ASA classification
- fit and well
- mild systemic disease
- severe systemic disease
- severe systemic disease with threat to life
- morbud
- brain dead
9mm suppurating poket with vertical bony defect on 15, differetial diagnosis?
periodontal abscess
periapical abscess
symptomatic periapibal abscess
SIGN guidelines, when not to remove impacted 3rd molars?
8’spredicted to erupt healthiliy
MH precludes XLA
Deeply impacted with no apical path
high risk of surgical complications
risk of mandibular fracture
asymptomatic contralateral 8 under LA
Strong indications for XLA of lower 8
periocornitis
abscess formation
caries in 8 with little useful restoration
external resoprtion of 8
What has happened when dripping from nose and had upper molar XLA
OAC
5 symptoms of OAC
Fluid in tooth socket - bubbles present
Direct vision
Blunt probe
nose blowing test
bone at trifucation of rottd
How to close OAC
<2mm then encourage bleeding of socket and clot formation and suture margins
Larger ones then close by buccal advancement flap, antiobitics
Close proximity to IDC
deflection of roots
deflection of IDC
darkening of root
narrowing of IDC
One alternative tx if too close to IDC
cornonectomy
Ideal imaging for 3rd moalr
half OPT
CBCT
2 nerves at risk of damaging during XLA of lower 8
lingual - supplies tongue
IDN - supplies lip and chin
Pt complain they have sialolith
pain
xerostomia
bad taste
thick salvia
fluctant swelling at mealtimes (postprandail)
What gland is most commonly affeted with sialoith
submandibular gland
Investigations done for sialolith
palpation of gland and duct
lower occlusal radiograph
sialography
How can sialotith be managed
removal via surgery
sialoendoscopic removal by basket retrival
shock wave lithtripsy
Risk factors for OAC
maxillary molars
root in antrum
cysts
ankylosis
large maxiallry antrum
divergent roots
what is juxta apical area
a well circumscribed radiolucent area lateral to root rather than at apex
4 maxillary spaces
palatal
labial
buccal
infraorbital
infratemporal
