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Intro to Oral Surgery & Pain Management > Final Exam Study Guide > Flashcards

Final Exam Study Guide Flashcards

1
Q

OMS training is vastly different from the rest of most of the dental specialty training programs and dental school education. What are the significant differences compared to general dentist education? (3)

A
  1. Extensive hospital, medical, and surgical trainings
  2. 100% of U.S accredited OMS training programs incorporate advanced general anesthesia training for maximum patient comfort and safety in office setting
  3. Bridge the gap between dentistry and medicine
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2
Q

List some of the various examples of OMS treatments:

A
  1. removal of teeth
  2. exposure of impacted teeth for orthodontic treatment
  3. re-contour the jaw bones
  4. preparation of jaws prior to XRT or placement of cardiac or orthopedic prosthetics
  5. reconstructive surgery
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3
Q

What are some reasons for an OMS to remove teeth?

A

A) malposed/impacted teeth
B) non salvageable teeth

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4
Q

What are some of the reasons an OMS may perform reconstructive surgery?

A

A) restoring form and function from aluvsive traumatic events, removal of pathology
& physiologic atrophy

B) restoration of continuity

C) Restoration of alveolar bone height and width

D) Restoration of osseous bulk

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5
Q

Give examples of some events that may cause an OMS to have to perform reconstructive surgery to restore form & function:

A

I) Avulsive traumatic events
II) Removal of pathology
III) Physiologic atrophy

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6
Q

The very first thing about writing in SOAP format:

A

CC

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6
Q

When writing a patients note, what type of patient record format is needed and recognizes in the medical profession worldwide?

A

SOAP Note

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7
Q

What do you need to ask the patient when you first meet them for SOAP note?

A

CC

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8
Q

Describe ASA I:

A

Normal healthy patient, no systemic disease

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9
Q

Describe ASA II:

A

Patient with mild systemic disease which is well controlled (example- well controlled HTN)

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10
Q

Describe ASA III:

A

Patient with significant systemic disease which limits activity but not incapacitating (example- CHF)

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11
Q

Describe ASA IV:

A

Patient with an incapacitating systemic disease which is a constant threat to life (example- Unstable angina pectoris)

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12
Q

Describe ASA V:

A

Moribund patient not expected to survive more than 24 hours (example- end stage kidney disease)

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13
Q

Normal healthy patient, no systemic disease

A

ASA I

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14
Q

Patient with mild systemic disease which is well controlled

A

ASA II

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15
Q

Patient with significant systemic disease which limits activity but not incapacitating

A

ASA III

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16
Q

Patient with an incapacitating systemic disease which is a constant threat to life

A

ASA IV

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17
Q

Moribund patient not expected to survive more than 24 hours

A

ASA V

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18
Q

Given the following situation, give ASA Classification:

Healthy 17 year old boy, no known medical history:

A

ASA I

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19
Q

Given the following situation, give ASA Classification:

43 year old female with well controlled HTN:

A

ASA II

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20
Q

Given the following situation, give ASA Classification:

54 year old male with CHF

A

ASA III

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21
Q

Given the following situation, give ASA Classification:

55 year old male with unstable angina pectoris

A

ASA IV

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22
Q

Given the following situation, give ASA Classification:

34 year old drug addict on hospice for end stage kidney failure

A

ASA V

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23
Q

What are the ways to reduce patient fear and anxiety?

A
  1. Hand holding (non-phamacological method)
  2. N2O/ O2
  3. Oral medications/ oral pre meds
  4. Intravenous medications
  5. General anesthesia
  6. Combinations of the above
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24
Q

How do you correctly write the medical consultation? What components need to be IN the consult? What are the STEPS?

A

STEP 1: Write an abbreviated soap note
STEP 2: Brief anticipated procedure
STEP 3: Ask the focused question and what you want to know
STEP 4: Print and fax

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25
Q

Whats the potential oral surgical patient logistic flow chart for UMKC dental school system?

(In other words, once a patient has been screened in DXR, what are the next few potential steps?)

A

Indication for tooth removal –> assessment of factors –> decision to treat or refer

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26
Q

Whats the potential oral surgical patient logistic flow chart for UMKC dental school system?

(In other words, once a patient has been screened in DXR, what are the next few potential steps?)

If you decide to REFER:

A

Refer to specialist –> follow up to manage potential complications

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27
Q

Whats the potential oral surgical patient logistic flow chart for UMKC dental school system?

(In other words, once a patient has been screened in DXR, what are the next few potential steps?)

If you decide to TREAT YOUR SELF:

A

Treat yourself –> with or without flap –> follow up to manage potential complications

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28
Q

In pre-surgical evaluation, how do you assess tooth mobility? How would you document this?

A

Assessment:
4: No mobility (high potential for ankylosis)
3: No mobility but ankyloses not a problem
2: Normal tooth mobility
1: Greater than normal mobility

documented through miller classification

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29
Q

Tooth mobility that is assessed as Stage 4: No mobility (high potential for ankylosis) includes teeth such as:

A

primarily molars, endo treated teeth or erupted 3rd molars

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30
Q

What is miller classification used to describe?

A

Tooth mobility

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31
Q

Describe Miller Classification for tooth mobility:

A

Class 1: less than 1 mm horizontal
Class 2: greater than 1 mm horizontal
Class 3: greater than 1mm horizontal and vertical mobility

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32
Q

The following describes

Class 1: less than 1 mm horizontal
Class 2: greater than 1 mm horizontal
Class 3: greater than 1mm horizontal and vertical mobility

A

Miller classification for tooth mobility

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33
Q

What is physiologic tooth mobility?

A

0.25mm

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34
Q

Miller classification for tooth mobility

Less than 1 mm horizontal:

A

Class 1

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35
Q

Miller classification for tooth mobility

Greater than 1 mm horizontal

A

Class 2

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36
Q

Miller classification for tooth mobility

Greater than 1 mm horizontal and vertical mobility

A

Class 3

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37
Q

Extraction forceps has handle, hinge, and beaks. When dealing with the handle, what are the different ways that a clinician can hold (grasp) on to it?

A

Horizontal grasp & Vertical grasp

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38
Q

What style of forceps are used when an operator is using a horizontal grasp?

A

American style forceps

“America is on the HORIZON”

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39
Q

Describe horizontal grasp with extraction forceps:

A
  • American style forceps
  • Handles are horizontal to the floor
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40
Q

When using a horizontal grasp with extraction forceps, the handles are always ____ to the floor.

For a maxillary extraction the palm should face ___

For a mandibular extraction the palm should face ___

A
  • horizontal
  • maxillary–> palm up
  • mandibular –> palm down
41
Q

When using the horizontal grasp with extraction forceps, what position should a right handed operator be in?

A

7-9 o’ clock

42
Q

What style of forceps are used when an operator is using a vertical grasp?

A

European style forceps

“Europe is VERY fashionable”

43
Q

Describe vertical grasp with extraction forceps:

A
  • European style forceps
  • Handles in vertical plane
  • for removal of mandibular teeth
44
Q

When would an operator use a vertical grasp with extraction forceps?

A

for removal of mandibular teeth

45
Q

Based on the following clinical situation determine:

A) Elevator:
B) Action:

  • Removal of sectioned roots following sectioning:
A

A) #30 & #31 (cryer)

B) wheel and axel- use with or without purchase point

46
Q

Based on the following clinical situation determine:

A) Elevator:
B) Action:

  • Removal of tooth or portion of tooth:
A

A) #41 (Crane pick)

B) Wheel and axel- use with purchase point

47
Q

Based on the following clinical situation determine:

A) Elevator:
B) Action:

  • Removal of maxillary 3rd molars both erupted and impacted
A

A) #73 and #74 (Miller) Potts

B) Wheel and axel

48
Q

Based on the following clinical situation determine:

A) Elevator:
B) Action:

  • Removal of larger single roots when forceps aren’t preferred
A

A) # 34-S & #46

B) Displacement

49
Q

Based on the following clinical situation determine:

A) Elevator:
B) Action:

  • Luxating teeth prior to forceps application:
A

A) #34-S, #46 & #301 sometimes

B) Lever action, fulcrum place on interseptal bone

50
Q

Based on the following clinical situation determine:

A) Elevator:
B) Action:

  • Removal of medium roots or medium size root tips when #34-S or #46 elevators are too large:
A

A) #301, #302, & #303

B) Displacement

51
Q

Based on the following clinical situation determine:

A) Elevator:
B) Action:

  • Removal of small root tips when tips have unobstructed pathway and are loose
A

A) Apex elevators (root picks)

B) Displacement

52
Q

List the mechanical motions of extractions:

A
  1. Lever
  2. Widge
  3. Wheel & Axel
53
Q

What mechanical motion is being described below?

“prying the tooth root tip from its socket”

A

Lever

54
Q

Describe how to “lever” during an extraction:

A
  1. engage a purchase point (groove or hole in tooth)
  2. grip edge of the blade and use bone as fulcrum
55
Q

Describe how to “wheel & axel” during an extraction:

A
  1. engage a purchase point
  2. use bone as fulcrum to rotate the tip out
56
Q

for maxillary extractions, what is the angle of the maxillary occlusal plane to the floor?

A

45-60 degrees

57
Q

When performing maxillary extractions, the patients shoulders are at the level of the:

A

surgeons elbow

58
Q

When performing maxillary extractions, the operator should be standing at the ___ position

A

7-8 o’clock position

59
Q

When performing maxillary extractions, what provides stability to the operator?

A

Feet spaced apart

60
Q

When performing maxillary extractions, what is the function of the non-dominant hand?

A

provides stability and counters traction of force

61
Q

For mandibular extractions, what is the angle of the mandibular occlusal plane?

A

Parallel to the floor

62
Q

When performing mandibular extractions, the patients shoulders area at the level of the:

A

surgeons elbow or lower

63
Q

When performing mandibular extractions, the operator should be standing at the ____ position

A

7-8 oclock

64
Q

What provides stability when performing mandibular extractions?

A

feet spaced apart

65
Q

What is the function of the non-dominant hand when performing mandibular extractions?

A

provides stability and counters traction force

66
Q

Another popular OMS position for maxillary extractions is when the operator is standing at _____ o’clock instead of 7-8 o’clock. The patient should be in a ___ position. The surgeon should grasp the forceps with the palm ____. The _____ is kept close to the body to reduce ____.

What is the downfall to the alternative position?

A

12 o’clock; fully reclined; facing up; arm; fatigue

Downfall: way easier for object to get in airway; throat pack necessary

67
Q

List all the possible forcep movements:

  1. ____ pressure
  2. _____ serves as fulcrum of rotation
  3. The more ____ the forceps adaptation, the shorter the fulcrum distance
  4. _____ movement
A
  1. BUCCAL pressure
  2. MIDDLE OF SOCKET serves as fulcrum of rotation
  3. The more APICAL the forceps adaptation, the shorter the fulcrum distance
  4. FIGURE 8 movement
68
Q

What forcep movement is being described below?

  • Expand socket on buccal side
  • Detach PDL on lingual side
A

Buccal pressure

69
Q

What is an advantage to adapting the forceps more apically and therefore shortening the fulcrum distance?

A

more uniform dilation of socket –> which reduces root fracture

70
Q

What forcep movement is being described below?

Combination of buccal pressure, lingual pressure, and rotation:

A

figure 8 movement

71
Q

Give an example of using figure 8 movement on the central incisor:

A

Basic movement is rotation because round/ovoid and conical root structure;

72
Q

What may also be used to help with the figure 8 movement?

A

unscrew fashion

73
Q

Correct forceps will:

A
  1. more apical position
  2. Tends to displace tooth with tearing up PDL with socket expansion at the same time
74
Q

When performing an extraction, what should your non-dominant hand be doing?

A

The non-dominant hand should hold the jaw/alveolar process - detecting alveolar process movement

75
Q

How do you detect alveolar process movement during an extraction in the maxillary arch?

A

pinch grasp

76
Q

Describe “pinch grasp”

A

A way to detect alveolar process movement during a maxillary arch extraction

Thumb and index finger on either side of the alveolar process adjacent to the tooth

77
Q

The pinch grasp should be used in the ___ arch

A

maxillary

78
Q

Thumb and index finger on either side of the alveolar process adjacent to the tooth

A

pinch grasp (detection of alveolar process movement in maxillary arch extraction)

79
Q

How do we detect alveolar process movement in the mandibular arch?

A
  1. mandibular sling grasp
  2. pinch grasp AND biteblock
80
Q

What is the purpose of the mandibular sling grasp used to detect alveolar process movement in mandibular extractions?

A
  1. Counteracts forces of extraction
  2. Prevents injury to TMJ
81
Q

What is the purpose of the pinch grasp AND bite block used to detect alveolar process movement in mandibular extractions?

A
  1. support TMJ
  2. bite block on opposite side
82
Q

A common oral surgery lingo “____ flap —> ____ mistake”

A

small flap –> big mistake

83
Q

What can occur if the flap is too small?

A

tearing of the tissue

84
Q

A mucoperiosteal flap needs to have a _____ to ensure adequate blood supply

A

broad base

85
Q

A mucoperiosteal flap needs to have a broad base. This is accomplished by making the:

A

apical portion wider than the coronal pportion

86
Q

A mucoperiosteal flap needs to be large enough to provide:

A

both visual access & instrument access

87
Q

T/F: With a mucoperiosteal flap, a large flap heals as rapidly as a small flap

A

true

88
Q

How does a mucoperiosteal flap heal? (direction)

A

side to side (NOT end to end)

89
Q

In regards to a mucoperiosteal flap, post surgical pain does NOT correlate with ____ but rather ____

A

NOT correlate with size of the flap but rather the amount of bone removed

90
Q

A mucoperiosteal flap needs to be repositioned and sutured over:

A

solid bone

91
Q

Why does a mucoperiosteal flap need to be repositioned and sutured over solid bone?

A

Increases the healing rate and decreases wound dehiscence

92
Q

A mucoperiosteal flap needs to avoid:

A

major anatomical structures such as nerves ad blood vessels

93
Q

Mucosperiosteal flap full thickness =

A

skin + subQ tissue + CT + periosteum

94
Q

For a mucoperiosteal flap, the margin of the flap should be at least ____ from the margins of a ____

A

5mm ; bony defect

95
Q

Common flap designs include: (2)

A
  1. envelope flaps
  2. Vertical releasing incision flap
96
Q

Describe an envelope flap:

A

1 tooth distal & 2 teeth mesial

97
Q

Describe a flap with vertical releasing incision:

A

1 tooth distal & 1 tooth mesial and includes papilla

98
Q

WHen creating a flap with a vertical releasing incision, the vertical release incision must be originating from either:

A

mesial or distal line angle

99
Q
A

Intro to Oral Surgery & Pain Management (4 decks)

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