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5th yr- Finals- CAD revision > Intro to minor oral surgery > Flashcards

Intro to minor oral surgery Flashcards

1
Q

How can tissues get damaged physically

A
  1. Compromised blood flow
  2. Crushing
  3. Desiccation
  4. Incision
  5. Irradiation
  6. Overcooling
  7. Overheating
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2
Q

How can tissues get damaged chemically

A
  1. Agents with unphysiologic pH
  2. Agents with unphysiological tonicity
  3. Proteases
  4. Vasoconstrictors
  5. Thrombogenic agents
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3
Q

Talk through the 4 stages of acute would healing

A
  1. Haemostasis
  2. Inflammatory phase
  3. Proliferative phase
  4. Remodelling
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4
Q

What happens 1 week post extraction

A
  1. What blood cells remove bacteria
  2. Breakdown of debris
  3. Fibroplsia begins
  4. Ingrowth of fibroblasts and capillaries
  5. Epithelium migrates down socket wall
  6. osteoclasts accumulate long crestal bone
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5
Q

What happens 2 weeks post extraction

A
  1. Granulation tissue fills the socket
  2. Osteoid deposition along alveolar bone lining socket
  3. Smaller socket forms
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6
Q

What happens 3-4 weeks post extraction

A
  1. Cortical bone resorbs from the crest and walls
  2. New trabecular bone is laid down
  3. Epithelium moves to crest
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7
Q

Name the 2 basic methods of healing

A

Primary and secondary intension

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8
Q

What is primary intention

A

edges of wound places and stabilised in same anatomical position prior to injury and allowed to heal

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9
Q

What is secondary intention

A

Implies a gap is left between edges of incision/ laceration
tissue loss has occurred around the wound ages
Significant amount of epithelial migration
slower healing that forms a scar

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10
Q

List the different types of bone cells

A
  1. Osteogenic cells
  2. Osteoblast
  3. Osteocyte
  4. Osteoclast
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11
Q

What are osteogenic cells

A

Stem cells

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12
Q

What are osteoblast

A

They are bone healing cells that form the bone matrix

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13
Q

What are osteocytes

A

They maintain bone tissue

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14
Q

What are osteoclasts

A

They resorb bone

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15
Q

Patients on which medication may have complex healing

A

Bisphosphonates

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16
Q

Name the 2 components that make up the inflammatory phase

A
  1. Cellular phase
  2. Vascular phase
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17
Q

What triggers the cellular phase

A

Triggered by activation of serum compliment via tissue trauma

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18
Q

What happens in the vascular phase of inflammation

A

Initially vasoconstriction occurs of the distributed vessels
This slows the blood flow into the injured area and promotes co angulation

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19
Q

What is the outcome of the cellular phase of inflammation

A

Neutrophil activation

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20
Q

List the characteristics inflammation

A
  1. Redness
  2. Swelling
  3. Heat
  4. Pain
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21
Q

What is released in the vascular phase of inflammation

A
  1. Histamines
  2. Prostogladins
  3. White blood cells
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22
Q

How Long does the inflammatory phase last

A

2-5 days

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23
Q

What follows the inflammatory phase

A

Proliferative phase

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24
Q

When does the proliferative phase begin

A

2-3 weeks

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25
What happens in the proliferative paste of wound healing
1. Fibrin strands form structure for fibroblasts to lay ground substance tropocollagen 2. Capillary formation 3. Collagen formation
26
Which phase follows the proliferative phase
Re modelling
27
How long does the remodelling phase last
Continues indefinitely
28
What happens in the remodelling phase
1. Previous collagen fibres are destroyed and replaced by new collagen that is orientated better 2. Wound strength slowly increases 3. Vascularity decreases as does erythema
29
What considerations do we need to take for good healing
1. Foreign material in wound site 2. Necrotic tissue present 3. Ischaemia 4. Wound tension
30
What foreign material can be present in the wound site
1. Bacteria 2. Dirt 3. Suture material 4. Anything not natural
31
What can happen if there is foreign Materia present int eh wound site
Chronic inflammatory reaction
32
Why is necrotic tissue in the wound site bad
1. As It acts as a barrier to ingrowth of reparative cells 2. It also prolongs the inflammatory state for white blood cells 3. Can be nutrients for bacteria
33
What is ischaemia
Reduction in blood supply affecting healing
34
Why is ischaemia bad
1. Further tissue necrosis occurs 2. Reduction in the delivery of wound antibiotic white blood cells and antibiotics
35
Why can ischaemia occur
1. Sutures 2. Poor flap design 3. Excessive external pressure 4. Internal pressure 5. Systemic BP Issues 6. Peripheral vascular disease 7. Anaemia
36
When can tension in the would site occur
If sutures are too tight
37
Why is tension bad
Can cause ischaemia and excessive scar formation as well as wound contraction
38
What patient factors might affect wound healing
1. Age 2. Medical history 3. Drug history 4. BMI 5. Social history 6. Anxiety
39
How can age affect wound healing
Increased age: 1. Increased complication 2. More medical complexity 3. Neoplasia
40
Which drugs can affect wound healing
1. Anticolagualnts 2. Steroids 3. Bisphosphonates 4. Immunosuppressive
41
How can BMI affect healing
Higher BMI: 1. Smaller mouths so harder to access 2. Bigger necks so airway problems 3. May have additional medical problems
42
What operator factors might affect wound healing
1. Competence 2. Experience 3. Environment 4. Assistance
43
What surgical factors might affect wound healing
1. Diagnosis 2. Access 3. Imaging 4. Pathology 5. Bone 6. Surgical site 7. Mouth opening
44
What do we look at when carrying out our extra oral examination
1. Structured aaporach 2. Cervical lymphadenopathy 3. Mouth opening 4. TMJ 5. Facial symmetry 6. Facial swelling 7. Other significant finding 8. VII and V nerve
45
What do we look at when writing our abnormalities for a radiograph
If you spot something abnormal note down STOP: 1. Site 2. Translucency 3. Outline 4. Previous imagine
46
What are some red flags we may see on a radiograph
1. Loss of symmetry 2. Distorted anatomy 3. Bone erosion 4. Teeth floating in air
47
What is trismus
Reduced mouth opening
48
What are the key properties of LA
1. Specific action 2. Reversibel 3. Rapid onset 4. Non irritant 5. No permanent damage 6. No systemic toxicity 7. Chemically stable 8. Can be sterilised 9. hypo-allergic 10. Non addictive
49
What are the 2 chemical structures LA can be made up of
1. Esters 2. Amides
50
Name the 2 components that make up LA
1. Drug 2. Vasoconstrictor
51
Why does LA contain a vasoconstrictor
1. Increased speed of onset 2. Extends duration 3. Increased depth of anaesthesia
52
List the properties of adrenaline
1. Naturally occurring 2. Increases rate and force of contraction of heart 3. increased BP 4. Vasoconstriction
53
List the properties of felypressin
1. Anaoligue of naturally occurring peptide vasopressin 2. Vascular smooth muscle contraction
54
Name the most common LA we use
2% lidocaine with 1:80,000 adrenaline
55
What is the max disease of 2% lidocaine with 1:80,000 adrenaline can we give
4.4mg per kg
56
how much lidocaine and adrenaline is there in 2% lidocaine with 1:80,000 adrenaline
44mg lidocaine 27.5mg adrenaline
57
When might we prescribe antibiotics in oral surgery
1. To prevent post operative infection 2. In a compromised host 3. Before placement of a foreign object/ material 4. Acute infection where you are unable to remove cause 5. Rapidly spreading infection 6. persistent recurring infection
58
In which patients might you consider antibiotics
1. Diabetes 2. ETOH 3. Patient with renal failure 4. Malignancy
59
Why might we do surgery in the mouth
1. Remove retained roots 2. Complete a procedure 3. Assess and access pathology 4. Impacted tooth 5. Tissue sample 6. Surgical Endodontics
60
List the key principles of oral surgery
1. Sufficient access 2. Preserve vital structures 3. Incisions on sound bone 4. Protect soft tissue 5. Minimise tissue damdage 6. Preserve blood supply 7. Closure of sound bone
61
Name the vital structures in the mouth
1. Inferior alveolar nerve 2. Lingual nerve 3. Greater palatine foramen 4. Incisal foramen
62
What is a flap
A section of soft tissue which: 1. Is outlined by surgical incision 2. Caries its own blood supply 3. Allows access to underlying tissues 4. Can be replaced to its original position 5. Can be maintained with surfaces 6. Has full thickness mucoperiosteal
63
How do we ensure we dont damage tissues when making a flap
1. Have firm controlled movements 2. Careful tissue handling 3. Ensure cooling when using rotary motors 4. Clear away debridement 5. Follow principles fo suturing
64
Which instrument do we use to make the incision
15/15C blade with number 3 handle
65
Which hand piece do we not use on ADC
Air rotor hand pieces as they can cause surgical emphysema
66
What is the purpose of suturing
To hold the tissues in placer to permit healing by primary intention and to control bleeding
67
Why is suturing important
Activates haemostasis
68
List the key properties of suturing material
1. Adequate tensile strength 2. Functional strength 3. Non capillary 4. Non reactive 5. Flexible and easy to knot 6. Sterilisable 7. Smooth 8. Resorb-able

5th yr- Finals- CAD revision (4 decks)

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