Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

BDS2 Clinical > Intro to Oral Surgery and Extractions > Flashcards

Intro to Oral Surgery and Extractions Flashcards

1
Q

MOPS

A

minor oral procedure surgery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

what are the 2 indications for extractions

A

clinical

and/or (usually both)

radiographic
(in case of unusual anatomy)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

10 reasons for unrestorable teeth that are indicated for extractions

A

Gross caries

Advanced periodontal disease

Tooth/root fracture

Severe tooth surface loss

Pulpal necrosis

Apical infection

Symptomatic partially erupted teeth

Traumatic position
- E.g. wisdom tooth biting into cheek

Orthodontic indications
- E.g. remove one of the premolars

Interference with construction of dentures
- Seems wrong as want more natural teeth, but if in detrimental odd anatomical position that would worsen the retention

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

straight upper anterior forceps

A

Totally flat unique
- Complete touching table surface

Cannot grab posterior teeth
- stretch cheek

Canine to canine on upper teeth
- Ideally upper central

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

upper universal forceps

A

Part of handle lifts of table

  • Prevent stretching teeth
  • Reach further back

Tip the same

Most single rooted teeth

  • Canines, 1st and 2nd molars
  • Not as good grip on molar
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

tips of straight upper anterior and upper universal forceps

A

have concave surface on either side
- Grab a root
used on Single rooted teeth

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

why is there a different design for upper molar forceps

A

3 roots
- 2 palatal and 1 buccal
Need either side
- Tips designed to engage roots regarding orientation

Point
- Designed to go into the furcation between 2 buccal roots

Triangle
- Beak to cheek

Smooth end on one side - concave like first ones
Grab single palatal root

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

point design of upper molar forceps

A
  • Designed to go into the furcation between 2 buccal roots

Triangle
- Beak to cheek

Smooth end on one side - concave like first ones
Grab single palatal root

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

lower forceps design feature

A

90 degree bend for good approach and access

No need for lower right and left
- 2 roots (Mesial and distal)
Furcation on both sides
- Pointy beak engage with furcation on buccal and lingual side

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

lower universal forceps

A

90 degree bend for good approach and access

Concave on both sides
- engage root surface

Designed for lower 5 to 5 - one root

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

lower molar forceps

A

90 degree bend for good approach and access

Pointy beaks
- Buccal and lingual furcation on lower 6s (mesial and distal root)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

‘cowhorn’ forceps

A

90 degree bend for good approach and access

Very pointy and sharp compared to others

Narrow ended

Highly polished - smooth

Used only 2 rooted lower molars

  • Need radiographs
  • Divergent/straight/separate roots

Put into furcation gap
Squeeze handle
Points go towards each other and lift the tooth up
- less pressure - good for children as bone softer in young
- less mobilising needed
- if not deep enough can crush crown

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

how to use ‘cowhorn forceps’

A

Put into furcation gap
Squeeze handle
Points go towards each other and lift the tooth up
- less pressure - good for children as bone softer in young
- less mobilising needed
- if not deep enough can crush crown

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

advantages of ‘cowhorn’ forceps

A
  • less pressure - good for children as bone softer in young

- less mobilising needed

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

disadvantage of ‘cowhorn’ forcep

A
  • if not deep enough can crush crown
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

3 general principles of extraction

A

Mobilise teeth with special instrument

Forceps on root

Various movements to expand bone socket to give ease of getting tooth out

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

bayonet forceps design

A

Easy to reach back with Z shape

  • Bayonet pattern
  • Don’t stretch cheek
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

why need for bayonet forceps

A

Hard to access upper wisdom teeth

Can use upper molar forceps or the top one

  • Root pattern variable
  • Don’t know where furcation’s are
  • Assume one rooted
  • Can be poor grip
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

upper bayonet third molar forceps

A

like universal with Z end

Part of handle lifts of table

  • Prevent stretching teeth
  • Reach further back

tip have concave surface on either side
- Grab a root

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

upper bayonet root forceps

A

Fine tip

  • Removing little roots
  • Fracture
  • Not wisdom tooth - too narrow, no grip
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

where is right handed operator in extractions of lower right molars

A

standing behind the patient on left to pt

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

where is left handed operator in extraction of lower left molars

A

standing behind the patient on right of pt

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

when does the operator stand in front of the pt in extractions

A

All upper teeth

  • Lower left if right handed
  • Lower right if left handed
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

where does a right handed operator stand when standing in front of the pt

A

in front of the pt to the right

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

where does a left handed operator stand when standing in front of the pt

A

in front of the pt to the left (mind spittoon)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

how should you change the pt positions for maxillary extractions

A

lie pt more flat

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

what does the correct extraction position allow

A

Non dominant hand cannot support jaw
- Retract cheek, hard palate, protect pt face

Let light in

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

purpose of elevators

A

Forceps good at extracting
- But straight to higher chance of breaking teeth

Minimise breaking teeth and get rid of excess easier use these
- Facilitate the extraction
Loosen tooth
- Roots are mobile - easier to get out

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

coupland’s elevators

A

Most popular

Different sizes

  • 1 - narrowest
  • 2
  • 3 - widest (top)

Half universal forceps
- Bit sharper at end

Tear PDL

Elevate the tooth

Individually wrapped

Ends can wear with time

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Cryer’s elevators

A

Sets of 2 in pack (R and L)

Pointy

Curved

Elevate broken fractured retained roots

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

how to differentiate right and left cryer’s elevators

A

Concave is pointing towards the ceiling - smile to the sky

Point to each other

One in right and left is left
And engraved usually

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

Warwick James elevators

A

Like fine Coupland

Sets of 3

  • Distinguish left and right like Cryers
  • then straight one

Curved is less pointy

Upper wisdom teeth
- Fit better in narrow space

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

3 elevators

A

Coupland’s

Cryer’s

James Warwick

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

non surgical extractions

A

Forceps and elevators

No flaps/incisions, no bone removal, no sectioning of teeth

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

surgical extractions

A

Incisions in gingivae/ mucoperiosteal flaps

Bone removal with drills or chizels

Tooth sectioning with drills

36
Q

why would you remove gum in a surgical extraction

A

Expose as much as area as can

Preserve soft tissue

Pathology at root need to clean

Radiograph indicated

37
Q

what is oral surgery reliant on

A

Entirely reliant on first stage of procedure - anaesthesia

Regional or block
- Number of nerves with 1 injection

Infiltration
- Underlying Anatomy hope to catch nerve desired

ID Block need to inject long buccal nerve too

38
Q

regional or block LA

A

Number of nerves with 1 injection

39
Q

infiltration LA

A

Underlying Anatomy hope to catch nerve desired

40
Q

what is the first consideration prior to extraction

A

access

- access is success

41
Q

corenectomy

A

Remove crown of tooth

Leave roots 
- Remove top of the tooth and leave roots near nerve to minimise damage
- Smooth root down (when healthy)
- 3mm bone around 
Should heal well

Can be used when roots are close to nerves, where surgical removal carries a higher risk of damage to the nerve

  • e.g. lower third molars that are half through so can have bacterial invasion
  • near ID nerve – bump can cause loss of sensation
42
Q

Impacted canines and premolars treatment options

A

They can be uncovered (exposed to allow the orthodontist to bring them into alignment)

  • Expose them and attach bracket to encourage them to come through into correct alignment
  • Cut away gum, drill away bone and pass to ortho

Or they can be surgically removed if they are causing problems, cannot be orthodontically aligned or are in the way/ preventing orthodontic tooth movement

43
Q

issues caused by impacted canines or premolars

A

Permanent Canines and premolars sometimes do not erupt

If left can cause problems to roots of other teeth

44
Q

when should you palpate for erupting canines

A

9 years

45
Q

Oro antral communication

A

acute communication between mouth and sinus

46
Q

oro antral fistula

A

Chronic communication is an epithelial lined tract between mouth and sinus

47
Q

what can cause an OAC/OAF

A

From canine to last molar in the upper arch – there can be a close relationship to the maxillary sinus

Extraction can result in a communication between the sinus and oral cavity

  • As tooth roots have extended into air sinus space
  • Granulated track tunnel from mouth to sinus
  • Repeat infections
  • Water runs out nose
48
Q

what must happen if OAC or OAF doesn’t heal

A

they do not heal they need to be surgically closed

Need to remove tissue and tract to get closure

Can look small in soft tissue, but when remove soft tissue reveal a large hole

Move tissue buccally to palate and close off with sutures

49
Q

excision

A

remove the whole lesion

scalpel needed

50
Q

incision

A

take a sample of the lesion

scalpel needed

51
Q

punch biosy

A

a core: punch a circle around the lesion (excision) or within the lesion (incision)

4mm or 6mm

Multiple layers of mucosa

52
Q

3 types of soft tissue biopsy

A

excision

incision

punch biopsy

53
Q

what is the point of soft tissue biopsies

A

Provide an answer to what is happening (pathological examination)

54
Q

how can you give pathologist indication of orientation of soft tissue biopsy

A

May suture through biopsy to give pathologist context

Medical Hx needed

Mesial and distal or superior and inferior margin

55
Q

biopsy for lesion that is suspected malignancy

A

do not remove whole lesion. Take a sample to identify it then produce a definitive treatment plan
- representative sample

56
Q

lichehn planus/lichenoid reaction

A

6 different presentation (variable)

Increase risk of developing oral cancer over time

Over reaction of immune system
- Stimulus response - funny presentation

57
Q

presentation of leukoplakia

A

White and red patches of unknown origin

White - thickened
Red - thinned

58
Q

mucoceles

A

damaged minor salivary glands
- saliva trapped in

mucous extravastation cyst

saliva leaked into submucosal layer

59
Q

minor salivary gland structure

A

tiny, grape like

60
Q

saliva retention cyst

A

tube for saliva into mouth blocked so cannot escape

61
Q

damage to minor salivary gland leads to

A

leak saliva where it shouldn’t be, body walls off and its stuck
- mucoceles

62
Q

ranula

A

Damage to sublingual salivary gland (major salivary gland)

like a large mucocele in the floor of the mouth.
- frogs belly

Often marsupialised.
- If does not resolve requires more complex surgery for removal

63
Q

what can cause mucoceles

A

trauma

64
Q

what is the most common minor salivary gland problem

A

mucocele

65
Q

what is the saliva like in mucocele

A

thicker, gluey consistency compared to saliva

66
Q

appearance of mucocele

A

Soft bluish swelling fluid filled

- Purple/dark if blood

67
Q

excision of mucocele

A

Not falsely inflate the size of the lesion
- Around site

Blunt dissection

  • Push layers of tissue off round it
  • Scissors in closed and then open up to remove tissue away

Ellipse
- Come together as straight line

Burst at top

68
Q

cysts

A

Epithelial lined fluid filled cavities in bone or soft tissue
- Many different types

69
Q

2 different ways of managing cysts

A

Enucleation
- removal of entire cyst

Marsupialisation

  • removal of part of cyst lining and leaving it open.
  • “De-roofing”
  • Body can start laying bone down as compromised
70
Q

enucleation of cysts

A

removal of entire cyst

71
Q

Marsupialisation of cyst

A
  • removal of part of cyst lining and leaving it open.
  • “De-roofing”
  • Body can start laying bone down as compromised
72
Q

radicular cysts associated

A

radicular cysts are associated with non vital or dead tooth

73
Q

periradicular surgery

A

Surgery around the root of the tooth

  • Failed root canal treatment/ non-resolving infection/cyst
  • Root fractures
  • Post Crowned Teeth – post perforations

Can involve debridement (cleaning), sealing perforations, apicectomy (removal of root apex)

Can refer to endodontic team

  • Root treatment is as successful
  • Less invasive
  • Less risk
74
Q

preposthetic surgery

A

E.g. removal of denture induced hyperplasia

  • Consistently rubbing on tissue - thicken and grow
  • Lumps in the mouth, Not worrying
  • But contribute to displacing denture
  • Like atrophic ridge – hard to get to fit

Excision of Denture Hyperplasia

75
Q

dentoalveolar infection treatment

A

incision and drainage

76
Q

dentoalveolar infection

A

Localised collections of pus, patient not systemically unwell – Can be incised and drained in general practice under LA

77
Q

dentoalveolar infection appearance

A

Bubble
- Not always like this

Can see sinus - dot
- Chronically draining pus

78
Q

danager of dentoalveolar infection on palate

A

can spread infra-orbital and reach eye

painful - palate should be bound to bone, not got flex

79
Q

how to tell if pt systemically unwell from dentoalveolar infection

A

Asymmetric

Assessed for heart rate and respiratory
- Sensitive markers of sepsis

Temperature
Bp

To OMFS
- Need more than removing source of infection of tooth and antibiotics

80
Q

large risk for submandibular dentoalveolar infection

A

Cross midline – Ludwig’s angina
- Risk to airway

cannot see angle or lower border of mandible as lost anatomy

81
Q

how to treat severe dentoalveolar infection

A

incision and drainage

IV antibiotics
- flush and wash out

82
Q

what does an infection lead to at its site

A

inflammation - inc blood flow and fluid to area

83
Q

cryosurgery/cryotherapy is

A

Liquid nitrogen/ Nitrous Oxide

- Freeze lesions

84
Q

cryosurgery/cryotherapy on

A

Haemangiomas (vascular lesion)
- risk of bleeding if excised
malformed blood vessels
congenital or developed

Trigeminal neuralgia
- cryo the nerve involved e.g. infraorbital nerve, mental nerve
facial pain – freeze nerve so no feeling, constantly numbed

85
Q

TMJ problems

A

Problems with jaw joint

Pain associated with muscles of mastication

Combination of muscle and joint pain

Often related to tooth grinding/clenching habits
- Parafunctional

86
Q

TMJ problem treatment

A

be treated with conservative advice and analgesia, occlusal splints/bite raising appliances (hard/soft)

Modifying habits
- Can be difficult to manage
- Have to manage pt expectation
Habit breaking strategies

BDS2 Clinical (6 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions