L7 Routine Post-Operative Management

Question 1

purpose of routine post operative management

Answer 1

1. assess outcome from surgery and provide instruction and therapy to promote recovery
2. rule out (or identify) and manage post operative complications

Question 2

complication

Answer 2

unfavorable outcome, not generally anticipated in the procedure

Question 3

operative morbidity

Answer 3

temporary or permanent disability observed during and after an operation

Question 4

who must be seen for post op check?

Answer 4

1. any intra-operative complicaiton
2. anyone started on therapeutic antibiotics
3. anyone at high risk for complicaitons

Question 5

classification of complications

Answer 5

1. intra-operative (during)
2. early post-operative (hours / days / 1 week)
3. late post operative (weeks / months)

Question 6

prevention of injuries to adjacent teeth

Answer 6

-use elevators properly
-avoid the use of elevators where restorations are present
-watch the path of the forceps carefully
-use thin special forceps where there is crowding or malposed teeth

Question 7

examples of thin special forceps

Answer 7

74N
150S
151S

Question 8

managing risk of injuries to adjacent teeth

Answer 8

-warn patient of possibility
-make patient aware of defective restoration or carious lesions BEFORE starting

Question 9

treatment of injuries to adjacnet teeth

Answer 9

-inform patient to occurrence and need for repair
-place temporary filling
-stabilize any partially avulsed teeth (splint)
-discuss post op percussion pain or temperature sensitivity

Question 10

treatment of root fractures

Answer 10

-closed technique
-open technique
-radiograph

Question 11

management of roots displaced within socket

Answer 11

-partially displaced roots usually should not be left in place
-if tooth is significantly mobile before the snap, the root is probably displaced

Question 12

diagnosis of root in maxillary sinus

Answer 12

-take radiograph
-determine size of the root
-assess the preoperative condition of th sinus
-determine if there was a pre-existing infeciton

Question 13

if sinus perforation is 2-3mm… (small)

Answer 13

-irrigate for visualization and possibly of floating root out through socket
-attempt to remove with hemostat
-attempt to retain roots if unable to retrieve
-inform and follow patient postoperatively

Question 14

if sinus perforation is larger than 2-3mm… (large)

Answer 14

removal of root through caldwell luc type sinus opening

Question 15

treatment of max bicuspid root beneath buccal periosteum

Answer 15

-reflect flap with vertical releasing incision to visualize apical region of bicuspid
-remove root with hemostat
-if palpable through tissue, deliver through a small stab incision right over the root

Question 16

diagnosis of max third molars in infra-temporal fossa

Answer 16

-radiographs-tooth usually lateral to lateral pterygoid plate and inferior to lateral pterygoid muscle

Question 17

treatment of max third molars in infra-temporal fossa

Answer 17

-make initial attempt to find and remove tooth with hemostat
-additional blind probing may push the tooth further away
-place pt on antibiotics
-refer to OMF surgeon

Question 18

delayed treatment due to max third molars in infra-temporal fossa

Answer 18

defer removal for 4-6 weeks

use needle to locate the tooth and disect