lecture 1 Flashcards
Dx development
_-a direct quote from the patient
_-the story of the patient’s chief compliant
_-a summary of the patient’s medical status as it relates to dental care: includes dangers, Rxs, allergies, need for prophylaxis
chief complaint - direct quote from the pt
history of present illness - story of the CC, Constitutional problems* - tooth causing other problems? Pain, fever shortness of breath?
past med history - summary of the pt’s med status as it relates to dental care
develpment of surgical Dx
3 diagnostic images we use
Periapical, pan, or CBCT- 3 images that we need
We don’t use bitewing in oral surgery
PA and panorex - here in school usually
first we develop a _ dx
then a _dx, this may include more than one problem (acute irreversible pulpitis, grossly carious, non-restorable)
first make differential Dx
then make final Dx and this can include more than one problem
infection control
pre-operative asepsis
surgical techniques to prevent infection, ____
post-op wound care instructions and hygiene
surgical techniques to prevent infection: incision, tissue handling, wound debridement, hemostasis
infection control
_ includes visibility (access, lighting, clear surgical field) and a qualified assistant
pre-op asepsis
infection control surgical technique of incision
- sharp blade of proper size
- _ stroke
- avoid anatomic structures
- _ to surface
- place incision in proper location for closure and healing
firm continuous stroke
perpendicular to surface
Usually need an assist
Nice clean, firm continuous strokes
infection control surgical techniques flap design
_ broader than _ to allow adequate blood inflow and outflow
_ away from surgical site and located over _
base broader than free margin
margin away from surgical site and located over sound bone
to allow adequate blood flow - base wider than free margin
Over sound bone
in the flap design, area of compromised blood supply as a result of a _ in the flap
button hole
infection control surgical technique be kind to soft tissue ~_ retraction ~careful _ suctioning ~avoid burns from drills ~_ forceps
gentle retraction
care metal suctioning - no jabbing
avoid burns
tissue forceps
infection control surgical technique _
~prevent excessive bleeding
~preserve visibility to facilitate surgery
~prevent hematoma
~prevent wound from breakdown and infection (4 things)
hemostasis
prevent wound breakdown and infection - pressure, packing, place drain if needed, closure
Packing - may place if bleeding a lot
Hemostastic agent or dressing to help form clot
infection control surgical technique _ ~thoroughly debride granulation tissue ~control bleeding from socket and bone ~pressure directly on wound ~hemostatic agents ~pressure dressing
hemostasis
clean out all dead tissue
infection control surgical technique _
~surgical excision of dead and devitalized tissue and removal of all foreign matter from a wound
~bone spicules/granulation tissue/tooth fragments
~adequate irrigation
debridement
control _
normal response to surgical trauma
careful tissue handling
edema
careful tissue handling and head elevation can help prevent edema
_ summary
~patient care and regulatory issues
~protects patient as well as dentist, staff and other pt’s
~often cited violation by State Dental Board
~indication of commitment to patient care/professionalism
asepsis
clean technique for surgery: _ gown gloves mask instruments are sterile when opened used for most office based procedures _ is a major problem
non-sterile gown
cross-contamination is a major problem
