Midterm Flashcards
Two congenital syndromes that cause deformities
Ectodermal dysplasia
Treacher Collin’s
3 ways to treat skeletal malocclusion
Orthognathic surgery
Growth redirection
Orthodontic camouflage
Problems with ortho camouflage
Possibly less stable
Possibly less esthetic
Perio compromise
Recent Innovation that has increased envelope?
TADs
What costs more when doing double jaw surgery
Hospital bill is $35,000, surgeon fee is $6,500
How to determine vertical position when doing jaw surgery
K wire placed in nasion
Pros/cons of BSSO
Pro:
Can advance or set back
Stable rigid internal fixation possible
Con:
Potential for alveolar nerve injury
Not good for anterior open bite (counterclockwise rotation)
What does BSSO stand for
Bilateral sagittal split ramus osteotomy
Pros of LeFort I
Move max in all planes Stable treatment of anterior open bite Allow segmentation of maxilla Low morbidity Internal rigid fixation possible
What is diet like after lefort
3 days liquid only, soft for 6 weeks
Why is surgery for cleft patients more difficult
Large max AP deficiencies Scar tissue VP incompetence Vascular compromise Palatal and nasolabial fistulas
Common teeth for cleft patients to lack
Lateral incisors
Large AP moves often require what
Distraction
Orthognathic surgery pros and 1 con
Limited morbidity Short hospital stay Rarely need wiring Intraoral incisions Satisfaction very high
Possible nerve damage
Week where facial structures fuse
7
Failure of Which processes to fuse is the cause of cleft lip/palate
Median nasal and maxillary
Highest race for cleft lip
Asian
Males are more likely to have cleft _, females more likely to have _
Cleft lip
Isolated cleft palate
_ often occurs with cleft
Middle ear disease
Rule of tens
10 weeks
10 lbs
Hemoglobin > 10
WBC < 10
When to close soft tissue of palate?
Why?
12 months
Speech
Velopharyngeal flap problems can lead to what
Nasal speech
Mouth breathing
OSA
Complications during intubation for surgery
Why do an alveolar bone graft for cleft palate pts
Continuous arch Support for adjacent teeth Bone for canine Support nose Close fistula
Most common time to do alveolar bone graft in cleft patient
Mixed dentition
Impacted vs unerupted
Unerupted is not breaking through mucosa. Impacted is not erupting within expected developmental time period.
4 theories about impacted 3rds
Mesial and distal growth difference
Inadequate arch
Dental dev behind skeletal dev
Obstructed by cyst, tumor, supernumerary tooth
Winter’s classification of 3rds
- Mesioangular (easiest)
- Distoangular (hardest)
- Horizontal (hard)
- Vertical (easy)
Order of prevalence of winters class for mand and max
Mand: Mesial Vertical Distal Horizontal
Max: Vertical Distal Mesial Horizontal
Therapeutic vs prophylactic
Therapeutic - treat active disease
Prophylactic - prevent future disease
Indications for removal
C PCP FLOOR PP Caries Path Crowding Perio Fracture Lack of attached gingiva Ortho Orthognathic surgery Resorption Pericoronitis Pain
Why is it better to get thirds out when young
Healing is faster
Surgery is easier
Where is no mans land on mandibular 3rds
Distolingual to mandibular 3rd. Can get the nerve
Snap or crack means what
A root has failed until proven otherwise
6 basic surgical principles
Suction, lighting, soft tissue reflection Pathway for removal Controlled force Sterile techniques Thorough debridement Adequate closure
What to do if there is a sinus perf
Antibiotic Decongestant Afrin Written and verbal instructions Suture tight Follow up
When does post op osteomyelitis happen
Smokers
Long wound healing
Immunocompromised
Direct vs indirect injury
Direct: where you’re hit
Indirect: opposite side
Step deformity:
Feel edge of mandible for a step fracture
Impacted 3rds lead to what type of fracture
Angle
Which injury to teeth have worst prognosis
Intruded
Splinting for too long causes what?
How long to splint avulsed tooth
Resorption and ankylosis
7-10 days
Formula for saline
8 oz water and 1/3 tsp salt
Why give doxycycline
Avulsed <2 hours, open apex, enhances revascularization
Why is it better to rupture a vein than an artery
Pressure can stop venous bleeding, won’t stop arterial
Lip damage, first suture?
Vermilion border. Step is noticeable
Types of fractures
Greenstick (partial)
Simple (one line)
Comminuted (multiple fractured pieces)
Compound (open)
4 principles of fracture management
Reduction
Stabilization
Immobilization
Prevent infection
Open vs closed reduction
Closed is no surgery, just using wires to perform MMF
Open is surgery to place plate over fracture to hold parts together
