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Oral Surgery III > Midterm Study Guide > Flashcards

Midterm Study Guide Flashcards

1
Q

What are the charactertistics of an ideal alveolar ridge?

A
  1. Proper jaw relationship
  2. Proprer configuration of alveolar process (Broad U-shape)
  3. No bony or soft tissue protuberances or undercuts
  4. Adequate attached keratinized mucosa in the primary denture-bearing area
  5. Adequate vestibular depth (BL)
  6. Adequate bone height and width
  7. Fixed tissue under denture
  8. No obstructing frenal or scar bands
  9. No displacing muscle attachments
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2
Q

When a tooth is no longer situated in the alveolar bone, what happens to the alveolar bone?

A

-Immediate change starts following tooth loss due to lack of functional stress from the PDL (PRIMARY CAUSE)

-The bone atrophies but muscle attachments remain in the same place leading to:
1. lack of floor of mouth on lingual side
2. Lack of vestibular depth on buccal side

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3
Q

What is the PRIMARY cause of immediate change of alveolar bone following tooth loss?

A

Lack of functional stress from PDL

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4
Q

Describe bone resorption from one person to another:

A

Unpredictable- in some people it is stabilized and in others you can have total loss of alveolar and underlying basal bone

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5
Q

Which arch resorbs more quickly following extractions?

A

Mandible

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6
Q

What component of the maxilla resorbs most quickly following extractions?

A

Hamular notch

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7
Q

Increasing the quantity or quality of bone or soft tissues in edentulous areas of the oral cavity:

A

Vestibuloplasty

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8
Q

The purpose of a vestibuloplasty is to reposition the alveolar mucosa and muscle insertions more ____ to gain ____

A

apically; vestibular depth

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9
Q

Another name for vestibuloplasty:

A

Relative ridge augmentation

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10
Q

Vestibuloplasty increases:

A
  1. surface area of fixed tissue for denture support
  2. depth of vestibules for denture flange extension
  3. depth of sulcus for healthy, firm soft tissue coverage of the ridge & adequate bony support for the denture
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11
Q

Indications for performing a RELATIVE alveolar ridge augmentation:

A

-Flat ridge with MODERATE resportion of alveolar bone
-2cm or MORE of bone present at mid-body of mandible

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12
Q

Where will height be increased for a RELATIVE alveolar ridge augmentation?

A

in symphysis and mid-body regions

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13
Q

Indications for performing an ABSOLUTE alveolar ridge augmentation:

A

-Flat ridge with EXTREME resorption of alveolar bone
-BONE GRAFTING is done to increase the bone height
-LESS THAN 2cm of bone at mid-body of mandible

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14
Q

If we have less than 2cm of bone at mid-body of mandible this indicates:

A

ABSOLUTE alveolar ridge augmentation

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15
Q

Where can you procure bone for AUTOLOGOUS bone graft to maxilla/mandible?

A

Iliac crest

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16
Q

Describe bone resportion in the maxilla:

A

Buccal-Palatal respiration (WIDTH)

Maxillary resportion = WIDTH

(also tends to get hypermobile soft tissue)

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17
Q

Describe bone resportion in the mandible:

A

SUPI

Superior-inferior resportion (HEIGHT)

(More bone resportion in mandible)

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18
Q

Bone resportion in enhanced by:

A
  1. surgery
  2. denture wearing
  3. low mandibular plane angle
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19
Q

What deficiencies may accelerate bone resportion?

A

Vitamin D & Calcium

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20
Q

What systemic diseases may accelerate bone resorption?

A
  1. Osteoporosis
  2. Endocrine dysfunction
  3. other conditions
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21
Q

List the possible causes of tooth impactions:

A
  1. inadequate arch length
  2. prolonged deciduous tooth retention
  3. malposition of impacted tooth
  4. excessive bone or soft tissue
  5. malposition of adjacent tooth/teeth
  6. associated pathology (third molars more prone)
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22
Q

What is the MOST COMMON cause of tooth impaction?

A

malposition of impacted tooth

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23
Q

Which teeth are most likely to become impacted (in order):

A
  1. Mandibular third molars
  2. Maxillary third molars
  3. Maxillary canines
  4. Mandibular premolars
  5. Mandibular canines
  6. Maxillary incisors
  7. Supernumeraries
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24
Q

If a MAXILLARY tooth is impacted, what position/orientation is it typically located in?

A

VERTICAL impaction

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25
Q

If a MANDIBULAR tooth is impacted, what position/orientation is it typically located in?

A

MESIOANGULAR impaction

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26
Q

What is the most difficult of an impacted tooth for removal?

A

Distoangular impaction

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27
Q

What classification system is used for third molar impactions?

A

Pell & Gregory Classification

28
Q

In Pell & Gregory classification of impacted third molars, what does class 1, 2, 3 describe?

A

Relation of mandibular third molar to anterior border of the ramus

29
Q

In Pell & Gregory classification of impacted third molars, what does class A, B, C describe?

A

The depth of impaction of maxillary or mandibular third molars in bone relative to adjacent tooth

30
Q

Determine the Pell & Gregory classification of the following:

-Sufficient amount of space between the anterior border of ramus and the distal of the second molar for the accommodation of the entire crown of the third molar

-situated ANTERIOR to the anterior border of the ramus with ADEQUATE room to erupt

31
Q

Determine the Pell & Gregory classification of the following:

-Space between the anterior border of the ramus and the distal of the second molar LESS THAN the MD diameter of the crown of the third molar

-Crown is 1/2 covered by anterior border of the ramus

32
Q

Determine the Pell & Gregory classification of the following:

-The entire third molar is within the ramus

33
Q

Determine the Pell & Gregory classification of the following:

-The occlusal plane of the impacted tooth is at the SAME LEVEL as the adjacent tooth

34
Q

Determine the Pell & Gregory classification of the following:

-The occlusal plane of the impacted tooth is BETWEEN the occlusal plane and CEJ of the adjacent tooth

35
Q

Determine the Pell & Gregory classification of the following:

-The occlusal plane of the impacted tooth is apical to the cervical line of the adjacent tooth

36
Q

What the are the radiographic predictors determining the proximity of the inferior alveolar nerve to an impacted mandibular third molar?

A
  1. Darkening of the root
  2. Interruptiuon of the white line cortication (lamina dura) of the canal
  3. Deflection or narrowing of root
  4. Diversion or narrowing of canal
  5. PA radiolucent area
37
Q

Why and where do you perform buccal hockey stick incision?

A

-Triangular flap for a full bony impacted third molar

-Must be on the BUCCAL to avoid damage to the lingual nerve

38
Q

For a buccal hockey stick incision you are trying to avoid damage to the:

A

Lingual nerve

39
Q

What are the various treatments to remove impacted teeth?

A
  1. flap & surgical removal
  2. section the tooth
  3. surgical exposure and orthodontic guided eruption
40
Q

What are the potential complications for performing impacted teeth surgery?

A
  1. hemorrhage
  2. fractured root or damage to adjacent tooth or tooth displacement
  3. or-antral or oro-nasal communication
  4. fracture mandible or maxillary tuberostiy
  5. nerve injury (paresthesia)
  6. infection
41
Q

Note maxillary sinus anatomy, what is in the bony box?

A

-should be empty and only filled with air
-the largest paranasal sinus is located in the maxilla
-pyramidal in shape
-lateral nasal bone forms the base
-ostium drains from maxillary sinus to middle meatus
-asymmetry can exist
-capacity is 15ccs

42
Q

Lining of the maxillary sinus cavity:

A

Scheiderian membrane

43
Q

What is the Scheiderian membrane made of:

A

Mucous secreting pseudostratified ciliated columnar epithelial cells oni the internal side

Fewer mucous glands on the lateral wall compared to the medial wall

44
Q

Gold standard for sinus imaging:

A

Waters radiograph

(sinus should appear radiolucent)

45
Q

About 10% of inflammatory episodes (sinusitis) are extensions of:

A

dental infections

46
Q

Time period for ACUTE sinusitis:

A

Less than 2 weeks

47
Q

Signs and symptoms of sinusitis:

A

-headache
-pain
-nasal obstruction
-nasal discharge
-toxic manifestations
-heavy feeling with bending
-congestion

48
Q

Treatment for acute sinusitis:

A

antibiotics (Augmentin) for pneumo & streptococci

Nasal decongestion (Afrin)

Steam inhalation (restores function of cilia)

Analgesics, NSAIDs & antihistamine

49
Q

Timeline for CHRONIC sinusitis:

A

greater than 3 months

50
Q

Complications of maxillary sinusitis:

A
  1. orbital abscess and orbital cellulitis
  2. intracranial abscess/meningitis
  3. cavernous sinus thrombosis
  4. spread of infection to neighboring sinuses, structures and organs
  5. osteomyelitis
51
Q

LeFort Type 1, 2 & 3 fracture patterns:

A
  1. Horizontal alveolar ridge
  2. Pyramidal nasofrontal structure
  3. Horizontal craniogavial dislocation
52
Q

Access for sinus lift:

53
Q

How can you visualize inside of maxillary sinus?

A

Caldwell luc approavh

54
Q

Do you need surgery with less than 2mm of OAC?

55
Q

2-6mm of OAC =

A

Figure 8 suture

56
Q

Greater than 7mm of OAC =

A

Surgical treatment (buccal flap)

57
Q

T/F: You can use buccal fat pad to close OAC

58
Q

Two different types of flaps to close OAF include:

A
  1. Buccal advancement flap
  2. Palatal rotation flap
59
Q

Best way to tell on radiograph of IAN involvement:

A

darkening of roots

60
Q

What is the purpose of buccal hockey stick shape?

A

To avoid damage to lingual nerve

(incison on buccal side)

61
Q

T/F: Purpose of valsalva maneuver is to check for sinus involvement in the mandible

A

False (maxilla)

62
Q

How long should Afrin nasal srapy be used?

A

2-3 puffs daily for 3-4 days

63
Q

Can you prescribe affrin for moderate OAF:

64
Q

What are the treatments for chronic sinusitis?

A

-nasal decongestant
-analgesic
-antibiotic
-possibly surgery

Oral Surgery III (2 decks)

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