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Minor Oral Surgery SCOT Flashcards

(57 cards)

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1
Q

5 reasons to surgically remove fresh roots

A

Large fragments
Infected/non-vital roots
Associated pathology
Risk re PMH
Orthodontic extractions

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2
Q

2 reasons to leave fresh roots

A

Small apical fragments that are not infected/no associated pathology
Small apical fragments close to important anatomical structures

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3
Q

6 reasons to surgically remove old roots

A

Large fragments not covered by bone
Painful/ulcerated through mucosa
Infected roots
Associated pathology
Risk re PMH
Prosthodontics

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4
Q

2 reasons to leave old roots

A

Symptomless
Important anatomical structures close

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5
Q

6 stages of a surgical extraction

A

Creation of a mucoperiosteal flap
Bone removal
Delivery of the root/tooth
Debridement
Wound closure
Aftercare

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6
Q

Why cut a flap with broad base

A

Ensures good blood supply to promote healing

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7
Q

Why cut flap to sub periosteal level

A

Ensures flap integrity

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8
Q

Why should the flap include inter-dental papillae

A

Promotes healing

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9
Q

3 reasons for bone removal

A

Exposes roots
Creates points of application for elevators/forceps
Provides space to facilitate delivery of roots

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10
Q

4 structures at risk during bone removal

A

Inferior alveolar nerve
Lingual nerve
Mental nerve
Maxillary antrum

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11
Q

Why must the state of bone be considered in elderly patients

A

Generally inelastic therefore requires more work to create points of application

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12
Q

Why must the angulation of the root be considered

A

Bone removal must follow the root

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13
Q

4 problems with too much bone removal

A

Can compromise creating a point of application
Increased post-op pain
Increased swelling
Slower healing

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14
Q

3 problems with too little bone removal

A

Inadequate access
Ineffective point of application
Prolongs surgery

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15
Q

3 advantages of ensuring a good wound toilet

A

Promotes healing
Reduces post-op inflammation and pain
Reduces risk of post-op infection

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16
Q

What needs to be removed during debridement

A

Fragments of bone, tooth, filling material
Granulation tissue
Haematoma
Sharp edges

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17
Q

What suture material and needle is commonly used for basic intra-oral suturing

A

3/0 vicryl rapide
22mm 1/2 circle cutting needle

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18
Q

What is the method of wound healing used for surgical extractions

A

Primary intention

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19
Q

What is the site of wound healing

A

Vascular tissue: dermis or sub mucosa

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20
Q

What is the benefit of slightly everting a wound

A

Ensures good dermis layer contact to promote rapid healing and minimise scarring

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21
Q

Where ideally should suture knots be positioned

A

Buccally or labially away from tongue

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22
Q

At which angle should the needle be forming introduced at and why

A

90 degrees to the tissue to avoid the needle cutting out

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23
Q

5 complications of tooth removal

Study These Flashcards
A

Dry socket
Oro-astral fistula
Tooth displacement
Intraoperative fractures
Haemorrhage

24
Q

Describe dry socket

Study These Flashcards
A

Localised inflammation of bone confined to lamina dura of a tooth socket

25
6 predisposing factors for dry socket
Excessive mouthrinsing Excessive LA Excessive soft tissue damage during procedure Smokers Poor OHI Contraceptive pill
26
Clinical appearance of dry socket
Loss of blood clot from socket and exposure of vital bone Socket margins with yellow slough
27
Symptoms of dry socket
Constant boring pain commencing several days post-op Radiating pain Worse on eating
28
3 management strategies for dry socket
Washout with saline Packing with Alvogel Analgesics
29
Describe Alvogel
Dry socket treatment containing strong antiseptics to reduce bacterial load, relieve pain and prevent entry of debris into socket
30
Describe oro-antral fistula
Epithelialised abnormal connection between oral and antral cavities
31
3 causes of pro-antral fistula
Extraction of teeth Injudicious use of elevators Surgical removal of teeth/roots
32
4 signs of immediate oro-antral fistula
Bubbling air in the socket Obvious hole Patient aware of air passing between mouth and nose Change in note of the suction
33
3 signs of chronic oro-antral fistula
Patient aware of fluid passing to nose Chronic sinusitis Foul taste/discharge
34
3 signs of chronic oro-antral fistula
Patient aware of fluid passing to nose Chronic sinusitis Foul taste/discharge
35
Management of suspected immediate OAC
Advise patient to avoid nose blowing
36
Management of immediate obvious or long standing OAC
Require closure with buccal advancement flap or palatal rotational tap Begin antial regime: antibiotics, analgesics, decongestants May need to remove chronically infected antral lining
37
5 sites of tooth displacement
Antrum Sinus Submandibular space Lung Stomach/GI
38
Signs of root displaced into antrum
Sudden give causing elevator to shoot upward No longer able to see root Visible communication into antrum
39
Management of root displaced into antrum
Open area to identity if lining is intact or torn If intact: look for root between antral lining and bone If torn: open and explore sinus and retrieve root 
40
3 intraoperative fractures
Buccal plate Tuberosity Mandible
41
3 risk factors for fractured buccal plate
Single standing molar tooth Difficult teeth (root pattern, hypercementosis, ankylosis) Middle aged or elderly patients
42
4 signs of fractured buccal plate
Audible crack Sudden give in resistance Abnormal mobility palpable buccally Torn buccal mucosa
43
Management of fractured buccal plate
Small fractures: no action required Large fractures: dissect the overlying mucosa free from fractured buccal plate then continue the extraction to prevent loss of the attached gingiva
44
4 risk factors for fractured tuberosity
Single standing maxillary molar tooth Difficult teeth (root pattern, hypercementosis, ankylosis) Pneumatisation of antrum mesial to single standing tooth Middle aged or elderly patients
45
5 signs of fractured tuberosity
Audible crack Sudden give in resistance Abnormal mobility palpable buccally and palatally Altered occlusion Torn mucosa buccally and palatally
46
Management of small and large fractured tuberosities
Small: dissect out the tuberosity to preserve the mucosa and close wound Large: dissect the tooth from the tuberosity to preserve the bone and mucosa, control infection/pain, dressings RCT and analgesics and antibiotics
47
3 risk factors for fractured mandible
Thin/ resorbed mandible Difficult teeth ( root pattern, hypercementosis ankylosis) Elderly patients
48
5 signs of fractured mandible
Audible crack Sudden give in resistance Abnormal mobility Torn buccal/lingual mucosa Bleeding from around the extraction site
49
Management of fractured mandible
Stop Assess Inform patient Contact (phone) local OMFS Dept
50
Define primary haemorrhage
Haemorrhage that occurs intra-operatively
51
Define reactionary haemorrhage
Haemorrhage that occurs 3-4 hours post operatively
52
Define secondary haemorrhage
Haemorrhage that occurs 7-10 days post-operatively
53
Management of reactionary haemorrhage
Gauze packs Surgicel pack Bone wax Suturing Re-issue post-op advice
54
3 causes of reactionary haemorrhage
Vasoconstrictor wearing off Patient interference with the wound Inadequate pain control
55
Cause of secondary haemorrhage
Infected socket
56
Management of secondary haemorrhage
Gauze packs Surgicel pack Bone wax Antibiotics
57
Management of primary haemorrhage
LA containing adrenaline Gauze packs Surgicel pack Bone wax Antibiotics

Oral surgery (7 decks)

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