Minor Oral Surgery Techniques for Fractured Teeth and Retained Roots Flashcards
What are reasons for teeth fracturing?
reasons for teeth fracturing:
- thick cortical bone
- root shape
- root number
- hypercementosis
- ankylosis
- caries
- alignment
What is hypercementosis?
hypercementosis is a root with too much cementum on it
What is ankylosis?
ankylosis:
- fusion between root and bone
- loss of PDL space
- direct contact between tooth and bone
- difficult to distinguish between the two
What are patient warnings to give to give prior to minor oral surgical techniques?
patient warnings prior to minor oral surgical techniques:
- explain the procedure to the patient
- if the tooth needs sectioning, describe this to the patient
- give the patient an idea of what to expect during the procedure - explain the minor oral surgical procedure in lay terms
- pressure, no pain
- lift the gum
- possible drilling (same drill as the one used for fillings)
- stitches
- if adjacent teeth are cllose by then it would be sensible to watn of possible damage to these teeth
What post-operative complications should a patient be warned of before a minor oral surgical procedure?
warnings of post-operative complications prior to minor oral surgical procedures:
- pain
- swelling
- bruising
- jaw stiffness
- bleeding
- dry socket
- infection (although this is unusual)
- nerve damage risk
- temporary, permanent, altered
A general surgical principle is to have X access with Y trauma
X - maximal
Y - minimal
What heal quicker - bigger flaps or smaller ones?
bigger flaps heal just as quickly as smaller ones
Why should a wide based incision be used with surgical techniques?
a wide based incision should be used with surgical procedures due to circulation
What kind of stroke should a scalpel be used in when making an incision?
when making an incision, a scalpel should be used in one firm continuous stroke
What can be said about angles in a surgical procedure?
there should be no sharp angles when creating an incision for a surgical procedure
What should there be minimal trauma to with a minor oral surgical procedure?
with a minor oral surgical procedure, there should be minimal trauma to dental papillae
In minor oral surgical procedures, flap reflection should be down to X and done clearly
X - bone
Tissue should be kept X during a minor oral surgical procedure
X - moist
When doing a minor oral surgical procedure, what should you ensure that flap margins and sutures lie on?
when doing a minor oral surgical procedure, ensure that flap margins and sutures lie on sound bone
When doing a minor oral surgical procedure, make sure thta wounds are not closed under X
X - tension
Following a minor oral surgical procedure, you should be aiming for healing by X to minimise scarring
X - primary intention
Why should you be aiming for healing by primary intention following a minor oral surgical procedure?
you should be aiming for healing by primary intention following a minor oral surgical procedure to minimise scarring
Why is soft tissue retraction done during a minor oral surgical procedure?
during a minor oral surgical procedure, soft tissue is retracted to:
- give access to the operative field
- protect soft soft tissues
What instruments can be used for soft tissue retraction?
soft tissue retraction - instruments:
- Howarth’s periosteal elevator
- Bowdler-Henry retractor (rake)
What type of flap is used for closure of an OAC?
a buccal advancement flap is used for closure of an OAC
What is a buccal gutter?
a buccal gutter is a gutter between the buccal cortex and buccal surface of the root
Where is a stitch placed first?
a stitch is placed in the first area that is incised
Flaps should be designed to be X than the defect that you are going to cerate
X - wider
Should a flap be resting on a hole?
no, a flap shouldn’t be resting on a hole - it should be on healthy bone
What instruments can be used to physically debride?
physical debridement:
- bone file
- handpiece
- Mitchell’s trimmer
- Victoria curette
What can a bone file or handpiece be used to remove?
a bone file or handpiece can be used to remove sharp bony edges
What can a Mitchell’s trimmer or Victoria curette remove?
a Mitchell’s trimmer or Victoria curette can be used to remove soft tissue debris
What can be used for irrigation in minor oral durgical techniques?
sterile saline/water into the socket and under the flap can be used for irrigation in minor oral surgery procedures
Where should sterile saline/water be used in irrigation in minor oral surgery procedures?
in minor oral surgical procedures, sterile saline/water should be introduced into the socket and under the flap for irrigation
During minor oral surgical procedures, where should be aspirated to remove debris?
during minor oral surgical procedures, you should aspirate under the flap to remove debris
When suctioning as part of a minor oral surgical technique, what should you check the socket for?
when suctioning as part of a minor oral surgical procedure, check the socket for retained apices
When suturing, what should be compressed?
when suturing, compress the blood vessels
What are the aims of suturing?
aims of suturing:
- reposition tissues
- cover bone
- prevent wound breakdown
- achieve haemostasis
- encourage healing by primary intention
Sutures can either be Xfilament or Yfilament
X/Y - mono
X/Y - multi
What are examples of resorbable sutures?
resorbable sutures:
- monocryl (monofilament)
- vicryl (multifilament)
What are examples of non-resorbable sutures?
non-resorbable sutures:
- prolene (monofilament)
- mersilk (multifilament)
What is a monofilament resorbable suture?
monofilament resorbable suture = monocryl
What is a multifilament resorbable suture?
multifilament resorbable suture = vicryl
What is a monofilament non-resorbable suture?
monofilament non-resorbable suture = prolene
What is a mulitfilament non-resorbable suture?
multifilament nono-resorbable suture = mersilk
How can haemostasis be achieved per-operatively?
peri-operative - achieving haemostasis:
- LA with vasoconstrictor
- artery forceps
- diathermy
- bone wax
How can haemostasis be achieved post-operatively?
post-operative - achieving haemostasis:
- pressure
- LA with vasoconstrictor
- diathermy
- Whitehead’s varnish pack
- surgicel
- sutures
