MOS techniques - fractured teeth and retained roots Flashcards
Why do teeth fracture
thick cortical bone root shape root number hypercementosis ankylosis caries alignment
What does the assessment consist of
history
clinical evaluation
radiographic evaluation
What do we say to the patient prior to the procedure
explain it
if tooth needs sectioning describe
give idea of what to expect during procedure
if adjacent teeth are close by then warn of possible damage
What can the patient explain during MOS
pressure, no pain lift the gum up possible drilling (same drill as one used for fillings) water from drill stitches
What are the post op complications to warn of
pain swelling bruising jaw stiffness bleeding dry socket infection (usual) nerve damage risk
What are the general surgical principles
maximal access with minimal trauma
bigger flaps heal just as quickly as smaller ones
wide based incision - circulation
use scalpel in one firm continuous storke
no sharp angles
adequate sized flap
minimize trauma to dental papillae
flap reflection should be done down to bone and cleanly
no crushing
keep tissue moist
ensure that flap margins and sutures will lie on sound bone
make sure wounds are not closed under tension
aim for healing by primary intention to minimize scarring
Why is soft tissue retraction important
access to operative field
protection of soft tissue
flap design facilitates retraction
What instruments can be used for soft tissue retraction
howarth’s periosteal elevator
bowler-henry retractor
How do we do physical debridement
bone file or handpick to remove sharp bony edges
mitchell’s trimmer or victoria curette to remove soft tissue debris
What can we use for irrigation
sterile saline/water into socket and under flap
How do we do suction
aspirate under flap to remove debris
check socket for retained apices
What are the aims of suturing
reposition tissues cover bone prevent wound breakdown achieve haemostasis encourage healing by primary intention
What are the restorable monofilament sutures
monocryl
What are the restorable multifilament sutures
vicryl
What are non restorable monofilament sutures
prolene
