OEQ Flashcards
All of the following are indications for anticoagulant use except
- MI
- COPD
- Venous thrombosis
- Pulmonary embolism
COPD
Tx for ecchymosis:
No tx necessary
T/F: Short incisions heal faster than long incisions
False- incisions heal edge to edge not end to end
T/F: The most reason for prolonged post-op bleeding OR delayed healing is failure to achieve primary closure
False- Not enough pressure
For extraction of mandibular molar, the chair should be positioned so that the mandibular occlusal plane:
is parallel to the floor when the mouth is open
What type of instrument is being shown? What action is being shown?
Triangular elevator; wheel & axel
When using forceps, what should be considered?
- Continually reseat the beaks apically
- Use controlled and deliberate forces when luxating and hold each for a few seconds
When using forceps, continually reseat the beaks ____
apically
When using forceps, use controlled and deliberate forces when ____ and hold each for ____
luxating; a few seconds
When removing MAXILLARY CANINES, which of the following is NOT true
- use strong palatal force because of thick palatal bone
- they can be difficult to remove because of long roots
- when isolated they can be grasped MD
- Labial plate can be easily fractured because it is very thin
False option is: Use strong palatal force because of thick palatal bone
When extracting maxillary canines what should you NOT do?
use strong palatal force
Maxillary canines an be difficult to remove because of:
long roots
When maxillary canines are isolated, they can be grasped:
MD
What is easily fractured when extracting maxillary canines and why?
labial plate easily fractured because its very thin
T/F: If a piece of bone is removed with the tooth it should be replaced in the socket and sutured
False
Mandibular 3rd molars can be displaced into which of the following?
- maxillary sinus
- infra temporal fossa
- submental space
- submandibular space
- mandibular canal
SubMANDIBULAR space & MANDIBULAR canal
(both answers have mandibular in them)
The one tooth that can be frequently removed with elevators ONLY:
Maxillary 3rd molars
Which flap has ONE relaxing incision?
Three corner
NEVER EVER place a vertical incision flap on:
Lingual side of the mandible
Contraindications for placement of vertical release incision lines:
- Canine prominence
- Mental foramen
- Palate
- INCISIVIE papilla
- Bony lesion
- Major frena
- LINGUAL SIDE OF MANDIBLE
Why should a flap be over an adequate margin of solid bone when repositioned?
Increased healing rate; decreases wound dehiscence
The margin of a flap should be atleast ____ mm from the margins of a bony defect
5mm
For mandibular flaps, an incision can be made from tip of one coronoid process, down the anterior border of the ramus, and along the crest of the alveolus to the tip of the opposing coronoid process without:
cutting any major structures except buccinators artery & long buccal nerve
Hazard areas for mandibular flaps: (3)
- Lingual region of 3rd molars (lingual nerve damage)
- Premolar buccal vestibular region (mental nerve/vessel)
- vestibular near 2nd molar (facial artery/vein)
What anatomical structure should be avoided with mandibular flap placement?
- lingual nerve
- mental nerve
- long buccal nerve
- facial artery
- buccinator artery (buccal artery)
T/F: For maxillary flaps, an incision from one tuberosity to the other along the alveolar crest will NEVER sever anything larger than a capillary
true
Hazard areas for maxillary flaps include:
- great palatine artery
- nasopalatine nerve
What is the most popular flap in dentistry?
full thickness (mucosal tissue + periosteum)
Mucosal tissue = Sub q tissue + CT
After plan A (closed extraction with elevators and forceps) has failed, plan B would entail:
Reflect a small envelope flap, access and visualization of bone
Envelope flap:
- Full thickness flap
- without vertical releasing incision (but 1-2 vertical incisions can be added)
- apical portion must be wider than vertical portion when doing vertical incision on this envelope flap
- 2M 1D (teeth)
T/F: Roots of mandibular molar has been M-D sectioned, flap created, bone removed, etc, and are still unable to be removed. Sectioning the root B-L will NOT aid in the removal
False- it will
Of the following patients, which is most qualified for an open, surgical extraction?
- Woman with RCT
- 30 year old male with dense buccal bone and normal roots
- male with super-erupted tooth and roots into pneumatized maxillary sinus
Male with super-erupted tooth and roots into pneumatized maxillary sinus
Which is not indicated for tooth extraction?
- radiation
- super-erupted
- ortho
- extensive caries
radiation
T/F: Female has chronic periapical infection around tooth. You extract tooth and small 2mm portion of root fractures and remains. It is okay to leave this behind because of the size
False- this is not okay with PA infection
Girl has surgical extractions and which of the following would be reasons to see her post op?
a- bright red bleeding for more than 24 hours after extraction
b- little swelling at first then increased rapidly after 5 days
c- little pain at first and then unbearable after 3 days
d- slight swelling 72 hours after extraction
e- bruised 24 hours after extraction
ABC
Two tabs of Tylenol #3 contain:
60 mg codeine & 600mg of Tylenol
When extracting a maxillary molar, a large part of the maxillary tuberosity is fractured. What should you do?
Stop extraction, splint tooth for 6-8 weeks, surgical extraction at that time
Patient is sent to you for ortho extractions of four PMs. You realized you have extracted the wrong tooth. what do you do?
- Rinse with saline
- Reimplant
- Call orthodontist to see about changing treatment plan
While extracting a tooth, you accidentally luxate the adjacent tooth and it is very loose. What should you do?
- Stop procedure
- Stabilize the tooth that was accidentally luxated
- Relive occlusion
- Splint
A 5 mm oral antral opening is created when removing a maxillary molar. You close with a figure 8 stitch, instruct patient to take “sinus precautions” and prescribe which of the following?
a- antibiotic (PCN)
b- nasal spray
c- possible nasal decongestant
T/F: Patient complains of prolonged numbness for a number of weeks after you performed a block and extraction. You should wait one year before referral to oral surgeon because that is how long it takes to heal
False
What is true of surgical?
- Can be packed with pressure
- Has antibacterial properties
T/F: Surgical is used with thrombin
False
Treatment of alveolitis?
irrigate with warm water and pack with sedative dressing
Incision lines can often collapse into the defect and cause dehiscence after surgical extraction, in order to prevent this how far should incisions be placed from the bony defect?
6-8 mm
Why are incisions NOT commonly placed near the canines?
- Bony eminence so gingiva is extremely thin
- Frena/muscle attachments
(ALL OF THE ABOVE)
Alveolitis symptoms (dry socket)
- foul smell
- narcotics cannot alleviate pain
- dull constant pain referred to ear 3-5 days after procedure
- socket appears empty
- When irrigating, black coffee grounds come out
- Irrigation with cold water is painful
What type of lever is used in the mandible?
Class III
A class I lever =
elevator (lever)
A blood pressure of 118/88 is considered:
elevated
A normal BP is:
less than 120 / less than 80
Hypertensive crisis BP:
Greater than 120/ greater than 180
What do you put in site #30 if you see the IA exposure AND excessive bleeding?
place collagen
What is the part of the suture needle that connects needle to material?
swage
T/F: On an operator, the sterile areas are everything above the waste including head and neck and excluding the posterior
false
1.8 cc carpal of 0.5% bupivicaine 1:50,000 contains:
9 mg bupivicaine; .009 epi
CC x percentage = mg of anesthetic
mg x epi ratio = epi
Process of making something free from bacteria or other living microorganisms
Sterilization
How do we accomplish sterilization in dentistry?
chemical steam, saturated steam, dry heat
Insulin Dependent DM= ASA class
Class III
Pt is on Coumadin what lab test do they need done?
INR
T/F: After lunation then using forceps in bucccal motion because buccal bone is thinner and less likely to cause root fracture
False; apical motion first then buccal motion
T/F: Dr. O writes too lengthy procedure notes that are not needed
False
What are the oral hemostatic challenges?
- tissues in mouth are highly vascular
- Extractions leave open wound
- Patient explore areas of mouth with tongue
NOT: normal oral bacterium lyse blood clots
T/F: Patient had surgery 6 hours ago and now are complaining of severe pain. You thing about having them return to the office to give narco prescription and re evaluate, but the patient lives 3 hrs away. Should you just give them the prescription?
No
All of the following are considered COPD:
- hypoxemia
- increased Co2
- inability of alveolar elasticity
What should you NOT do with COPD patient?
give 6-8 liters of O2
T/F: A drill should be
HIGH speed
LOW torque
Rear exhaust
False
Which suture has only one tie and the ability to hold medicaments in the socket?
Figure 8
A 65 year old female e patient with history of NIDDM , GERD, and pack a day smoker for past 40 years. She keeps good record of her glucose which are never over 250 and her A1C is 6.5. She comes to you swollen, in a lot of pain and unable to eat or drink. She can wiggle the crown of the tooth that is bothering her.
T/F: You may extract the tooth at this time:
True
When should a dialysis patient come in for an extraction?
day after dialysis
Pt had MI 6 months ago, cleared now, and under care of cardiologist. What is the max dose of epi he can receive?
.04 mg
3 cartridges of 4% articaine 1:200k epi (least amount of epi)
Patient comes in with ecchymosis, what is the treatment?
No treatment
When using forceps, which of the following shouldn’t be considered?
- continually reseat the beaks apically
- hold for a few seconds to allow bone to expand
When removing a maxillary premolar, which of the following is NOT true?
use strong palatal force because of thick palatal bone
Mandibular 3rd molars can be displaced into which of the following?
- submandibular space
- mandibular canal
Of the following patients which is most qualified for an open surgical extraction?
64 year old male with super-erupted tooth and roots into very pneumatized maxillary sinus
Which of the following is NOT an indication for an extraction?
radiation caries secondary to area being irradiated
While extracting a tooth that is locked out (pushed lingual because of crowding) you inadvertently luxate the adjacent tooth and it is now loose. What should you do?
Stop and splint the accidental luxated tooth
What is true of surgicel?
- easy to pack
- antibacterial properties
- can pack with pressure
Alveolitis treatment:
irrigate socket
sedative dressing
Incisions are not commonly placed near the canines because of which of th following?
- bony eminence so thin gingival tissues
- frenulum attachment
- something else valid
(all of the above)
The main purpose of a flap is to:
provide access to the area (then visualization second I think)
What is the part of the needle called that should NOT be touched and connect the threat to the needle?
Swage
On an operator, the sterile areas are everything above the waist including the head and neck:
false
T/F: After lunation, first use a buccal force
False- apical force first
Surgical sterile technique refers to keeping microbes out of surgical sites in surgery. Medical sterile technique refers to keeping medical professionals/staff free of microbes
Both statements true
What is the absolute cut off for BP when performing dental treatment?
180/110
T/F: Hypertrophy referes to excessive wound healing beyond the border. Keloids refer to excessive wound healing within the wound borders
False
All of the following require antibiotic prophylaxis except:
rheumatic fever
list examples of situations that require antibiotic prophylaxis:
- previous infective endocarditis
- congenital heart defect repaired 5 months prior
- prosthetic heart valve
All of the following are indications for tooth extraction except:
mild controlled platelet disorder
Wound repair heals through what mechanism?
- proliferation
- migration
- contact inhibition
Spontaneous and subjective altered sensation that is not painful/uncomfortable
parastehsia
Reduction in the number of viable microorganisms not connected to public health standards
decontamination
Max permissable dose for acetominophin =
ibuprofen=
4000mg
3200mg
Elevating a tooth out is a class 1 lever.
Mandible is a class 1 lever.
first statement true; second statement false
OS should support finger on adjacent tooth or bone when using elevator to get roots in maxilla
true
