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BDS Exam style questions > OMFS > Flashcards

OMFS Flashcards

1
Q

What are the signs and symptoms of maxillary fracture?

A

Mobility of maxilla
Pain
Epitaxis
Numbness
Occlusal changes
Bony step formation

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2
Q

What are the LeFort Classifications?

A

Lefort- must involve pterygoid plates
1- Teeth and palate mobile
2- Involves nose mobility (into medial orbit)
3- Involves orbit mobility- all nasal bones and orbital bones included

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3
Q

What special investigations are used for fractures of the maxilla?

A

Occipitomental radiograph- 15 and 30 degrees

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4
Q

How is fracture of the maxilla managed

A

Closed reduction +/- fixation

Open reduction with internal fixation

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5
Q

What are the signs of a zygomatic-orbital fracture?

A

Facial asymmetry
Numbness in face
Pain
Difficulty moving eye
Restriction of looking up
Subconjucitval haemorrhage
Periorbital echymosis
Limited mouth opening

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6
Q

What radiographic views are requested for zygomatic-orbital fracture?

A

Occipitomental- 15 and 30 degrees

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7
Q

What are the treatment options for a zygomatico-orbital fracture?

A

Conservative management

ORIF

Closed reduction +/- fixation

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8
Q

What post operative advice is given to patients with zygomatic-orbital fracture?

A

Avoid nose blowing

Pain manangement advice

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9
Q

What are the signs and symptoms of mandibular fracture?

A

Limited opening
Occlusal derangement
Bleeding- sublingual haematoma
Asymmetry
AOB
Step deformity

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10
Q
A
  1. Involvement of soft tissue- simple/compound/comminuted
  2. Number- single, double, multiple
  3. Side- unilateral, bilateral
  4. Site
  5. Direction of fracture line- favourable or unfavourable
  6. Displacement
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11
Q

What radiographic views are used for mandibular fracture?

A

If plain (2 at right angles)- OPT and PA mandible

CBCT

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12
Q

How is mandibular fracture managed?

A

Control pain and infection- NSAIDs and ABs

If undisplaced- no tx

If displaced- closed with IMF or ORIF

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13
Q

What is a cyst?

A

A pathological cavity having fluid, semi-fluid or gaseous contents & which is not created by the accumulation of pus

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14
Q

What are the inflammatory cysts?

A

Odontogenic:
Radiciular cyst (and residual)

Inflammatory collateral cyst
-> Paradental
-> Buccal bifurcation cyst

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15
Q

What are the developmental cysts?

A

Odontogenic:
Dentingerous (eruption) cyst
Odontogenic keratocyst
Lateral periodontal cyst

NO:
Nasopalatine duct cyst

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16
Q

What are the treatment options for Cysts?

A

Enucleation

Marsupialisation

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17
Q

What are the advantages of enucleation?

A

Whole lining can be examined pathologically

Primary closure

Little aftercare needed

18
Q

What are the disadvantages of enucleation?

A
  • Risk of mandibular fracture with very large cysts
  • (Dentigerous cyst) wish to preserve tooth
  • Old age/ill health- can’t be put under GA
  • Clot-filled cavity may become infected
  • Incomplete removal of lining may lead to recurrence
  • Damage to adjacent structures
  • Daughter cysts in the keratocyst lining – to remove all of these would cause damage to adjacent structures/anatomy (have to use marsupialisation)
19
Q

What are the advantages of marsupialisation?

A

Simple to perform

Spares vital structures

20
Q

What are the disadvantages of marsupialisation?

A
  • Opening may close & cyst may reform
  • Complete lining not available for histology
  • Difficult to keep clean & lots of aftercare needed
  • Long time to fill in
21
Q

Where does an odontogenic keratocyst develop from?

A

Rests of Serres

22
Q

How does an OK appear histologically?

A

Daughter/sateillite cysts (if these are left they will form a new cyst)

Parakeratinised pithelial lining

No rete pegs in epithelium

Basal palisading- basal cells at same height

Evidence of multicentric growth with finger like projections

Cavity- wavey appearance

23
Q

How does an OK appear radiographically?

A

Well defined

Scalloped margins

Often multilocular

Often cause displacement of adjacent teeth

Root resorption is uncommon

24
Q

What are the issues with OK?

A

Late presentation- grows mesially-distally then starts to displace cortical bone/teeth

Recurrence- daughter cells

25
Q

What condition is associated with OK?

A

Gorlin-Goltz syndrome

26
Q

What does a radicular cyst develop from?

A

Epithelial rests of mallasez

27
Q

What are the histological features of Radicular cysts?

A

Connective tissue capsule

Epithelial lining- NK stratified squamous

Cholesterol clefts

Hyaline/rushton bodies

Mucous metaplasia

Inflammation

28
Q

How does a radicular cyst appear radiographically?

A

Round/oval

Well-defined

Coricated- margin continuous with lamina dura of non-vital tooth

Larger lesions may displace adjacent structures

Long standing lesions
-> External root resorption
-> dystrophic calcification

29
Q

Where does a dentigerous cyst develop from?

A

Reduced enamel epithelium

30
Q

How do dentigerous cysts appear histologically?

A

Thin NK Stratified squamous epithelium lining
-> attached to ACJ of unerupted tooth

May look like radicular cyst if inflamed

31
Q

How do dentigerous cysts appear radiographically?

A

Corticated margins attached to cemento-enamel junctionoftooth

Larger cysts may begin to envelope root of tooth

Initially symmetrical- may expand unilaterally as it gets larger

May be evidence of displacement of involved tooth and cortical bone

32
Q

Where are dentigerous cysts most commonly seen?

A

Unreupted:

Mandibular 8s

Maxillary 3s

33
Q

What are the epithelial derived odontogenic tumours?

A

Ameloblastoma

Adenomatoid Odontogenic Tumour

Calcifying Epithelial Odontogenic Tumour

34
Q

What are the histological features of Ameloblastoma?

A
  • Islands present within fibrous tissue background, bordered by cells resembling ameloblasts (columnar cells, dark stained nucleus)

Follicular:
Tissue in middle of follicles- loose tissue similar to stellate reticulum (may be cystic changes or squamous metaplasia within follicles)

Plexiform:
- Similar to follicular but different arrangement
- Ameloblast like cells arranged in strands with stellate reticulum like tissue between
- Fibrous tissue support

35
Q

What is a mixed epithelium and mesenchyme tumour?

A

Odontoma

36
Q

What is a mesenchyme tumour?

A

Odontogenic myxoma

37
Q

What are the indications for orthognathic surgery?

A

Fully grown

Functional and aesthetic issues- mental health impact

Severe skeletal discrepancy

38
Q

What are the risks of orthognathic surgery?

A

Pain

Nerve damage

Bleeding

Infection

Relapse

39
Q

What special investigations are done for orthognathic surgery?

A

Radiographs

Study models

Photographs- 2D/3D

40
Q

What are the types of mandibular surgery?

A

Saggital split

Genioplasty

Vertical sub-sigmoid osteotomy

41
Q

What are the types of maxillary surgery?

A

Le Fort 1

Anterior maxillary osteotomy

BDS Exam style questions (15 decks)

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