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OMS > oms y3t3 > Flashcards

oms y3t3 Flashcards

1
Q

majority of infections due to what kind of bacterial

A

aerobes
anaerobes (will eventually be the predominant species)
streptococcus (Alpha hemolytic)

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2
Q

what is pathway of spread of infection affected by

A
  1. thickness of overlying bone at apex: drainage of infections spread through path of least resistance
  2. rship of perforation of bone to underlying mm attachment: higher than mm attachment = sinus opening at skin. lower than mm attachment = intra oral
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3
Q

ludwig angiina

A

aggressive rapid spread of cellulitis involving subL submd submn spaces
complications: airway obstruction, dysphagia, spread to other spaces

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4
Q

pri vs sec oral candidiasis

A

pri - condition is confined to mouth and peri oral tissue
sec - the oral candidiasis is just an oral manifestation of systemic mucocutaneous candidiasis

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5
Q

tx of candida

A

nystatin swish, *cannot give w chx
clotrimazole (oral)

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6
Q

which tissue can regenerate

A

only bone regenerates, all other tissues heal by scar

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7
Q

definition of dental implants

A

implants are perimucosal device which are BIOCOMPATIBLE AND BIOFUNCTIONAL and is placed within mucosa or bone in the oral cavity to provide support for fixed or removable prosthesis

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8
Q

definition of osseo integration

A

a TIME DEPENDENT healing process whereby clinically asymptomatic rigid fixation of alloplastic material is achieved and maintained during functional loading

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9
Q

factors that affect OI

A
  • implant biocompatibility
  • implant design
  • implant surface
  • implant bed
  • sx technique
  • loading conditions
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10
Q

attachment on natural tooth vs on implants

A

both have unbroken perimucosal seal between soft tissue and tooth surface / implant abutment surface
natural tooth: hemidesmosomes + PDL
implants: hemidesmosomes (LJE) only

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11
Q

parts to an implant crown

A
  1. crown (prosthetic)
  2. abutment
  3. titanium post (fixture)
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12
Q

titanium alloy

A

tit-6-alu-4-vanaium

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13
Q

what is steady state bone response

A

bone reso = bone depo

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14
Q

what is “pitch” of an implant

A

pitch = the no. of threads per unit length
increased pitch and depth btwn individual threads allow for improved contact area btwn bone and implant

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15
Q

which type of bone is best for implant success

A

type 2 bone: thick layer of cortical bone surrounding dense trabecular bone
usually found in lower posterior jaw
takes ~4mth to OI

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16
Q

features that are essential to proper implant sx

A
  • careful cooling of sx drill to prevent bone from heating up
  • using sharp drills
  • using graded series of drills that gradually increase in diameter
  • proper drill geometry
  • moderate lvl of insertion torque
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17
Q

what is fibro osseous integration

A

tissue to implant contact w dense collagenous tissue btwn implant and bone. presents as being clinically firm but over time due to masticatory mvmt, more fibrous tissue forms, poor LT success

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18
Q

some complications of implants

A

peri implantitis
penetration of sinus
implant loosen drift into sinus
aesthetic poor
fractured implant component
perforation of anatomical structures

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19
Q

best time to book medically complicated pt

A

morning!!!

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20
Q

what are 3 components of gasgow coma scale

A

eye opening
motor
verbal

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21
Q

le fort fracture pattern tend to cause hematomas where

A

at the junction of hard and soft palate

22
Q

sublingual hematoma is characteristic of

A

md fractures (particularly parasymphysis)

23
Q

what xrays for mx fracture

A

occipittomental view (aka waters view)
OPG

24
Q

what xrays for md fracture

A

lateral oblique
towne’s view
occlusal

25
Q

xrays to take for condylar fracture

A

reverse townes
pos-ant of skull
opg

26
Q

most common etiology of facial fractures

A

road traffic accidents

27
Q

most common site of md fraacture

A

body of md
sub condylar

28
Q

classification of type of fracture:
1. green stick
2. simple
3. comminuted
4. compound

A
  1. greenstick: incomplete separation at the fracture
  2. simple: complete separation, minimal fragmentation
  3. fractured bone is in multiple segments
  4. communication of margin of fractured bone w external envt
29
Q

favourable vs unfavourable fracture

A

favourable = less displacement of fractured part when mm pulls
unfavourablel = mm pull results in more displacement

30
Q

closed reduction vs open reduction

A

closed - any tx that doesnt involve open sx exposure of fracture
open - sx access is required

31
Q

what does lindahl’s classification of condylar fracture include

A
  1. fracture level (which part of condyle)
  2. rship of condylar fragment to md
  3. rship of condylar head to fossa
32
Q

unilateral effusion / hemarthrosis of condyle

A

ipsilateral POB
midline shift away

33
Q

unilateral fracture + dislocation

A

premature contact + midline shift towards

34
Q

bilateral fracture + dislocation

A

AOB, loss of ramus height

35
Q

bilateral dislocation wo fracture

A

md prognathism, inability to ocl

36
Q

when is ORIF required

A
  • condylar displaced into middle cranial fossa
  • inability to obtain adequate ocl by closed reduction
  • foregin body
  • lateral extracapsular displacement of condyle
  • bilateral condyle fracture in edentulous pt when splinting is impossible
37
Q

presentation of le fort 1 fracture

A

AOB, split palate, swelling, increased LAFH, epistaxis (nose bleed)

38
Q

presentation of le fort 2 fracture

A

AOB, hypertelorism (eyes further apart), periorbital ecchymosis, subconjunctival hemorrhage, epistaxis

39
Q

presentation of le fort 3 fracture

A

AOB, diplopia, periorbital ecchymoses, flattening of cheeks, subconjunctival hemorrhage, tilting of ocl plane

40
Q

how to tx midface fractures when ocl is affected

A
  • reest proper ocl rship w md
  • IMF
  • anatomical reduction + stabilisation of fractured site (direct wiring, bone plates)
41
Q

how to tx mid face fractures when ocl is not affected

A
  • open reduction e/o or i/o
  • small bone paltes or wiring to stabilise
42
Q

principles of tx for fractures

A
  1. reduction
  2. immobilisation
  3. fixation
  4. rehabilitation
  5. restore previous injury form and fn
  6. precise hard tissue repair
  7. soft tissue redrape
  8. restore volume, aesthetics
43
Q

load bearing vs load sharing plates

A

load sharing: monocortical screws. plate and bone share the functional loading
load bearing: bicortical screws

44
Q

when to used closed reduction

A
  • minimal displacement
  • comminuted fractures
  • able to obtain pre injury ocl
  • pt refuse orif
  • no impairment of fn
45
Q

what is imf

A

est a proper ocl rship by wiring teeth tgt
- pre fab arch bars
- ivy loops

46
Q

benefits of orif

A

orif = there is an internal rigid fixation
- direct visualisation of fragments for accurate reduction and fixation
- better comfort and convenience bc not need IMF for so long
- better post op nutrition & hygiene
- better general post op mx of pt w multiple injuries
- early md metabolism –> early restoration of normal jaw activity

47
Q

what is used for md fixation

A
  • ti bone plates, screws
  • wires, elastics, arch bars,
48
Q

when is orif not indicated, e/o fixation indicated instead

A
  • infection v severe, pt have trismus, comminuted fractures (nothing to plate tgt)
49
Q

steps for ORIF

A
  1. put teeth into ocl with imf or hold in place
  2. make incision to expose fracture
  3. reduce by manipulating anatomy
  4. fixation by putting plates & screws (at least 4)
  5. release IMF (but may be kept on if still needs IMF for stability and guidance)
  6. check ocl
  7. closure of incision
50
Q

risk of IMF

A

PT IS AT RISK FOR tmj ankylosis or fibrosis or severe limited mouth opening. do not imf for >2 weeks

51
Q

minimum buccal lingual width of bone for implants

A

at least 1mm of bone surrounding implants

OMS (1 decks)

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