Oral and Maxillofacial Surgery Flashcards
What is involved in OMF surgery?
Dentoalveolar, trauma hard and soft tissue, orthognathic surgery, facial deformity, oncology and reconstruction, craniofacial surgery cleft lip, temporomandibular joint disorders
What is the aetiology for facial trauma?
Assault, fall sports, road traffic accident, industrial and self harm
How are mandibular fractures fixed?
Closed by open reduction and internal fixation by using mini titanium plates
Where can midface trauma affect?
Zygoma
Maxilla
Naso/orbital/ethmoidal
What is the most common cause for orofacial swelling?
Odontogenic infection
Threat to airway
What is a prognathic mandible?
Prominent mandible
Top teeth don’t meet bottom teeth
Jaw needs moved forward and bottom back
What can be a useful scan for surgical planning?
Lateral cephalogram with patient picture
What is the most common type of oral malignancy?
Squamous cell carcinoma of oral mucosa
What is the 5 year survival rates for squamous cell carcinoma of oral mucosa?
Stage 1 - 86%
Stage 4 - 20%
What are worrying signs of squamous cell carcinoma?
Area of redness
Combined white/ red lesion
Indurated area of ulcer
Ulcer present for 3 weeks +
New melanin pigmentation
Describe healthy oral mucosa
Mucus membrane which overs all structures in oral cavity except teeth
Varies in colour from pink to brownish purple depending on skin colour
Describe healthy floor of mouth
Lingual frenulum and sublingual folds
Folds end at papillae at base of lingual frenulum
Duct of submandibular gland opens into papilla
Describe a healthy tongue
Flexible muscular organ
Rough texture is produced by tiny papillae - filiform, fungiform, foliate and circumvallate
Sensory nerves - lingual, taste - chorda tympani, motor nerve - hypoglossal
Describe a healthy palate
Should be pink, smooth and moist - keratinised
Towards anterior teeth, rows of ridges very in height
What is the difference in safe and cancerous ulcers?
Safe - no induration, grey and red halo, short lived
Cancer - induration, rolled edge
What is the name for white patches on oral mucosa?
Leucoplakia
What is the name for red patched on oral mucosa?
Erythroplakia - usually more sinister
What is candidiasis?
Overgrowth of candida albicans
What is the prevention/ treatment for denture stomatitis?
Remove dentures at night
Soak dentures nightly in dilute milton or chlorhexidine
Antifungal medication: Topical - Nystatin, amphotercin B and miconazole
Systemic - fluconazole
Describe oral thrush
Acute fungal infection
White patches can be easily removed to reveal red areas of inflammation
May be painful
What are contributory factors to aphthous ulcers?
Haematinic deficiencies
Stress
Trauma to oral mucosa
Menstruation
Hereditary
Describe major aphthous ulcers
Typically affect posterior part of mouth
Up to 1 cm in diameter
Prolonged healing of several weeks and may scar
Describe minor aphthous ulcers
Affect non keratinised sites
Usually cheeks, floor of mouth and labial mucosa
Can have 1-5 ulcers at one time
Heals in 2 weeks
What is the treatment of aphthous ulcers?
Symptomatic, antiseptic mouthwash, tetracycline mouthwash, topical steroid preparations
What is xerostomia?
Dry mouth due to reduced or absent saliva flow
Symptom of certain medical conditions
Side effect of radiation to head or neck, and medications
What are clinical features of xerostomia?
Severe tooth destruction
Dry atrophic and fissured tongue
Mucosal soreness and infections
No salivary pool
Parotid gland enlargement
Oral candidiasis
Inflammation and fissuring of lips (cheilitis)
What is the cause of herpes labialis?
Reactivation of HSV from trigeminal ganglion
What are the clinical features of herpes labialis?
Vesicular, ulcerated, or crusting lesion which typically affects mucocutaneous junction of lip
Often preceded by prickling sensation
