oral surgery 1 Flashcards
4 principles of flaps in oral surgery
- maximal access with minimal trauma
- big flaps heal just as fast as small ones
- should be no sharp angles
- flaps should be mucoperiosteal - involve both the mucosa and periosteum to adequately access bone
why is bone removal not done using an air driven handpiece
air driven handpieces pose a risk of surgical emphysema which carries a sepsis risk
instead motor driven ones are used
what type of handpiece is used if removing bone in oral surgery
motor driven straight electrical handpiece with saline cooled round bur
what instruments could by used to perform physical debridement of the socket and under the flap
mitchells trimmer (spoon one end, sharp tip the other)
victoria curette (spoons both ends)
bone file
what are the 2 broad classifications of sutures
resorbable or non resorbable
monofilament or polyfilament
why might a tooth have abnormal resistance to an extraction
ankylosis , thick cortical bone, twisted roots, divergent roots
what areas of alveolar bone are most likely to fracture during an extraction
buccal plate , around canines or molars
what should be done if there is a jaw fracture during extraction
inform patient
take a radiograph to confirm
refer to specialist
give analgesia
if delay before seeing specialist give antibiotics
3 ways maxillary sinus could become involved during an extraction
oro-antral fistula, loss of root in antrum, tuberosity fracture
factors increasing risk of involvement of maxillary sinus
extractions of upper molars and pre molars
close relationship of roots to sinus on x ray
last standing molars
large bulbous roots
older pt
previous OAC
recurrent sinusitis
Reasons for crown fracture during extraction
gross caries
root shape
hypercementosis
ankylosis
alignment
where is most common location for dry socket
lower jaw, risk increases the more posterior you go so lower 8s biggest risk
3 possible flaps
1 - crevicular incision , 1 sided , cut along gingival margins , less bleeding and scarring however poorer access
2 - mesial/ distal relieving 2 sided flap - mesial preferred to distal in most cases
3 - mesial and distal relieving 3 sided flap
why are flaps created
to allow access to bone to either..
1 - create buccal gutter that will allow elevator and luxator access
2 - use motor turbine drill to separate the roots
discuss the pros and cons of different suture types (strings)
monofilament sutures scar less - not a huge issue inside mouth but if suturing skin these should be used
resorbable monofilament sutures takes ages to resorb
non resorbable monofilament give good results but are hard to use
most common for us is resorbable multifilament
