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Spring 2018 > Oral Surgery 1 > Flashcards

Oral Surgery 1 Flashcards

1
Q

Why study radiographs before extraction

A 
Lone molars
Deep caries/fracture
Weird roots
Lesion under tooth
Crown
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2
Q

In the standing extraction position, where should the mandible/maxilla be located

A

Maxillary arch level with surgeon’s elbow or below

Mandible parallel to floor

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3
Q

Instead of pulling the tooth, what do you do

A

Push
Rock
Rotate

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4
Q

3 types of elevators

A

Wedge
Lever
Wheel and axle

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5
Q

2 purposes of elevators

A
  1. Loosen teeth, create space

2. Remove parts of tooth or root (primary mechanism for 3rd molar)

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6
Q

A straight elevator does what to the tooth

A

Pushes DOESN’T SCOOP

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7
Q

Primary use of cryer elevators

A

Removing residual roots of multi-rooted teeth

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8
Q

How to use forceps

A
  1. Seat forceps by applying force apically
  2. B, L, or rotational force to expand alveolus to release tooth
  3. Minimal traditional force
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9
Q

8 steps to extraction

A
  1. Anesthesia (profound)
  2. Soft tissue release
  3. Elevate tooth
  4. Adapt forceps to tooth
  5. Lunate with forceps
  6. Remove tooth from socket
  7. Examine socket for soft tissue/granulation (curette)
  8. Gauze over socket and compress with occlusal forces
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10
Q

150 and 151 forceps remove what

A

Any, universal

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11
Q

Cow horn 23 removes what

A

Mandibular molar

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12
Q

What removes max anterior and premolars

A

1

150

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13
Q

Max canines are removed with what

A

1

150

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14
Q

Max 1st premolar is extracted with

A

1

150

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15
Q

Max 1/2nd molars are extracted with

A

150
53 R/L
88 R/L

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16
Q

Mandibular incisors/canine/premolars forceps

A

151

Ash

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17
Q

Surgical extraction

A

Removal of tooth with:
Flap
Removal of bone
Tooth in multiple pieces

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18
Q

When doing a flap, you should cross the gingival margin when

A

At the line angle of the tooth

19
Q

5 types of mucoperiosteal flaps

A 
Envelope
Three cornered
Four cornered 
Semi-lunar
Y incision
20
Q

Indications for open extraction

A

When you need to be more careful

  • sinus proximity
  • avoid excessive force
  • ankylosis
  • dense bone

Weird morphology

  • roots
  • exostosis
21
Q

When can you leave a root tip

A 
Small piece <4mm
Deeply embedded
Not infected
Not mobile
Risk of removal> leaving it
Inform and counsel pt.
Document
Refer if needed
22
Q

Impacted vs unerupted

A

I: failure to fully erupt within expected time

U: tooth not having perforated oral mucosa

23
Q

T/F all unerupted teeth are impacted

A

FALSE

24
Q

Formation of 3rd molars
Crown?
50% of root?
Average?

A

Crown - 14
50% of root - 16
Av. - 20

25
Q

Winter’s classification

A

Based on inclination of impacted tooth to long axis of 2nd molar

M-angular
D-angular
Horizontal
Vertical

26
Q

Therapeutic vs prophylactic indication for 3rd molar removal

A

T: treat active process/disease
P: prevent future disease

27
Q

Indications for removal of third molars

A 
Pericoronitis
Caries
Pathological resorption
Pathology
Eruption pain
Crowding
Post-ortho
Orthographic surgery
In line of a mand. Fracture
Perio
Lack of att. Ging
28
Q

Why is it hard to pull 3rd molars in old people

A 
Highly calcified bone, less flexible
Slower recoop
Mand. Fracture easier
Non resolving Pins and needles 
Osteomyelitis and infection easier
29
Q

Order of which teeth get extracted the most

A

Man 3rd > max 3rd > max canine > man PM > Man canine > max PM > max CI > Max LI > man 2nd molar

30
Q

Peak pain occurs _

A

12 hrs after surgery

31
Q

The first analgesic should be taken _

A

Before local wears off

32
Q

Long acting local anesthetic to use before discharge

A

Marciano

33
Q

Don’t prescribe more than _ worth of pain meds

A

3 days

34
Q

Two options for meds post surgical extraction

A

10 of:

Tramadol 50 mg
Norco 5 mg/325 mg (hydrocodone/acetaminophen)

35
Q

Peak swelling post surgery

A

36-48 hrs

36
Q

T/F post op infection diagnosis can be made over the phone

A

FALSE

37
Q

4 stages of wound healing cascade and main cell of each

A

Hemostasis - platelet
Acute inflammation - granulocytes
Proliferation - monocyte/macphage
Remodeling - fibroblast

38
Q

What happens in the 4 stages of wound healing

A

Hemo - stop bleeding

Inflammation - stabilize clot, signal to cells to clean up wound

Proliferation - collagen and caps form on fibrin, provisional matrix where bone can form

Remodeling - woven bone replaces collagen, then mature bone

39
Q

Normal healing timeline

A

1: mild-mod discomfort
3: socket healed over

4-6: lamina dura to resorbed radiographically

40
Q

Things that mess up healing time (6)

A 
Bad hygiene
Bony pathology
Smoking
Radiation
Anti-resorptive drugs
Suppression of host defenses

BRASSB

41
Q

Dry socket:

A

Loss, lysis, or breakdown of the blood clot prior to its maturation into granulation tissue

42
Q

Things that increase risk for dry socket

A

Mandibular tooth
Smoking
Oral contraceptive
Pericoronitis

43
Q

Osteomyelitis:

A

Bone infection. Medical and surgical issue, can lead to significant morbidity

Spring 2018 (18 decks)

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