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Finals 2021! > Oral Surgery > Flashcards

Oral Surgery Flashcards

1
Q

Problems Associated with Unerupted Teeth (4)

A
  1. Resorption of adjacent teeth.
  2. Pericoronitis.
  3. Eruption under a denture.
  4. Internal Resorption
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2
Q

Reasons for Failure of Eruption (4)

A
  1. Mechanical obstruction; supernumeray teeth, cyst, odontogenic tumour.
  2. Insufficient space; micrognathia, premature loss of deciduous teeth.
  3. Head and neck syndromes; Cleidocranial dysostosis, Pierre-Robin.
  4. Genetic and endocrine abnormalities, e.g. hypothyroidism, hypopituitarism.
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3
Q

Incidence of supernumeary teeth in pts with clefts (1)

A

15% of pts with clefts have supernumerary teeth.

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4
Q

Incidence of midline supernumerary teeth (1)

A

1-3% (note most common site is the maxillary midline, then 9s then supernumerary mandib premolars).

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5
Q

Clinical Presentation of Cleidocranial dysostosis (5)

A 
Hypoplastic maxilla and zygomas.
Multiple supernumerary teeth.
Abnormal tooth morphology.
Normal eruption of primary teeth.
Severe eruption probs with permanent teeth.
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6
Q

Clinical Presentation of Pierre-Robin Syndrome (3)

A

Retrographic mandible (tongue falls back in throat –> difficulty breathing).
Crowding/unerupted dentition.
Airway issues.

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7
Q

Management of Pierre-Robin Syndrome (1)

A

Distraction; early modern Tx reduces impact.

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8
Q

Prevalence of no eruption & ectopic eruption of maxillary canines (1)

A

1.7%

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9
Q

Incidence of palatally impacted canines (1)

A

85%

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10
Q

What does SLOB stand for? (1)

A

Same
Lingual
Opposite
Buccal

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11
Q

Treatment of Unerupted Maxillary Canines (5)

A
  1. No Tx.
  2. Extraction of the deciduous canine.
  3. Surgical removal.
  4. Surgical exposure.
  5. Surgical transplantation
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12
Q

Technqiues for Surgical Exposure and Ortho Alignment of Ectopic Maxillary Canines (4)

A
  1. Palatal; open or closed exposure.

2. Buccal; apically repoisitoned flap or closed exposure.

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13
Q

Indications for Surgical Transplantation of Ectoptic Maxillary Canines (3)

A

Last resort option.
When it is not possible to expose and orthodontically align the canine.
Pt doesn’t want prolonged ortho.
Failed alignment after surgical exposure.

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14
Q

Pre-operative Assessment Prior to Surgical Transplantation of Ectoptic Maxillary Canines (3)

A
  1. Must have sufficient room within the arch.
  2. Must have sufficient room vertically.
  3. Sufficient alveolar bone available.
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15
Q

Problems Associated with Third Molars (10)

A
  1. Abnormal position (cheek biting).
  2. Caries, pulp & PA pathology in second and third molars.
  3. Periodontal problems.
  4. Pericoronitis.
  5. Resorption -internal & external for 7s.
  6. Cyst formation (dentigerous).
  7. Difficulty with OH and food packing.
  8. Often invovled in line of mandibular #s.
  9. In way of orthognathic surgery.
  10. Potential risk in the future for vulnerable and medically compromised pts.
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16
Q

Definition and causes of pericoronitis (3)

A

Inflammation in the soft tissues around the crown of a partially erupted tooth.
Caused by bacterial infection &/or trauma.

17
Q

Symptoms of Pericoronitis (7)

A
  1. Pain or discomfort.
  2. Soft tissue swelling in the region of the partially erupted tooth.
  3. Difficulty eating, swallowing or operning mouth.
  4. Tenderness on closing if opposing tooth in contact with inflamed soft tissues.
  5. Unpleasant taste or smell.
  6. May feel unwell with pyrexia.
  7. May be a recurring problem.
18
Q

Signs of Pericoronitis (6)

A
  1. Inflammation of soft tissues around crown of partially erupted tooth.
  2. Localised intra-oral swelling.
  3. Evidence of trauma from opposing tooth.
  4. Pus +/-
  5. Local lymphadenopathy +/-
  6. Facial swelling +/-
19
Q

Management of Pericoronitis (4)

A
  1. Irrigation beneath gum flap with saline or CHX m/w.
  2. Remove upper 8 if traumatic occlusion.
  3. Advise HSMW/CHX and analgesics -if needed (spreading infection or immunocompromised) can prescribe metronidazole 400mg TDS & drain pus if present.
  4. Review; assess outcome and assess third molars (monitor or removal?)
20
Q

Angulation/Type of Impaction of Lower Third Molars (6)

A
  1. Vertical; easiest to extract, risk of periocoronitis.
  2. Mesio-angular; more difficult, risk of food packing & caries in 7s.
  3. Horizontal; even more difficult, risk of food packing & caries in 7s.
  4. Disto-angular; very difficult, risk of pericoronitis.
  5. Transverse; tricky!!
  6. Inverse
21
Q

Radiographic Assessment Prior to Removal of Lower Third Molars (8)

A
  1. Diagnosis.
  2. Type of impaction.
  3. Depth of tooth within bone; compare level of ACJ at mesial aspect of 8 with distal aspect of 7 (unless distally inclined in which case compare the distal aspect of 8’s ACJ with 7).
  4. Crown form.
  5. Root form & number; fused & conical, straigh & separate, pincer shaped or complex.
  6. Coronal or root pathology.
  7. Other pathology (cyst, caries in 7s?)
  8. Relationship with mandibular canal.
22
Q

Radiographic Signs to Suggest Juxtaposition of the Mandibular Canal to the Third Molar Roots (5)

A

Signs siginificantly related to nerve injury:

  1. Radiolucency across the roots of the third molar.
  2. Deviation of the mandibular canal.
  3. Interruption of the white line of the canal (loss of superior cortex).

Signs considered to be clinically important:

  1. Deflection of the third molar roots by the canal.
  2. Narrowing of the third molar root.

narrowing of canal??

23
Q

Treatment Options for an Impacted Third Molar (4)

A
  1. Monitor
  2. Removal
  3. Operculectomy
  4. Coronectomy
24
Q

Definition of a Cyst

A

A pathological cavity with fluid, semi-fluid or gaseous contents and which is NOT created by the accumulation of pus.
It is usually but NOT always lined by epithelium.

25
Q

What is the simple classification of cysts of the jaws?

A
  1. Epithelial Cysts:
    a. Odontogenic;
    i. Inflammatory
    ii. Developmental
    b. Non-odontogenic:
    i. Nasopalatine duct cyst.
    ii. Nasolabial Cyst.
  2. Cyst-like lesions (NOT epithelial lined).
26
Q

What are the different types of odontogenic cysts of an inflammatory origin?

A
  1. Radicular cyst -related to a non-vital tooth.
  2. Residual cyst.
  3. Collateral/Paradental cyst.
27
Q

What are the different types of odontogenic cysts of a developmental origin?

A
  1. Follicular cysts;
    a. Dentigerous cyst.
    b. Eruption cyst.
  2. Odontogenic Keratocyst.
  3. Gingival cyst (or alveolar cyst/Epistein pearls in infants)
  4. Lateral periodontal cyst/Botryoid odontogenic cyst.
  5. Glandular odontogenic cyst.
  6. Calcifiying odontogenic cyst.
  7. Orthokeratinised odontogenic cyst.
28
Q

What are the frequencies of different jaw cysts?

A 
Radicular = 60%
Follicular = 20%
Keratocyst = 5%
Nasopalatine = 5%
Others < 5%

Finals 2021! (9 decks)

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