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BDS5 > Oral Surgery > Flashcards

Oral Surgery Flashcards

1
Q

What is an OAC

A

Communication between the maxillary sinus and the oral cavity

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2
Q

What are the predisposing factors for an OAC

A

-Close to antrum
-Large antrum
-Submerged teeth
-Hypercementosis
-Excessive force
-Periodontal disease and bone loss

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3
Q

What is the treatment for an OAC

A

-If small, simple horizontal mattress suture
-If large, buccal advancement flap
-Antral regime

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4
Q

What is the antral regime

A

-Antibiotics
-Steam inhalation (Karvol)
-Nose drops (ephedrine)
-No nose blowing, wind instruments

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5
Q

What are the clinical findings for an OAC

A

-Hollow sound in the socket with the sucker
-Bubbling in the socket
-Regurgitation of fluid
-Antral lining between the roots of the tooth
-Radiographic defect in the antral floor

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6
Q

What is an OAF

A

-Occurs when the OAC becomes epithelialise

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7
Q

What are the signs and symptoms of an OAF

A

-Chronic sinusitis
-Regurgitation of fluids
-Nose bleeds
-Fluid in sinus on radiograph
-Antral mucosa prolapse in the mouth

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8
Q

What is the treatment for OAF

A

-Antibiotics before the surgery
-Excision of the fistula tract
-Buccal advancement flap

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9
Q

What are the risk factors for a fractured tuberosity

A

-Lone standing molars
-Hypercementosis
-Excessive force
-Bulbous roots
-Large antrum

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10
Q

What is the treatment for a fractured tuberosity

A

-If small, dissect the fragments out and close, antral regime
-if large, allow to heal for 8 weeks and splint, then surgical removal, antibiotics

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11
Q

How to treat displaced roots

A

-2 radiographs
-Removal under GA
-Cadwell Luc procedure
-Antral regime

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12
Q

Causes of acute sinusitis

A

-Decreased drainage
-Infection
-Deviated septum
-Debilitated patient

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13
Q

Signs and symptoms of acute sinusitis

A

-TTP but vital teeth
-Pain over the mid face
-Pain on bending down
-Facial swelling
-Purulent discharge
-Pyrexia

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14
Q

-What is the treatment for acute sinusitis

A

-Antral regime
-Analgesics
-Bed rest

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15
Q

What are the signs and symptoms of chronic sinusitis

A

-Mucopurulent discharge
-Nasal obstruction
-Thickened antral mucosa

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16
Q

When to refer infection to hospital

A

-Rapidly spreading infection
-Immunocompromised
-Pyrexia
-Raised floor of mouth
-Difficulty breathing/swallowing
-Deviated uvula
-Trismus

17
Q

What special tests to do for referring infection to hospital

A

-Temperature
-Pulse and blood pressure
-Radiographs
-Blood glucose
-CRP

18
Q

What is Ludwig’s angina

A

-Bilateral swelling of the submandibular, sublingual and submental spaces

19
Q

What are the factors that can affect spread of infection

A

-Number of virulence factors
-Host immune response
-Natural barriers (e.g. muscles)
-Site of source of infection

20
Q

What are the treatment options for spreading infection

A

-Identify the source of infection first
-Extraction
-Draining through root canal
-Incision and drainage

21
Q

What are the indications for extractions of wisdom teeth

A

-Unrestorable caries in 7
-Non-treatable periapical pathology
-Resorption of adjacent teeth
-Cysts/tumours
-Preventing jaw surgery

22
Q

What is pericoronitis and what type of bacteria is involved

A

-Inflammation of the soft tissue overlying a partial erupted tooth
-Streptococci, anaerobic bacteria

23
Q

Early symptoms of pericoronitis

A

-Pain
-Swelling
-Halitosis
-Trismus
-Lymphadenopathy

24
Q

Initial management of pericoronitis

A

-Good OHI
-Irrigate with CHX/saline
-Debridement of operculum under LA
-Analgesics
-CHX mouthwash
-Grind opposing cusps

25
Q

Describe tooth and local factors to consider before extraction

A

-Crown to root ratio
-Bone density
-Adjacent teeth
-Anatomical structures
-Mouth opening

26
Q

Main signs of proximity to iD canal on radiograph

A

-Darkening of roots
-Interruption of tramline
-Diversion of canal

27
Q

Describe a coronectomy

A

-Section the crown off the tooth
-Remove all enamel
-Ensure roots are 2-4mm below crestal bone level

28
Q

Contraindications for coronectomy

A

-Caries
-Apical pathology
-Root mobility

29
Q

Principles of flap design

A

-Suture over sound bone
-Preservation of interdental papilla
-Ability to extend or close
-Wider at the base to maintain good blood supply
-Avoids vital structures

30
Q

What are the contra-indications for NSAIDs

A

-Pregnancy
-Asthmatic
-GI bleeds

31
Q

What is the analgesic ladder

A

-Non-opiods (paracetamol, ibuprofen)
-Weak opioids (codeine)
-Strong opioids (morphine)

32
Q

What are the complications of LA

A

-Injection into parotid gland causes facial palsy
-Injection into muscle causes trismus
-Haematoma if laceration of vein
-Intravascular injections can cause tachycardia, blindness

BDS5 (4 decks)

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