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DEN4SKE > Oral Surgery > Flashcards

Oral Surgery Flashcards

1
Q

What are the indications for 3rd molar extraction?

7

A

Recurrent Pericoronitis
Periodontal disease
Root resorption of 2nd molar
Gross dental caries
Odontogenic cyst/tumour
Supra-erupted (maxillary) - ST damage
Non-functional

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2
Q

Definition of a dentigerous cyst

3

A

RL surrounding crown of erupting tooth >3mm
Attaches to CEJ of tooth
Exclusive to permanent dentition

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3
Q

Where does a dentigerous cyst originate from?

A

Epithelium of follicle of developing tooth

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4
Q

Dentigerous cyst differential diagnosis

3

A

Unicystic ameloblastoma
ondotogenic keratocyst
hyperplastic dental follicle

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5
Q

Name 4 secondary facial spaces

A

Pterygomandibular
temporal
retropharyngeal
parotid

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6
Q

3 points

How do retained 8s affect periodontal status

key points from White paper - 2007

A

visible 3rd molars = higher incidence of periodontitis of 8 and adj. teeth
These teeth are only partially responsive to periodontal therapy
Periodontal defects increase with age around retained 8s

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7
Q

True or False - morbidity associated with surgical removal of 8s increases over age of 25

A

True

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8
Q

List 4 patient factors that should be assessed and why

A

Size - access
Age - elasticity of bone
Presence of infection - anaesthesia, trismus
anxiety - ability to tolerate procedure

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9
Q

List 5 factors that should be assessed in I/O exam and why

A

distance to 2nd molar - likelihood of impaction under ramal bone
Crowding - access
Soft tissue around 8 - periocoronitis
Caries - likelihood of coronal fracture during exo
Thickness of bone adj to external oblique ridge

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10
Q

4 categories - depth/angle, roots, anatomy around tooth, position. 11 pt

List the elements of a difficult surgical case

A

Distoangular
Class III ramus
Class c depth
Long thin roots
divergent/curved roots
narrow PDL
thin follicle
dense inelastic bone
contact with 2nd molar
close to IAN
complete bone impaction

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11
Q

List the 4 classifications according to Winter

A

Mesioangular
Distoangular
Verical
Horizontal

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12
Q

Describe class A depth according to Pell and Gregory

A

Occ plane of 8 = occ plane of 7

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13
Q

Describe class B depth according to P+G

A

occ plane of 8 is between occ plane and CEJ of 7

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14
Q

Describe class C depth according to P+G

A

occ plane of 8 is below CEJ of 7

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15
Q

Describe class 1 ramal position according to P + G

A

8 has sufficient room anterior to border of ramus to erupt

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16
Q

Describe class 2 ramal position according to P + G

A

1/2 of 8 is impacted in ramal bone

17
Q

Describe class 3 ramal position according to P + G

A

8 is completely impacted in ramal bone

18
Q

What are the 3 key markers for IAN involvement with 3rd molar

A
  1. Darkening of canal as it passes over tooth structure
  2. Deviation of canal below tooth root
  3. Loss of upper border of canal
19
Q

What are the 4 types of flaps

A
  1. distal relieving incision
  2. envelope flap
  3. buccal extension flap
  4. triangular flap
20
Q

What is the potential issue with raising a buccal flap?

A

Can cause delayed periodontal healing and increased CAL

21
Q

What is a pro and con of an envelope flap design?

A

Pro: decrease change of haematoma + post op bleeding (conservative)
Con: Limited access for deep impaction

22
Q

Why is bone removed?

A

to allow for better access and point of application for instruments

23
Q

How much bone should be removed?

A

Enough to expose entire crown to level of furcation

24
Q

What are the 5 stages of a surgical extraction?

A
  1. raise flap
  2. remove bone
  3. section tooth
  4. wound toilet
  5. closure
25
Q

What are the 3 types of nerve injury and describe each

A
  1. Neuropraxia - blunt or compression injury = loss of function for hours or. months
  2. Axontomesis: loss of continuity of axon or myelin sheath. Weeks
  3. Neurotmesis: severe contusion, laceration or stretch. Loss of connective tissue. Complete loss of function. Often permanent
26
Q

What are the 5 patterns of sensory loss?

A

Hyperaesthesia - heightened sense
Hypoaesthesia - decreased sensitivity
Paraesthesia - abnormal sensation
Dysthesia - abnormal unpleasant sensation
Anaesthesia - lack of sensation

27
Q

What is the prevalence of permanent IAN injury?

A

<1%

28
Q

What is the classification for maxillary wisdom teeth?

A

I - fully/partially erupted
II - wisdom tooth above apices of 7
III - wisdom tooth below apices of 7

29
Q

Why is sectioning often not necessary for maxillary 8s?

A

alveolus is softer than mandible

30
Q

What is a considerable risk when extracting a class III maxillary molar?

A

Displacement of tooth into sinus or infratemporal space.

DEN4SKE (8 decks)

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