Oral surgery Flashcards
what are some medical condition considerations for extractions
high blood pressure, angina, recent MI, cardiac defects, valve replacement, previous endocarditis, hypertrophic cardiomyopathy, liver and kidney disease, diabetes, epilepsy, haemophillia A&B
what are some drugs that need to be considered before XLA
anticoagulant therapy, antiplatelet therapy, chemotherapy/radiotherapy, bisphosphonates
what are some clinical considerations prior to XLA
medical history, location of the tooth, remaining coronal tooth structure, caries extension, adjacent tooth status, presence of extra oral swelling, adjacent anatomical structures, planned tooth replacement
what are the characteristics of a envelope/sulcular flap
extended horizontal sulcular incision, requires minimum two teeth for good vision
what are the advantages of a envelope/sulcular flap
no relieving incisions, easy re-approximation of the flap
what are the disadvantages of a envelope/sulcular flap
can tear under pressure, difficult reflection, limited visualisation
what are the indications for a envelope/sulcular flap
aesthetic region, minimally invasive periodontal surgical treatment
what are the characteristics of a 2-sided flap
envelope with one relieving incision - mesial or distal for greater access, acts as a compromise between aesthetics and access
what are the advantages of a 2-sided flap
better access compared to an envelope flap, adequate blood supply
what are the disadvantages of a 2-sided flap
gingival recession, limited access to long roots
what are the indications of a 2-sided flap
aesthetic zone where greater access is needed, minimal bone removal, third molar extractions, surgical XLAs, apicectomy, cyst removal
what are the characteristics of a 3-sided flap
envelope with two relieving incisions, mesial and distal, provides optimal access and vision
what are the advantages of a 3-sided flap
optimal access and vision, easy re-approximation of flap to its original position
what are the disadvantages of a 3-sided flap
prone to gingival recession
what are the indications of a 3-sided flap
third molar XLAs, apicectomy, cyst removal, impacted tooth exposure, bone graft, buccal advancement flap, apical respositioning flap, surgical procedures involving more than one tooth
what are the characteristics of a smeilunar incision
incision made across the mucoperiosteum away from the gingival margin
what are the advantages of a smeilunar incision
no gingival recession, PDL remains intact
what are the disadvantages of a smeilunar incision
scarring, difficult to replace flap, limited access, prone to tearing, paraesthesia risk
what are the indications of a smeilunar incision
apicectomy
what are the principles of a flap design
- gain access with minimum trauma
- large flaps heal at the same rate as smaller flaps
- broader base to maintain blood supply
- for a full thickness mucoperiosteal flap, cut to bone using a firm continuous incision not feathered
- avoid sharp angles
- either include or exclude the papillae entirely
- do not crush the tissue
- keep moist with saline
what are the elevator principles
- elevator tip is inserted between bone and tooth mesially
- do not lever off adjacent teeth
- avoid excess force
- do not apply force towards major anatomical structures
- support pts jaw and ridge
- use under direct vision only
- take care not to push into sinus
what are resorbable sutures
suture material is absorbed by tissues, the patient doesn’t need to come back, used in areas where suture removal is difficult
what are non-resorable sutures
tensile strength doesn’t reduce and it is not absorbed by tissues, requires the patient to return for suture removal, used in areas where a suture is required for a longer duration
what are monofilaments
suture consists of a single strand, less filaments reduces the number of sources of possible infection
what are polyfilament
suture consists of several strands twisted together, easier to handle, more filaments increases the number of sources of possible infection, fluid and bacteria may accumulate
