Oral Surgery Flashcards
Osteoradionecrosis has the highest incident rate within the first ___ years of radiotherapy. What is the % rate?
- first 3 years
- 70%
which jaw has the higher risk of ORN? give 2 reasons why
mandible
less vascular
denser bone
what are the 5 conservative Tx for ORN?
antiseptic MW antibiotic hyperbaric oxygen therapy ultrasonic therapy sequestrectomy
what is the Marx’s classification? (3)
severity of ORN
has 3 stages
based on response to hyperbaric oxygen therapy
what is the newest classification for ORN severity? (3)
Notani (in 2002)
has 3 stages
based on radiographic and clinical findings
What bacteria causes actinomycosis ?
Actinomyce isrealii
What antibiotic is effective against actinomycosis? (2)
Penicillin
Doxycycline (if penicillin allergy)
according to NICE guidelines, what conditions constitutes an urgent referral for oral cancer? (7)
unexplained ____ lesion for >3 weeks
- red and white patch
- ulceration or mass
- tooth mobility
- horseness
- lump in neck
- pain in head/neck associated with otalgia (ear ache)
- persistent swelling of parotid or submandibular gland
what are the post XLA socket healing stages? (3)
0-3 weeks - inflammation
3-4 weeks - proliferation
6-8 weeks - remodelling
flap design rules (7)
Maximise blood supply
o broad base
o oblique/curved relieving incisions
o avoid prolonged retraction
- Avoid overtense sutures
- Avoid damage to nerves
- Support margins on bone
- Larger rather than smaller (one unit anterior and one unit posteriorly)
what is
- Lignocaine
- Septocaine
- Scandonest
- Citanest
2% lidocaine
septocaine - 4% articaine
scandonest 2% mepivicaine
citanest - 2.5% prilocaine
flap designs
- types (6)
- trapezoid
- triangular
- envelope
- Y-shaped (for palatal exotoses)
- semilunar (Caldwell-Luc)
- pedicle
suture material
- types (2)
- examples (4)
resorbable
- collagen, vicryl
non-resorbable
- silk, nylon, prolene, titanium
what flap is made to manage OAC?
pedicle flap
- buccal advacement
- palatal rotational flap
signs of roots of 8s close to IDC? (6)
IDC canal
- diversion
- darkening
- narrowing
- loss of lamina dura
- Deflection of root of lower 8s as they approach IDC
- Interruption of juxta apical area
bone grafts
- types (3)
- autogenous (self)
- xenograft (dif species)
- allograft (same species)
where are autogenous grafts taken from? (4)
ramus
chin (symphysis)
tuberosity
hip
histology shows __, what is the diagnosis?
- outer basal cell layer is comprised of elongated palisaded cells with reversed nuclear polarity
- towards basement membrane, overall appearance looks like piano keys
- above basal cell layer, is a zone of very loosely packed stellate cells with large spaces between them
ameloblastoma
elongated cells resemble pre-ameloblast
loose cells resemble stellate reticulum
what is the Tx for ameloblastoma?
excision with 1cm margin of normal bone
what is TNM? (3)
assessing cancer stage
TNM
- Tumour size
- Lymph node involvement
- Metastasis
How is T in TNM graded? (4)
(in max diameter) T1 - <2cm T2 - 2-4cm T3 - >4cm T4 - extends to involve other structures (ie mandible or skin)
how is cancer prognosis assessed? (2)
- stage (TNM)
- grade (histology)
How is N in TNM graded? (5)
N0 - no lymph node involvement
(in single ipsilateral node ___ max diameter)
N1 - <3cm
N2a - 3-6cm
N2b - multiple ipsilateral node, not more than 6cm
N2c - bilateral or contralateral node <6cm
N3 - >6cm
How is M in TNM graded? (2)
M0 - none
M1 - distant metastasis
