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SET 5 (Roent, Oral Diagnosis & Oral Surgery) > Oral Surgery (doc micks) > Flashcards

Oral Surgery (doc micks) Flashcards

1
Q

Horizontal incision along the crest of the ridge or gingival sulcus
Without incision

A

Envelope flap/ Crestal flap/ Sulcular/ Horizontal

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2
Q

with 1 VI

A

Triangular Flap

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3
Q

with 2 VI

A

Trapezoidal flap - best access

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4
Q

for small apical lesion but with normal bone support

convex area is directed towards the occlusal

A

Semilunar Flap

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5
Q

submarginal incision flap ( Luebke -Ochsenbein)

A

Modified Trapezoidal Semilunar Flap

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6
Q

ORo - antral communication (Max. sinus perforation)
Traumatic extraction or aggressive infection
Most commonly displaced root- Palatal root of Max. 1st Molar

A

Pedicle Flap

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7
Q

1-2mm - Oro antral comminication

A

No tx

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8
Q

2-6mm

A

Figure of 8 to retain clot

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9
Q

6mm or larger

A

Watertight closure with

  • Buccal advancement flap (Berger’s technique)
  • Palatal pedicle flap
  • Pedicled Buccal fat pad
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10
Q

to remove infected tissue , mucosa, or foreign objects from max. sinus
At the maxillary premolar area above the roots

A

Caldwell- Luc Technique

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11
Q

BE. ‼️📌 Where can you find stratified squamous epithelium in the max. sinus

A

In cases of Oro- antral fistula

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12
Q

Mechanical Principles of Extractiom

A
  1. ,Expansion of Bony socket
  2. Lever
  3. Wedge
  4. Wheel & Axle
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13
Q

extraction forces

A

Apical- Buccal - Lingual - Rotation- Traction

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14
Q

Order of Extractiom

A

Max. first before Mandibular

Posterior first before Anterior

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15
Q

BE‼️📌 weakest portion of the needle

A

HUB

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16
Q

Where to grip the needle holder

A

2/3 from the tip of the needle

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17
Q

Closest of ideal suture

A

Goretex

Polyetrafluoroethylene

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18
Q

BE‼️📌 Goretex can also be used as a barrier membrane material for

A

GTR

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19
Q

single sutures with separate knots

best securing the papilla

A

Interrupted

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20
Q

long span multiple extraction cases

A

Continuous

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21
Q

used to close open socket & to prevent clot displacement

A

Figure of 8

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22
Q

everted wound edges (ex. maxillary torus removal)

for suturing two adjacent papillae with one suture

A

Horizontal Mattress

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23
Q

controlling bleeding deep soft tissue incision

A

Vertical Mattress

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24
Q

Tooth Displacement

A
  1. Maxillary Sinus
  2. Infratemporal space/ Fossa
  3. Buccal space
  4. Submandibular Space
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25
Q

is thin bone & may fracture

A

Max. Tuberosity

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26
Q

remove suture tightly

A

If more than 2/3

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27
Q

If less than 2/3

A

detached to periosteum - reposition fractured segment suture tightly

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28
Q

If tooth is infected

A

remove tooth them fractured tuberosity & suture tightly, irrigate well

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29
Q

impacted max. 3rd molar is pushed through the periosteum

A

Infratemporal fossa/ space

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30
Q

Dry socket

A

Alveolar Osteitis / Fibrinolytic Alveolitis

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31
Q

suspected malignancy

A

Do not Exo
because of the risk of tumor seeding
Lateral spread of malignant cells along a wound/ needle tract

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32
Q

When is pain felt in cases of dry socket

A

2-4 days

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33
Q

can be rub off

A

Candidiasis

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34
Q

Stretch

A

Leukoedema

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35
Q

can’t rub off /stretch

A

Leukoplakia

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36
Q

Wound Healing 3 Phases

A

Inflammatory
Proliferative
Remodeling

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37
Q

Initial Lag phase, Immediate 2-5 days

  • Hemostasis
  • Vasoconstriction- spontaneous reaction
  • Platelet aggregation
  • Thromboplastin makes clot
  • Inflammation
  • Vasodilation
  • Phagocytosis
A

Inflammatory Phase

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38
Q

Fibroblastic Phase : 2 days - 3 wks

  • Granulation - main purpose : fill defect , facilitate further healing granulation tissue formation
  • Fibroblast lay bed of collagen - reticular type III
  • fill defects and produces new capillaries
  • Contraction
  • wound edges pull together to reduce defect
  • Re-epithelialization
A

Proliferative Phase (;Fibroblastic Phase 2days - 3wks)

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39
Q

new collagen forms which increases tensile strength of wounds
Scar tissue is only 80% strong as original tissue

A

Remodeling Phase (3 wks - 2 yrs)

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40
Q

stabilized essentially same anatomic position prior to injury
- Wound repair then occurs with minimal scar tissue

A

Primary Intention

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41
Q

gap left is betweem woumd edges after repair (tooth socket)

it implies that tissue loss has occurred in the wound & requires granulation tissue

A

Secondary Intention

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42
Q

occurs when a wpund is initially left open for a period of observation before closure
Associated with tissue grafts & implants

A

Tertiary Intention (Delayed Primary Closure)

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43
Q

What intention is dental implants

A

Tertiary Intention

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44
Q

Local measures to control hemorrhage

A
  1. Local pressure
  2. :Gelfoam
  3. Extraction socket packing materials
  4. Electrocautery or Electrosurgery
  5. Ice or cold compress
  6. Tannic Acid / Tannins (Tea bag)
  7. Sutures
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45
Q

3 types of Hemorrhage

A
  1. Primary
  2. Secondary
  3. Reactionary
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46
Q

during surgery hemorrhage

A

Primary

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47
Q

occurs up to 2 wks post. op (infection)

A

Secondary

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48
Q

hours after surgery disruption of wound

A

Reactionary

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49
Q

‼️📌BE.

What do you call bleeding in an extraction socket after a few days due to wound sepsis-

A

Secondary

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50
Q

‼️📌BE
Primary Lesions
FLAT= MAPA
Flat non- palpable lesions- skin discoloration
(ex. freckles, flat moles, port- wine stain)

A

ex.
Macule
Papule

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51
Q

<10mm - small

A

Macules

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52
Q

> 10 mm - large

A

Papule

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53
Q

‼️📌BE

Elevated Lesions - PA-PLA- Nod

A

Papule
Plaques
Nodule

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54
Q

ex. of Elevated Lesion

A

Nevi, warts , lichen planus, insect bites

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55
Q

<10 mm small

A

Papules

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56
Q

> 10 mm - large

A

Plaques

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57
Q

firm lesions that extend into the dermis or subcutaneous tissue

A

Nodules

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58
Q

ex. of nodules

A

Cysts
Lipoma
Fibroma

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59
Q

Clear- fluid filler blister VBP

A

Vesicles
Bullae
Pustules

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60
Q

clear fluid filler blister - <10mm- small

A

Vesicles

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61
Q

clear fluild filler blister

>10mm large

A

Bullae

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62
Q

vesicles contain pus

A

Pustules

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63
Q

‼️📌BE

What primary lesioj appears loculated

A

Vesicles

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64
Q

Secondary Lesion

A
  1. Erosions
  2. ,Ulcers
  3. Fissure
  4. Atrophy
  5. Excoriation
  6. Crusts (scabs)
  7. :Scale
  8. Scar
  9. ,Eschar
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65
Q

shallow, superficial opening that shows loss of part or all of the epidermis

A

Erosions

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66
Q

crater-like lesions with loss of the epidermis & at least part of the dermis

A

Ulcers

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67
Q

linear often painful deep breaks within skin surface

result of excessive xerosis (dryness of skin)

A

Fissure

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68
Q

localized shrinking of the skin which result in paper thin, wrinkled skin with easily visible vessels
results from loss of epidermis, dermis or both

A

Atrophy

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69
Q

linear erosion caused by scratching , rubbing or picking

A

Excoriation

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70
Q

consist of dried serum, blood or pus over damaged layers of skin
Occurs in inflammatory or infectious skin diseases (eg. impetigo)

A

Crusts (scabs)

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71
Q

thin, compressed superficial accumulation of horny epthelium

A

Scale

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72
Q

permanent fibrotic skin changes that develop as consequences of tissue injury

A

Scar

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73
Q

necrotic tissue discarded from the surface of the skin following injury or disease
Burn px or gangrene

A

Eschar

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74
Q

elevated lesions caused by localized edema

A

Urticaria (wheals or hives)

75
Q

non-blamchable, small foci of hemorrhage.

Causes include platelet abnormalities

A

Petechiae <3 mm

76
Q

3-10 mm larger area of hemorrhage that may be palpable

may indicate a coagulopathy

A

Purpurs

77
Q

> 10mm flat , discoloration from bleeding underneath the epithelium

A

Ecchymosis

78
Q

extravasation & pooling of blood into a space within tissues

A

Hematoma - tumor like

79
Q

portion of axon distal to the site of injury degenerate

within 78 hrs phagocytosis by adjacent schwann cell & by macrophages

A

Wallerian degeneration

80
Q

schwann cell outgrowths from portion of axon distal to site of injury attempt to connect the proximal & distal nerve stumps

A

Bungner’s Band

81
Q

axonal outgrowths randomly aligning with fibrin clot

A

Neuroma

82
Q

proximal to the site of injury

A

Retrograde/ Primary Nerve

83
Q

Which classification always requires bone & tooth reduction

A

Horizontal

84
Q

Winter’s Line

occlusal plane help assess the axial inclination of the impacted tooth

A

White line

85
Q

alveolar crest shows amount of overlying bone

A

Amber

86
Q

vertical line from amber line to CEJ on mesial side; measures depth of impaction
if 5mm longer, is indicative that the tooth should be removed under GA

A

Red line

87
Q

Preparing for wound closure

A
  1. Curette- remove the follicular sac attached to distal 2nd molar
  2. Bone file
  3. Irrigate w/ NSS- Isotonic solution
88
Q

bone is broken
skin or mucosa is not broken
no communication between fracture & external environment

A

Simple Fracture / close fracture

89
Q

both bone & skin are broken
seen in oral cavity even if no mucosal lacerations
PDL space provides communication with external environment

A

Compound fracture / open fracture

90
Q

1 bone more than 1 fracture line

A

Complicated fracture / Complex fracture

91
Q

bone is broken into several pieces because fracture line did not travel in a linear pattern
can be simple (crush wounds)
Compound (gun shot wound)

A

Comminuted Fracture

92
Q

one side fracture other side is bent

more common in younger patients because bone is more resilient (high organic content)

A

Greenstick

Tx. Interdental wiring

93
Q

📌‼️BE

What type of fracture implies damage to adjacent vital structures

A

Complex fracture- free fragment can impinge on the adjacent structures

94
Q

Floating Jaw

Surgical principle in orthognathic surgery

A

Le Fort I (Horizontal/ Guerin’s / Low Maxillary/ Transmaxillary Fracture)
Le Fort I Osteotomy

95
Q

Base:
Apex:
Battle’s sign or Post - Auricular Ecchymosis
Hemorrhage of pterygoid plexus- connection of veins
Raccoon Eye- bilateral hemorrhages of the eye

A

Dentition
Nasofrontal suture
Le Fort II / Pyramidal Fracture

96
Q

Tx. Le Fort II

A

Upper Eyelid Incision

97
Q

discontinuity between the cranial bone & facial bones
Dish face (big concavity)
CSF rhinorrhea

A

Le Fort III/ Transverse Fracture/ Craniofacial Dysjunction/ Basilar Fracture

98
Q

3 common sites of Fracture

A

Condyle
Angle
Symphysis

99
Q

📌‼️BE

bilateral condyle + symphysis

A

Guardsman Fracture

100
Q

bilateral mand. body fracture (edentulous px)

A

Bucket Handle Fracture

101
Q

Ellis Classification

A
102
Q

Tripod Fracture

A

Zygomaticomaxillary Complex Fracture

103
Q

📌‼️BE

Which is not a sign w/ Tripod Fracture

A

Anosmia

104
Q

sinuses

A

Water’s View

105
Q

view of both arches (Orthopantograph)

A

Panoramic Radiograph

106
Q

condylar neck fractures

similar to postero-anterior view

A

Reverse- Towne’s View

107
Q

zygomatic arch

A

Submentovertex View / Jug handle

108
Q

ORIF

A

Open reduction & Internal Fixation

109
Q

Dental wiring for wiring technique jaw fracture

A

External fixation

110
Q

tooth tied to the tooth using stainless steel wire

A

Interdental Wiring Technique

111
Q

bone tied to the bone using stainless steel wire

A

Interosseous Wiring Technique

112
Q

used edentulous mandible

A

Circumferential wiring

113
Q

📌‼️‼️‼️BQ.

  1. Best tx for Greenstick fracture of Mandible
  2. Condylar Neck Fracture displaces the condyle due to
  3. Radiographs useful in confirming Mandibular Fracture
  4. Basic Principles in tx Mandibular Fracture
  5. Fracture at Mand. condyle (subcondylar region) jaw deviates where?
A
  1. INTERDENTAL Wiring
  2. Lateral Pterygoid Muscle
  3. Panoramic Best: CBCT
    1. Reduction & Fixation 2. Restoration of Occlusion
  5. Forward medially
114
Q

Subcondylar fracture of mandible

A

same side jaw deviation

115
Q

Muscles determines the infection Intraoral & Extraoral swelling

A

Masseter
Buccinator
Mylohyoid

116
Q

Above mylohyoid

A

Intraoral swelling

117
Q

Below mylohyoid

A

Extraoral swelling

118
Q

For Mand. Teeth
More posterior:
More anterior:

A

Below mylohyoid

Above mylohyoid

119
Q

guide to occlusion

A

Splint

120
Q

‼️📌BE

What muscle does the needle pass through conventional IAN block

A

Buccinator Muscle

121
Q

Cellulitis ( Phlegmon)

A 
Acute
Severe/ Generalized
Large
Diffused borders
Doughy to indurated
No pus
Greater seriousness
Aerobic /  Mixed
122
Q

Abscess

A 
Chronic
Localized
Small
Well- circumscribed
Fluctuant
Yes pus
Less seriousness
Anaerobic
123
Q

‼️📌BQ

  1. Most serious complication from Facial Abscess secondary to infected maxillary canine
  2. Needle aspiration of central bone lesion
  3. 3rd molar imfection DIRECTLY spreads to
  4. Infection in the pterygomandibular space
A
  1. CST
  2. We need to see if vascular lesion (Hemangioma)
  3. Submandibular, Pterygomandibular, Parapharyngeal spaces
  4. Intraoral drainage perforates the buccinator muscles
124
Q

Px. experiences difficulty breathing & speaking
Submandibular
Sublingual
Submental spaces

A

Ludwig’s angina

125
Q

Tx. Ludwigs Angina

A

IV antibiotics
Emergency department first
Prevent further airway obstruction first

126
Q

infection of the marrow spaces/ cancellous bone

A

Osteomyelitis

127
Q

necrotic bone separated from healthy bone

A

Sequestrum

128
Q

sclerotic bone that shields healthy bone away from necrotic bone
Radiopaque & is not removed

A

Involucrum

129
Q

exit of pus preventing further spread of infection

A

Cloaca

130
Q

surgical removal of sequestra to prevent the spread of infection & minimize tooth mobility & bone loss

A
131
Q

allow you to visualizs the entire infected area

eliminatin of healthy bone until you expose the undercut

A

Saucerization

132
Q

removal of undermined & infected cortical plates of bone

A

Decortication

133
Q

retrograde progression of infection against the flow of veins from the source of infection towards the cavernous sinus

A

CST / CS Thrombophlebitis

134
Q

Types of Biopsy

A
  1. Excisional
  2. Incisional
  3. Exfoliative Cytology
  4. Fine Needle Aspiratiom Biopsy
135
Q

not the most accurate

A

Exfoliative Cytology

136
Q

used in radical neck dissection
Malignant lymph nodes of the necks are removed , frozen & immediately examined until 2 consecutive nodes are determined to be benign

A

Frozen-Section Biopsy

137
Q

Specimen handlinfg

A

10% Formalin solution

138
Q

total removal of a cystic lesion

A

Enucleation

139
Q

surgical opening a cystic cavity

to decrease intracystic pressure & prevent further expansion of cyst

A

Marsupialization// Decompression// Partsch Operation

140
Q

with removal 1-2mm of bone around the entire periphery of the cystic cavity
this is reserved for more aggressive pathologic lesions
prevent recurrence

A

Enucleation with Curettage

141
Q

cauterizing & fixating agent that penetrates cancellous spaces in the bone at 1.5-2mm

A

Carnoy’s solution

142
Q

carnoys solution
anti mitotic
used for SCC & BCC

A

5- FLUOROURACIL ointment

143
Q

Dimension for choosing an Implant

A

Length- vital structures

Width - adjacent teeth implants

144
Q

Greater surface area

A

Greater osseointegration

145
Q

Between implant & vital structure & Between implant & natural tooth

A

1.5mm

146
Q

Implant - Implant

A

3mm

147
Q

What to do if implant approximates vital structure on post-op radiograph

A

Withdraw implant

148
Q

Why titanium

A

Biocompatible

149
Q

Why is constant irrigation necessary

A

Necrosis 47*C

150
Q

What is the direct connection between lining bone & a load bearing endosseous implant at the light microscopic level

A

Osseointegration

151
Q

Types of Implants

A
  1. Endosseous
  2. Subperiosteal
  3. Transosseous
152
Q

surgically inserted into the jaw bone

Most commonly used type

A

Endosseous

153
Q

custom made to fit on supporting areas in the jaws

type of implant that RIDES on bone underneath the mucoperiosteum

A

Subperiosteal

154
Q

penetrate the entire jaw

A

Transosseous

155
Q

Bone Repair

A
  1. Osteogenesis
  2. Osteoconduction
  3. Osteoinduction
156
Q

formation of new bone from osteoprogenitor cells

A

Osteogenesis

157
Q

passive framework or scaffold to guide formation of a new bone

A

Osteoconduction

158
Q

illicit bone formation

A

Osteoinduction

159
Q

Classification of Grafts

A
  1. Autogenous (autografts)
  2. Allogenic ( allograft)
  3. Isogenic (Isografts)
  4. :Xenogenic
  5. Alloplast
160
Q

same individual
best
iliac crest, lateral ramus , ant. mandible

A

Autogenous (Autografts)

161
Q

cadaver

A

Allogenic (allografts)

162
Q

high rate of dieases transmission, infection

A

Fresh- Frozen

163
Q

osteoconductive , used together with autografts

A

Freeze- Dried

164
Q

exposes BMP which are osteoinductive

osteoconductive but lacks mechanical strength

A

Demineralized Freeze Dried

165
Q

same species & related

A

Isogenic (Isografts)

166
Q

another species usually bovine , porcine

A

Xenogenic

167
Q

synthetic graft material

A

Alloplast

168
Q

Mostly cortical bone mass
Ant. Mandible
High implant stability but low blood supply

A

D1

169
Q

Thick cortical bone with coarse trabecular bone underneath
Ant.& Posterior Mandible
High implant stability with excellent blood supply

A

D2

170
Q

Porous cortical bone with fine trabecular bone underneath
Posterior Mandible, Ant. Posterior Maxilla
Low implant stability

A

D3

171
Q

Mostly fine trabecular bone
Posterior Maxilla
Most challenging

A

D4 - soft

172
Q

What characteristic of Chlorhexidine makes it valuable antiseptic mouth rinse?
long term effect stay add antimicrobials

A

Substantivity

173
Q

long narrow beak with parallel striations

A

Hemostat

174
Q

Can autoclave

A

Fraser Aspiration

175
Q

Disposable syringe

A

16-18G, 10-20cc

176
Q

worst place perforate the lower molar

A

Bifurcation

177
Q

No radiograph evidence

+ percussion

A

Symptomatic Apical Periodontitis

178
Q

151 mandibular
44 - rf
16
17

A
179
Q

Maxillary
150
69

A
180
Q

Mental foramen implant

A

5mm

181
Q

IAN implant

A

2mm

182
Q

Buccal & Lingual implant

A

1-2mm

183
Q

Max. Sinus implant

A

1mm

SET 5 (Roent, Oral Diagnosis & Oral Surgery) (4 decks)

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