Oral Surgery Introduction

Question 1

What does ‘Minor Oral Surgery’ refer to?

Answer 1

MOS = smaller elective (planned) operations such as, removing wisdom teeth, impacted teeth, apicectomies and biopsies.

Question 2

What is Aseptic technique?

What is Asepsis?

Answer 2

An aseptic technique minimises the risk of contamination during an invasive procedure.

Asepsis = the absence of pathogenic (harmful) organisms.

Question 3

List 5 principles which must be maintained during an aseptic technique:

Answer 3

1. Use of sterile gloves
2. Appropriate hand decontamination
3. Protective uniform - scrubs, gowns and aprons
4. Check all sterile packs for damage and date
5. Not re-using single use items

Question 4

How is an envelope flap (sulcular flap) created?

How is the flap raised?

When is a envelope flap typically used?

Answer 4

Envelope flap: Incision is made around the necks of the teeth along the free gingival margin

Envelope flap is raised using a periosteal elevator

Envelope flap is useful for surgical extraction of a tooth or root

Question 5

What is a two-sided flap (3 corner flap/triangular flap)?

Answer 5

A two-sided flap is an envelope flap with one added vertical incision

Question 6

What is a three-sided flap (4 corner flap/trapezoid flap)?

Answer 6

A three-sided flap is an envelope flap with two added vertical incisions

Question 7

What is a semilunar flap?

When is a semi-lunar flap useful?

Give an example of a major prominence a semilunar flap should not cross

Answer 7

Semilunar flap = curved incision to access the root apex

Useful for periapical surgery and avoids trauma to papillae and gingival margin

Semilunar flap should not cross the canine eminence

Question 8

When is a Y incision used and where is it typically used?

Answer 8

Y incisions are used on the palatal for maxillary palatal torus and impacted canines

Question 9

What is a pedicle flap?

Answer 9

Pedicle flap = mobilises from one area then rotates to fill in a soft tissue defect in another area

Question 10

What is flap necrosis?

Answer 10

Flap necrosis = when the blood supply is comprised so healing is compromised

Question 11

How is flap tearing avoided?

Answer 11

Flap should be large enough to avoid tearing

Question 12

What is flap dehiscence?

Answer 12

Flap dehiscence (hole in flap) = opening/rupture of a surgical wound when flap is under too much tension

Question 13

What is used to remove bone?

What is used as a coolant?

Answer 13

Bone is removed using a surgical slow speed hand piece

Saline is used as a coolant before irrigating

Question 14

What are the two types of suture materials?

What is the most common suture material used in dentistry?

Answer 14

Two types of suture material:
1. Absorbable
2. Non-absorbable

Non-absorbable, natural e.g. silk (braided) are most commonly used in dentistry

Question 15

What is the most common needle size and shape used?

Answer 15

1/2 circle

Reverse cutting needle - less tendency to cut through the mucosa

Question 16

What are the most commonly used tissue forceps in dentistry?

Answer 16

Multiple teeth tip tissue forceps

Question 17

What type of knot is used in a suture?

Answer 17

A square knot

Question 18

How do you remove a suture?

Answer 18

Using sharp scissors, cut flush under the knot and grab the knot to pull the cut side through

Question 19

What is the most desired wound healing for surgical wounds?

Answer 19

First intention wound healing

Question 20

If there are post-operative complications such as infection, what type of healing occurs?

Answer 20

Secondary intention

Question 21

What type of healing occurs when there is a gross infection or loss of tissue from trauma or debridement?

Answer 21

Third intention

Question 22

Why are obese patients at risk of post-operative wound infections?

Answer 22

Due to having excess adipose tissue which does not have a good blood supply

Question 23

Why should a longer healing time be expected for elderly patients?

Answer 23

Because elderly patients lose muscle tone and elasticity and circulation can be impaired