ORAL SURGERY - SBA examples Flashcards
what are signs of mandibular fractures?
- bruising on the FOM
- step in the occlusion
- anterior open bite
- palpable step in the lower border of the mandible
what are symptoms of mandibular fractures?
- pain on swallowing
- pain, swelling, redness, increased heat in the jaw/ear area
- difficulty speaking, chewing and breathing
- numbness/ bruising on face and neck
- trismus
what is used for pre-operative inter maxillary fixation for a displaced dentate fractured mandible?
eyelet wires
what are the classifications of mandibular fractures?
simple (closed linear)
compound (open to mouth/ skin)
pathological (weakened area by pathology)
comminuted
what are condylar neck # usually found alongside?
of the angle or canine region of the opposite side of the mandible
what is a guardsman # of the mandible?
bilateral condylar + symphyseal
caused by a fall on the point of the chin
what differs with rx for a condylar neck #?
may be fixed several days later - usually within 2 weeks
what radiographs are essential in order to diagnose and assess mandibular fractures?
DPT + PA mandible
what radiographs are used to assess condylar # prior to fixation?
CT scan
what type of mandibular # needs abx?
compound (perforates through periosteum and skin, so through tooth socket into oral cavity)
what symptom is associated with a parasymphyseal #?
unilateral numbness of lower lip and anterior teeth - due to the mental foramen and incisive nerve
what symptom is associated with a mandibular body #?
bilateral numbness of lower lip and anterior teeth
when should teeth be removed in regards to a facial #?
wisdom teeth, grossly broken down, perio infected teeth in the # line
how are teeth involved in facial # preserved?
provisional abx
adequate reduction and immobilisation
endo
what is the most appropriate rx for a displaced # of the parasymphysis?
open reduction with 2 mini-plates for fixation
where would plates be placed for a mandibular angle#?
1 plate along or just below the oblique line of the mandible
what technique is used to treat # of edentulous mandibles?
thick reconstruction bone plates (load bearing)
how are condylar # managed?
pt <12 years old: analgesia, soft diet, intermaxillary elastic guidance (if needed)
pt > 12 years old: elastic traction for occlusion, reassessment 7 days later, if spontaneous occlusion not possible - ORIF
what is the most common method of treating mid face#?
internal fixation with intraosseous plating
what is the general appearance of lichenoid lesions?
reticular
uniform
homogenous
bilateral (if medication related)
what kind of biopsy is used for homogenous lesions?
incisional biopsy of most concerning area
why do you avoid biopsying ulcers?
it may not give the best tissue to show invasive cancer as an ulcer generally has lost epithelium and has lots of necrotic material
how is a suspected vesiculobullous lesion investigated?
an incisional biopsy of blistered area sent on ice - for immunofluorescence using antibodies to determine where the split in the epithelium occurs
the tissue is sent on ice and not fixed by transporting it in a solution of saline with formalin
when would you do FNA to investigate pathology?
a lump within a major gland
what investigations are carried out for sjogrens?
labial gland biopsy - cut through mucosa of lower lip to identify between 5 and 8 lobules of minor salivary glands (as changes in the these are mirrored with major glands)
what flap is used for surgical removal of a mesioangularly impacted lower 3rd molar?
triangular flap
where is the triangular flap cut for a mesioangularly impacted 3rd molar?
distal relieving incision - up ascending ramus
coronal incision - down the alveolar crest fibres of tooth including papilla of 7 and 8
mesial relieving incision - from the 7 into the sulcus
what is the general rule for units of flaps?
one unit infront one behind
what suture material is best for anterior of the mouth?
a fine suture material - 4/0 or 5/0
how is the diagnosis for acute atrophic candidiasis made?
on clinical grounds:
a history of sore mouth following abx
mouth/ tongue hard and soft palate appear red and sore
when would aspiration cytology be used?
fluid containing lesions i.e., cysts
what lesions would you find PAS positive hyphae?
candidal leukoplakias
when would you want an MRI for suspected salivary gland path?
tumours that involve the deep lobe of the parotid gland
what investigation would be chosen for localised salivary gland lumps?
ultra-sound guided fine needle aspiration cytology
what is a marked difference between pleomorphic adenoma and warthins tumour?
warthins tumour can be bilateral
