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BDS3 Oral Surgery > Oral Surgery Zoom - elevators > Flashcards

Oral Surgery Zoom - elevators Flashcards

1
Q

3 types of elevators

A

coupland’s elevators

cryers

warwick james

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2
Q

how do elevator types differ

A

in shape of blade and handle

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3
Q

3 basic components of elevators

A

handle

shank

blade

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4
Q

types of coupland’s elevators

A

3 sizes

1 - narrowest
2
3- widest

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5
Q

how to hold a couplands elevator

A

rounded handle in palm of hand and index finger on shank

Apply sufficient force while maintaining adequate support to prevent slippage

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6
Q

movement of coupland elevator

A

rotational

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7
Q

shape of cryers elevator

A

triangular shape blade with pointed tip

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8
Q

types of cryer’s elevator

A

right
left

right sitting on right, left sitting on left (blade tip in)

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9
Q

use of cryer’s elevator

A

molar root extraction

Apply buccally to engage with furcation
Or placed within a socket to elevate a fractured root

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10
Q

types of warwick james elevators

A

straight

right

left

blade directed to oppostie side talking about

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11
Q

use of right and left warwick james elevator

A

used to elevate maxillary 3rd molars

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12
Q

shape of straight warwick james elevators

A

flat and convex surface

used similarly to Couplands

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13
Q

how to use couplands elevators

A

lower right 4 root

When using elevators, ensure adequate support with the thumb and index of supporting hand
Place Coupland in mesial or distal contact points with concave surface facing the tooth root
Place perpendicular to the long axis of the root
Rotational movement applied to elevate the root

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14
Q

how to use cryers

A

lower first molar

Support
Hold like couplands
Tip of cryers used to engage the furcation and rotational movement to elevate the root
- Useful in extraction of molar roots

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15
Q

luxators

A

Different shape of blade
- Rounded, sharp cutting blade whereas couplands more angled

Designed to fit periodontal space and separate periodontal ligamnent
- Allows widening of socket prior to extraction

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16
Q

use of luxators

A

positioned parallel to long axis of the root

only to separate PDL not elevate the tooth

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17
Q

pt history in oral surgery

A

Presenting complaint- ask what they are hear for

HPC

  • Pain, swelling - address their primary concerns first
  • SOCRATES
  • Severity
  • Scale – can compare with past appointments
MH 
- Use completed medical history form as a guide
- Continue to assess
- Language barrier
- Understanding barrier
- Thinking not relevant 
- Systemic enquiry - All systems in body 
- Remember how you do so don’t miss
- Give examples to jog them 
Duodenal ULCERS and ASTHMA
- Cannot have ibuprofen 
Blood thinning/ bleeding issues 
- Medications 
- Reactions/allergies to medications/food/materials 
DH 
- Focus on extraction experience
Ask if they have had before 
- When 
- How was it
- Just LA or need GA, IDB 
- Broken tooth 
- Problems afterwards – bleed/infections
Establish their level of anxiety 
SH 
- Smoking 
- Alcohol – units
- Occupation 
- Caring responsibilities 
Will these be jeopardised for time if GA/surgery
Prepare them for this
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18
Q

extra oral exam

A

Asymmetry

  • Swelling
  • Redness
  • Drop - palsy
Lymph nodes
- Stand above and look down on pt
Submandibular
Submental 
Cervical 
- Compare both sides
Enlarged
Tender
TMJs
- Two fingers over condyle 
- Pop out when open  
- Move freely 
- Clicks
- Crunching 
Ask pt 
Muscles of mastication 
- Master
Sides of cheeks, clench teeth 
Part of bulging 
Hypertrophy with grinding 
- Temporalis
Fingers at temples
Bulging

Trismus
- Limited opening
Ask pt before look – have they noticed reduction
- What is their normal, any Problems

Get measurement
- Callipers
Upper incisal edge to lower incisal edge
2 finger – not too bad, can eat and talk, and airway

19
Q

intra oral examination

A 
Soft tissues 
NAD – no abnormality detected
- Buccal mucosa
- Hard palate
- Surfaces of tongue x4

Unharmful ones – but note

  • White striae – lichenoid
  • Linea alba
  • Polyp
  • Haemangioma – tend to be older
Teeth 
General comment
- Gross caries all teeth 
- Excellent OH, teeth well alligned
Focus on problem area
- Is the tooth carious 
- Surfaces left 
- Restorations present 
- Mobility 
- TTP – tender to percussion (infections under roots)
20
Q

presenting the pt

A

Get clinician to review your work

  • Summarise all the information you have gathered and present it to your clinician
  • Start with patients’ name and where they have been referred from

Identify the problem area and be prepared with a diagnosis or two

  • Suggest special investigations that might aid your diagnosis
  • X-ray comments

Mark the tooth to be extracted, as well as surrounding gingivae

Complete the whiteboard on the wall- make sure you include patients name, CHI number, medical history, tooth to be extracted

Use terminology for pt – pt friendly

Complete consent form along with clinician

21
Q

communicating with pt in oral surgery

A

Use patient friendly language

Establish a rapport with patient during history taking

You will be nervous, but so will your patient

Identify beforehand with your clinician what you will be expected to do eg local anaesthetic +/- extraction

Avoid waving LA needle or forceps in front of patient

Clincian must be in the room when you are giving LA/ extracting tooth

Never discharge a patient without confirming with a clinician

Ask for help

22
Q

how many upper forceps are there

A

6

23
Q

how many lower forceps are there

A

4

24
Q

upper straight forcep

A

flat handle, thick beak

use on upper anterior 1, 3, 3

25
Q

upper universal forceps

A

curved handle

used on upper 4, 5, or 3

26
Q

upper root forceps

A

curved handle

narrower beak to get into periodontal space

27
Q

upper molar forceps

A

right and left

  • beak to cheek
  • interact with birfucation

curved handle

28
Q

bayonet types

A

normal and roots (narrower beak)

upper teeth

bend in handle

29
Q

feature in all lower forceps

A

90 degree bend in handle between handle and beak

30
Q

lower universal forceps

A

used on lower anteriors and premolars (4-4)

31
Q

lower root forceps

A

narrower beaks, thinner

used on any lower roots

32
Q

lower molar forceps

A

beaks on both sides to engage bifurcation on buccal and lingual side

33
Q

cowhorn forceps

A

used on lower molars

squeeze tooth out

34
Q

most widely used elevators

A

couplands

35
Q

why use elevators

A

Elevated, extracting teeth when cannot get grip with forceps (retained roots)

Loosened before applying pressure with forceps

36
Q

luxators features

A

rounded, like spoon

Insert parallel to long axis of tooth
Shear of PDL to aid forceps removal

37
Q

process for tools when extracting tooth

A

Use luxator
Elevator – loosen, widen socket
Forceps to extract

38
Q

where does right handed operator stand for pt upper right and upper and lower left

A

stand in front to right

patient reclined to enable good visualisation of the tooth being extracted

raises pt mouth to your elbow level

non dominant hand retracts soft tissue and supports alveolar bone

39
Q

where does right handed operator stand for pt lower right quadrant

A

Behind pt right shoulder

Patient is in an upright position

Raise the patients’ mouth to just below elbow level

Support mandible as well as alveolar bone and retract tissues
- Counteract force of extraction

40
Q

how to extract tooth with forceps

A

Get forceps as far down route as can

Try not to traumatise gingiva

Use non-dominant hand to guide forceps into place if necessary and retract tissue

Beaks of forceps are designed to fit snugly around the crowns

Engage with bifurcation

Once you are confident the forceps are positioned correctly apply the relevant forces to loosen the tooth

41
Q

first force used when extracting any teeth

A

apical pressure

42
Q

force for extracting single rooted teeth and premolats

A

apical

then rotations

then should have some tooth movement and buccal movement to extract

43
Q

forces for extracting molar teeth

A

apical

then figure of 8
- roots diverge and splayed in different directions
- expand sockets so all roots involved
buccal movement out

tiring

BDS3 Oral Surgery (8 decks)

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