Orthodontic/Dental Surgery

Question 1

List two indications for TMJ arthroscopy.

Answer 1

1. The treatment of intracapsular disorders 2. The treatment of
   internal derangements
   Jaffe RA, Samuels SI. Anesthesiologist’s Manual of Surgical
   Procedures. 4th ed. Philadelphia, PA: Lippincott Williams and
   Wilkins, 2009: 260.

Question 2

For what reasons would a TMJ (temporomandibular

joint) arthrotomy be performed.

Answer 2

Fibrous or bony ankylosis, tumor resection, chronic dislocation,
severe fibrous adhesion removal in the TMJ, severe
osteoarthritis, painful nonreducing disc dislocation.
Jaffe RA, Samuels SI. Anesthesiologist’s Manual of Surgical
Procedures. 4th ed. Philadelphia, PA: Lippincott Williams and
Wilkins, 2009: 260.

Question 3

What are some possible complications of TMJ

arthroscopy/arthrotomy.

Answer 3

Facial and trigeminal nerve damage, partial hearing loss,
vertigo, ear fullness, hemorrhage,
Jaffe RA, Samuels SI. Anesthesiologist’s Manual of Surgical
Procedures. 4th ed. Philadelphia, PA: Lippincott Williams and
Wilkins, 2009: 260.

Question 4

What are the advantages of arthroscopic TMJ

procedures compared to open surgical techniques?

Answer 4

There is better preservation of blood flow and lymphatic
drainage to the joint, and there is less disruption of periarticular
tissue.
Jaffe RA, Samuels SI. Anesthesiologist’s Manual of Surgical
Procedures. 4th ed. Philadelphia, PA: Lippincott Williams and
Wilkins, 2009: 260.

Question 5

Will muscle relaxation and general anesthesia
always improve the mouth opening of an individual
with TMJ disorders?

Answer 5

No.
Jaffe RA, Samuels SI. Anesthesiologist’s Manual of Surgical
Procedures. 4th ed. Philadelphia, PA: Lippincott Williams and
Wilkins, 2009: 264.

Question 6

What patient populations necessitate general

anesthesia or deep sedation for oral/dental surgery?

Answer 6

1. Mentally retarded patients 2. Young children 3. Patients with
   oral sepsis 4. Patients with poorly controlled seizure disorders
2. Patients presenting for TMJ procedures.
   Jaffe RA, Samuels SI. Anesthesiologist’s Manual of Surgical
   Procedures. 4th ed. Philadelphia, PA: Lippincott Williams and
   Wilkins, 2009: 264.

Question 7

Where is the preferred placement of an endotracheal

tube for a patient undergoing dental surgery?

Answer 7

Nasotracheal
Jaffe RA, Samuels SI. Anesthesiologist’s Manual of Surgical
Procedures. 4th ed. Philadelphia, PA: Lippincott Williams and
Wilkins, 2009: 262.

Question 8

What can result from damage to the lingual nerve

during surgical tooth extraction?

Answer 8

Numbness of the tongue
Jaffe RA, Samuels SI. Anesthesiologist’s Manual of Surgical
Procedures. 4th ed. Philadelphia, PA: Lippincott Williams and
Wilkins, 2009: 262.

Question 9

What can result from damage to the inferior alveolar

nerve during surgical tooth extraction?

Answer 9

Lip numbness
Jaffe RA, Samuels SI. Anesthesiologist’s Manual of Surgical
Procedures. 4th ed. Philadelphia, PA: Lippincott Williams and
Wilkins, 2009: 262.

Question 10

Patients with rheumatoid arthritis presenting for
surgical correction of TMJ disorder may have what
associated problems that can complicate intubation?

Answer 10

Instability/immobility of the cervical spine and immobility of the
cricoarytenoid joint.
Jaffe RA, Samuels SI. Anesthesiologist’s Manual of Surgical
Procedures. 4th ed. Philadelphia, PA: Lippincott Williams and
Wilkins, 2009: 264.