OS - Basic surgical technique Flashcards
What are the 9 stages of surgery?
Anesthesia Acess Bone removal, if necessary Tooth division as necessary Debridement Suture Achieve hemostasis Post-op instructions Post-op medications
What are the basic principles to ensure a successful surgery?
Risk assessment - Check patients MH and good planning
Minimise trauma to hard and soft tissues
Aseptic techniques to minimise infection
Before you start surgery and give the patient any anesthetic, what must you have done?
Got consent
Surgical pause and checked the surgical safety checklist.
What are the general OS principles that should be adhered to when carrying out flap surgery?
Wide based incision - This allows for better blood circulation
One smooth stroke - Don’t want to cut with saw motion as will leave a ragged edge and won’t heal as well.
No sharp angles
Adequate size of flap - Big flaps allow for better access and heal just as fast as smaller ones.
The flap is a mucoperiosteal flap so therefore should be all the way down to the bone
Minimise truama to dental papilla
Keep tissue moist
Ensure sutures margins lie on solid bone
Make sure the wound isn’t closed under tension
Aim for healing by primary intention, as this minimises scarring
What are the 2 types of flaps in MOS?
3 sided flap
Envelope
What instruments can be used to retract the soft tissues?
Howarths periosteal elevators
Rate retractors
What are the benefits of retracting the soft tissues out of the way?
Improves the operator’s field of view, can see the access site better.
It protects the soft tissues
What hand-piece and bur is used for bone removal?
An electric straight handpiece with saline cooled bur.
Why are air-generated handpieces not used to remove bone?
Due to the chances of air getting trapped in the cancellous bone. Which then causes surgical emphysema, which can lead to infection.
What are the 3 types of elevators
Couplands
Cryers
Warwick Jame
What are some tips when using elevators to avoid injury to the patient?
Do not use too much pressure, have your fulcrum finger on bone, not the adjacent tooth.
The pressure should also not be directed towards any of the nearby major structures (maxillary sinus, lingual nerve, IAN)
Always have direct vision of the access site
Make sure the elevators are sharp and in good condition.
After use DEBRIDEMENT of bone fragments is essential.
What are some uses of elevators?
To Elevate teeth before forceps
To Ex teeth without forceps
To remove stubbed roots, retained roots, and root apices
Loosen teeth
Why must you ALWAYS make sure there is no leftover debris after an operation?
As debris is a common source of infection
What are the 3 main ways to make sure all debris is removed after an operation?
Physical debridement - bone file or handpiece to remove any sharp bone edges. Victoria curettes and Mitchell trimmer to remove soft tissue debris
Irrigation - Sterile saline solution to irrigate into the socket and under flap
Suction - Aspirate under the flap to remove debris and check for any retained apices.
What are the aims of the placement of sutures?
Healing by primary intention Reposition of tissues Prevent wound breakdown Cover bone Achieve haemostasis
