OS Flaschards Flashcards
If an extraction progresses to a surgical what should you do - 8 mark
Remove the crown
Stop and evaluate
Explain to the paitent what has happened
Ensure pre-op radiogrpah has been taken
Discuss tx options with the patient
Leave and monitor
Progress to surgical removal
Refer
How might you explain a minor surgical procedure to the patient
Pressure no pain
Lift the gum up
Possible drilling - water from drill
Stitches
Name 6 general surgical principles
Maximal access with minimal trauma
Wide based incision
Use scalpel in one continuous stroke
No sharp angles
Minimise truama to dental papillae
Keep tissue moist
Make sure wounds are not closed under tension
Describe a 1 sided/ envelope flap
Relatively long
Incorporates more papillae
Good for superficial surgical access
Describe a two sided flap
Incorporates either a mesial/distal relieving incision
Arguably better access
Can be difficut to suture the relieving incision
Describe a 3 sided flap
Incorporates both a mesial and distal reliving incison
Excellent surgical excess
Difficult to suture both relieving incison
Take care with nearby anatomical structures
What paitents are at risk of infective endocarditis
Paients with a prosthetic valve
Patients with previous IE
Paitent with any congenital heart disease
Name 5 risk factors for OAC
Extraction of upper molars and premolars
Close relationship of roots to sinus on radiogrpah
Last standing molars
Large bulbous roots
Previous OAC or reccurent sinus ins
What would be 5 signs of an OAC peri-operatively
Bone removed at trifiurcation
Bubbling at socket
Valsalva test
Change in suction sound
Direct vision
What are 5 peri-operative signs of an OAC
Bone removed at trifurcation
Bubbling at the socket
Valsalva test
Change in suction sound
Direct vision
What are 5 post operative signs of OAC
Unilateral discharge
Fluid from nose when drinking
Salty disachage
Difficultly smoking and drinking though a straw
Non healing socket
What is the prescription for phenoxymethylpenicllin for a patient wiht sinusitis
250mg 40 tablets 2x tablet 4x daily for 5 days
What happens if an OAC is not closed
If not closed promptly - sinusitis in 50% of Paients within 48 hours
Food/ salvia accumulation in the sinus
Infection
Impaired healing
Managment if root dislodged in the sinus - 7marks
Confirm presence of roots with PA or OPT
If small consider monitoring but advise possibility of infection
Refer or raise buccal advancement flap
Use copious amounts of saline and suction to see if root can be achieved
Widen socket with water cooled bur to increase the chance of retrieving the root
Use of ribbon gauze
Consider endoscopic or Caldwell luc procedure
In peri-radicular surgery how much of the root do we usually remove and at what angulation
3mm from apex at 90 degrees to expose as few dentinal tubules as possible
