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xD2 Oral Surgery Midterm > OSM Extraction I and II > Flashcards

OSM Extraction I and II Flashcards

1
Q

What is the primary instrument for making incisions?

A

Scalpel w/ no. 15 blade held in a pen grasp

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2
Q

What is required once an incision is made and what is the best instrument?

A

Reflect tissue from underlying cortical bone in a single layer

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3
Q

What are 2 uses of the pointed end of No 9 Molt periosteal elevator?

A
  1. Begin periosteal reflection

2. Reflect dental papilla from between teeth

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4
Q

What is the use of the round end of the No 9 Molt periosteal elevator?

A

To continue elevation of periosteum from bone

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5
Q

What is the motion used for the pointed end No 9 Molt Periosteal Elevator?

A

Twisting prying motion commonly done when elevating dental papilla between teeth or attached gingival around tooth to be extracted

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6
Q

What are 2 reasons to use soft tissue retractors?

A
  1. Visibility during surgery

2. Protect soft tissue from sharp instruments

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7
Q

What are the 2 most popular cheek retractors?

A
  1. Austin retractor

2. Minnesota retractor

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8
Q

What is the most efficient stroke for the No 9 Molt periosteal elevator?

A

Push stroke with either blunt or pointed end to slide underneath periosteum to separate it from bone

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9
Q

Most common instrument used to retract the tongue during routine extractions?

A

Mouth mirror

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10
Q

What is the most common instrument to grasp soft tissue?

A

Adson forceps (primarily the anterior mouth)

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11
Q

What is used to grasp soft tissue in the posterior mouth?

A

Stillies forceps

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12
Q

For most dentoalveolar surgery what is the normal way to control bleeding?

A

Pressure. If more, use hemostats

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13
Q

What instrument is most commonly used for removing bone in dentoalveolar surgery?

A

Rongeur forceps

-bone cutting

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14
Q

How are rongeur forceps used?

A

Small biting motions to remove small bits of bone

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15
Q

What can be used to remove larger sections of bone more aggressively?

A

Burs in a high speed, high torque handpiece. No 557 fissure bur, No 703 fissure bur, No 8 round bur, or acrylic bur-like bur

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16
Q

In what motion do bone files only remove bone?

A

Pulling motion only

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17
Q

What instrument used to remove granulomatous tissue or cysts or any debris from a tooth socket?

A

Curette

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18
Q

How is a needle holder designed?

A

locking handle, short, stout beak with cross hatchings

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19
Q

Why can’t hemostat be used for suturing?

A

parallel grooves in beak decrease needle control

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20
Q

What is the design of a suture needle?

A

Curved to allow access with either a tapered tip or a triangular cutting tip

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21
Q

How is the suture needle held in the needle holder?

A

held approximately 2/3 distance between tip and needle base

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22
Q

How is the needle holder held by the operator?

A

Thumb and ring finger through rings with index finger along the length of the needle holders

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23
Q

How is suture material classified?

A

Diameter, resorbability, mono or polyfilament

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24
Q

What is necessary when extracting mandibular teeth to prevent stress on the TMJ?

A

Support mandible with Bite Block

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25
Q

Is surgical suction the same as general dental suction?

A

No it has a smaller orifice to more adequately remove fluid from site and avoid tissue injury by sucking tissue into orifice

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26
Q

What instrument is used to luxate teeth from the surrounding bone before applying forceps?

A

Elevators

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27
Q

What are 3 components of an elevator?

A

Handle, shank, blade

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28
Q

When is it best to use the straight elevators?

A

At the beginning of luxation of erupted tooth

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29
Q

When are triangular elevators (Cryers) best used?

A

when broken root remains and adjacent socket is empty

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30
Q

What motion is used with the Cryer elevators?

A

Wheel and axel

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31
Q

What instruments are used for removing tooth from alveolar bone?

A

Extraction forceps

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32
Q

What are the 3 basic components of extraction forceps?

A

Handle, hinge, beak

33
Q

What is the design of extraction forcep beaks?

A

Designed to adapt to tooth root near junction of crown and root

34
Q

What are the extraction forcep beaks designed to grasp : the root or the crown?

A

Root

35
Q

Maxillary extraction forcep beaks designed how?

A

Single rooted teeth, and teeth with 3 roots

36
Q

Why not have a maxillary forcep designed for two rooted teeth due to the maxillary first premolar commonly having two roots

A

The 2 roots normally occur in the apical 1/3

37
Q

After luxation, Maxillary single rooted teeth are removed with what?

A

Maxillary universal forceps No 150

38
Q

No 150 Maxillary universals can be used on what teeth?

A

Maxillary central incisors, maxillary lateral incisors, Maxillary canines, maxillary premolars

39
Q

Modified No 150 used for premolars because its beak has benn modified to be more parallel

A

150A

40
Q

These maxillary forceps can be used for maxillary incisors and canines. They are straight.

A

No 1 forceps

41
Q

What is the morphology of the maxillary molar roots?

A

3 rooted, 1 palatal root and a buccal bifurcation

42
Q

How must a maxillary molar extraction forcep be designed to accommodate this root morphology?

A

have smooth concave beak for palatal root and pointed beak to engage buccal bifurcation

43
Q

Due to their design, how are Maxillary molar extraction forceps presented?

A

in pairs (right and left)

44
Q

What are the most common maxillary molar forceps?

A

No 53 right and left

45
Q

These are a variation for Maxillary molar extraction with longer more accentuated beaks. Still presented as pairs.

A

No 88 right/left upper cowhorn forceps

46
Q

What is a problem associated with No 88 Upper cowhorn forceps?

A

Crush crestal alveolar bone and can remove large portion of buccal plate

47
Q

What are English forceps?

A

Vertical hinge and vertically positioned forceps

48
Q

What is required in the design for mandibular extraction forceps?

A

Beaks that can be used for single rooted teeth (incisors, canines, premolars) and 2 rooted teeth (molars)

49
Q

Forceps most commonly used for mandibular single rooted tooth extraction

A

No 151 Lower universal forceps

50
Q

Modified No 151 for mandibular premolar teeth with more parallel beaks. Only to be used on mandibular premolars

A

No 151A

51
Q

What is the risk with using the English forceps on mandibular anterior single rooted teeth?

A

Can generate great force and increase risk of root fracture

52
Q

What is the root morphology of the mandibular molars?

A

Two rooted with bucco-lingual bifurcation

53
Q

What does the single bucco-lingual bifurcation on mandibular molars mean for the presentation of the mandibular molar forceps?

A

Only need one, don’t need a right and left like maxillary because mandibulars lack a palatal root

54
Q

What is the design of mandibular molar forceps?

A

Straight handles with beaks set obliquely downward with pointed tips to engage buccal and lingual bifurcations

55
Q

What is the commonly used mandibular molar forceps?

A

No 17

56
Q

What is an alternate to the no 17 molar forceps?

A

No 87 cowhorn forceps

57
Q

How are No 87 Cowhorns used?

A

Once seated, the handles are pumped up and down while handles are squeezed together to squeeze the tooth out of the socket

58
Q

What are the 5 general steps for exodontias?

A
  1. Loosen soft tissue around tooth (#9 Molt)
  2. Luxate tooth with elevator
  3. Adapt forceps to root
  4. Luxate tooth with forceps
  5. Remove tooth from socket w/ gentle traction
59
Q

Are the 5 steps considered together or separately and can some be skipped?

A

Consider as separate steps. Some may be modified/omitted as situation dictates

60
Q

What instrument and how is it used to luxate the tooth?

A

small straight elevator (#301) using bone as fulcrum, not adjacent teeth

61
Q

Which beak is normally seated against the tooth root first: buccal or lingual?

A

Lingual

62
Q

When luxating the tooth with forceps, what direction is the pressure applied, and which way is lateral movement made first: buccal or lingual?

A

Srong apical pressure, luxate to buccal first, then lingual, then alternate

63
Q

Is initial luxation aggressive or gentle?

A

Gentle

64
Q

What is the pressure and direction a tooth is removed from the socket with the forceps?

A

Gentle traction, normally toward the buccal

65
Q

What are 2 things luxation does for extraction?

A

Expand socket Disrupt PDL

66
Q

Are teeth ever removed by “pulling” them?

A

No

67
Q

What is done finally with the extraction site after the tooth is removed?

A

debride any granulation tissue, check and smooth any bony margins, suture if necessary

68
Q

What are three reasons a suture is required after surgery?

A
  1. control bleeding
  2. Hold something in the socket (e.g. Gelfoam)
  3. Position tissue
69
Q

What are 4 considerations for the order of extraction?

A

Maxillary first
Posterior first
Most difficult first/ or last
Symptomatic tooth first, especially if doubt entire procedure can be completed in one appointment

70
Q

What are the three forces applied to teeth?

A
  1. Luxation
  2. Rotation
  3. Traction
71
Q

When removing a tooth, what should the operator be doing to the alveolus with his non-extracting hand?

A

Stabilizing alveolus w/ thumb and forefinger on either side of ridge

72
Q

What is the general guideline for patient positioning for the extraction of Maxillary teeth?

A

Pt semireclined w/ maxillary occlusal plane 60 deg to floor at elbow height of operator. Chairback approximately 120 deg from horizontal(180 deg, with upright being 90 deg)

73
Q

What is the general guideline for patient positioning for the extraction of Mandibular teeth?

A

Pt more upright so mandibular occlusal plane near parallel w/ floor, height at elbow level or lower for operator comfort. Chairback approximately 110 from horizontal(180 deg, with upright being 90 deg)

74
Q

What is the ultimate guide for positioning of operator /how one plans to remove the tooth?

A

Always consider the root and crown anatomy of the tooth to be removed

75
Q

What is the movement normally used with single rooted teeth, especially if conically shaped root?

A

Rotation/traction

76
Q

which forceps are especially useful for grasping teeth that are loose in the mouth?

A

Russian tissue forceps (they are round-ended)

77
Q

a heavy instrument used to elevate whole roots or even teeth after purchase point has been prepared

A

crane pick

78
Q

forceps: universal upper

A

150

79
Q

forceps: universal lower

A

151

xD2 Oral Surgery Midterm (6 decks)

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