Presurgical Assessment

Question 1

TWAT-WAFFLE

Answer 1

Spencer

Question 2

Dick-Butt

Answer 2

Also Spencer

Question 3

Poorly controlled diabetic: changes to appointment

Answer 3

No treatment until they reach THEIR maximum control

Question 4

Well controlled diabetic: changes to appointment

Answer 4

No changes needed

Question 5

End-stage Renal: changes to appointment

Answer 5

Med consult

Question 6

Risks from Leukemias and Lymphomas (2)

Answer 6

-Infection from low fxning white cells -Thrombocytopenia

Question 7

Cardiac disease: changes to appointment

Answer 7

No treatment until stable post 6 months?

Question 8

Risks from Cardiac problems: (3)

Answer 8

-Bleeding -Acute MI -CVA

Question 9

Pregnancy: When do we do extractions

Answer 9

2nd Trimester

Question 10

Drugs of concern: Anti-coagulants and 3 more

Answer 10

1. Corticosteroids 2. Immunosuppressive 3. Chemo

Question 11

Risks for patients with history of radiation AT site of extraction and possible treatment?

Answer 11

-Osteoradionecrosis -Hyperbaric O2 treatment

Question 12

Highly anxious people: changes to appointment

Answer 12

Sedatives

Question 13

Complications for extraction due to Infection (2)

Answer 13

1. Hard to get numb 2. Hard to open mouth fully

Question 14

Surgical options for treating pericornitis? -Mild -Severe (4)

Answer 14

-Mild: Extract -Severe: 1. Debride 2. Irrigate 3. Anti biotics 4. Extract IF it is in occlusion on gingival tissue

Question 15

Causes of limited opening

Answer 15

1. Trismus 2. TMD 3. Muscular Fibrosis

Question 16

What may cause teeth to be Ankylosed? (3)

Answer 16

-Submerged primary molars that have no permanent Tooth. -Endo-treated teeth -History of trauma

Question 17

*Just for fun…. *Which arch is more susceptible to osteoradionecrosis?

Answer 17

Mandible! less substantial blood supply

Question 18

Which tooth most commonly has risk of oral antral fistula?

Answer 18

MAXILLARY 1st Molar

Question 19

High Risk cases for Oral antral fistulas? (2)

Answer 19

1. Indentation of the sinus at the roots of molar 2. Teeth related to sinus are Isolated. This increases the risk of fracture of these teeth and maxillary tuberosity into the sinus.

Question 20

Fracture risk: -Pointed apices vs rounded apices

Answer 20

Pointed: more likely to fracture Rounded: Hard to extract with less risk of fracture

Question 21

Risks for endo-treated tooth

Answer 21

-Brittle (more brittle longer it is after endo-treatment) -Endo treated teeth that were avulsed or replanted are at risk of ankylosis.

Question 22

Extraction concerns for primary molars

Answer 22

Removal of Permanent tooth bud with the primary molar -recommend sectioning for careful extraction

Question 23

The more dense the bone, the greater risk for:

Answer 23

Root fracture -?(and apparently alveolar bone fracture too?)

Question 24

What properties of a tooth lead to greatest risk of injury to inf alveolar N? Overall risk in %?

Answer 24

Most posterior (3rd molar) Impacted (not erupted) *1% RISK

Question 25

What is the orientation/position of the 3rd mand molars and the inf alveolar canal.

Answer 25

The canal is buccal to the 3rd molars