PRINCIPLES OF SURGERY

Question 1

T/f

the more respect you give to the soft tissue, there will
be lesser inflammation after surgery

Answer 1

T

Question 2

T/f

Surgical procedures by itself are traumatic
 Incisions
 Reflecting the tissue
 Removal of some bone

Answer 2

T

Question 3

T/f

When the blade comes in contact with the bone, it is always tooth-bound

Answer 3

T

Question 4

T/f

The blade holder must be held in a modified pen grasp manner
 Just like holding a pen

Answer 4

T

Question 5

T/f

The mouth is highly vascular
 Found beneath the tongue are blood vessels
 Would lead to profuse bleeding when
accidentally cut

Answer 5

T

Question 6

T/f

The best way to avoid complication is always prevention

Answer 6

T

Question 7

T/f

Incisions should always be in a single straight continuous manner

Answer 7

T

Question 8

T/f

Make sure that your arm is near the body to have better control

Answer 8

T

Question 9

T/f

Have a finger rest our guard especially in long incisions
You cannot incise with a floating hand
 Look which finger is comfortable e.g.
pinky fnger, ring finger

Answer 9

T

Question 10

T/f

THE BLADE SHOULD ALWAYS BE POSITIONED AT 60° IN RELATION TO THE BONE

Answer 10

F

(THE BLADE SHOULD ALWAYS BE POSITIONED AT 90° IN RELATION TO THE BONE)

Question 11

T/f

When creating a tissue layer that is to be sutured closed, the blade should be kept perpendicular to the tissue surface to create squared wound edges. Holding the blade at any angle other than 90 degrees to the tissue surface creates an oblique cut that is dif􏰀cult to close properly and compromises blood supply to the wound edge.

Answer 11

T

Question 12

Ifitiscutat90°,itwouldbeeasyto reapproximate, adjust and suture the squared wound edges
 This would heal by ___ intention faster and cleaner

Answer 12

primary

Question 13

T/f

If is not cut at 90°, there will be overlapping of the flaps
 One tissue would go up and protrude while
the other goes down
 There is no space to readapt with the tissue
 This would heal longer by secondary intention.

Answer 13

T

Question 14

T/f

When the soft issues try to heal after surgical procedure, it needs to be supported by a solid stable structure underneath for it to heal properly because there is a bone.

Answer 14

T

Question 15

If the bone is removed because an incision is made on top of a bony defect, it will have no support underneath for it to heal properly

 It will collapse into the defects and lead to healing with secondary intention rather
than primary intention.

 It will heal longer and can lead to ____.

Answer 15

dehiscence

Question 16

Always maintain ___ to 8 mm from the most distal boundary of the defect to the incision line

Answer 16

6

Question 17

T f

6 to 8 mm can still rest on sound or solid structure to support the healing tissue after the surgery

Answer 17

T

Question 18

Whether it is three or four cornered incision, the minimum distant from the tooth in question should be ___ tooth anterior and 1 tooth posterior

Answer 18

1

Question 19

T/f

If the defect or lesion is big, the 1 tooth anterior and 1 tooth posterior cannot be followed.

 Instead, extend the incision in such a way that when placing a releasing incision there is a minimum distance from the most distal extension to the incision line

Answer 19

T

Question 20

T/f

RELEASING INCISIONS SHOULD BE ALWAYS FROM THE SULCULAR AREA TOWARDS THE ANGULAR MUCOSA

Answer 20

T

Question 21

RELEASING INCISIONS SHOULD BE ALWAYS FROM THE SULCULAR AREA TOWARDS THE ___ MUCOSA

Answer 21

ANGULAR

Question 22

What should the assistant use to kep the lip away from your incision?

Answer 22

 Mouth mirror
 Minnesota Retractor

Question 23

T/f

Jagged edges or improper tissue overlap will
heal with secondary intention

Answer 23

T

Question 24

T/f

Molt 9 Mucoperiosteal Elevator

When trying to reflect the tissue, use the convex side facing towards the bone

Answer 24

F

(When trying to reflect the tissue, use the CONCAVE side facing towards the bone)

Question 25

T/f Molt 9 Mucoperiosteal Elevator The first part that should be reflected is at the junction of the horizontal incision and vertical incision  Using pushing motion, push until it reflects  Go to the interdental papilla then do prying motion

Answer 25

T

Question 26

Where should put the suture?

Answer 26

At the junction of the horizontal and vertical incision (First put at the junction, then horizontal and vertical respectively depending on the length needed maybe 2 or 3)

Question 27

Distance minimum of ____ mm per suture

Answer 27

3 (For canine, anterior teeth)

Question 28

Too close is not also good because the suture is made of ____

Answer 28

Miltifilament (-It is like a rope  Saliva and bacteria are trapped wicking)

Question 29

There are monofilament and multifilament sutures. The one commonly used in the clinics is ___ which is a multifilament  Multi􏰀lament is used better because it is workable and does not resist manipulations unlike the monofilament that resists like nylon

Answer 29

silk

Question 30

T/f Silk is also affordable Silk is not resorbable. However, if it is not taken out from the tissue, it will be degraded by the enzymes of the tissue and eaten up by macrophages in 6 months

Answer 30

T

Question 31

The ideal time the stitches have to come in contact should not be more than ____ days  If it stays longer, it will just be an irritant because its function is already done  The tissues have been sticked together with re-epithelialization  Microorganisms wick within the strands and develop suture tract infection

Answer 31

7 to 10

Question 32

T/f The top of the tissue is contaminated since it was exposed to saliva, food and liquids for 7 to 10 days. To remove the stitches without pulling any exposed contaminated suture under the gums, cut ABOVE the knot so that everything is pulled out without contaminating the tissue underneath. This prevents suture tract infection

Answer 32

F (The top of the tissue is contaminated since it was exposed to saliva, food and liquids for 7 to 10 days. To remove the stitches without pulling any exposed contaminated suture under the gums, cut UNDERNEATH the knot so that everything is pulled out without contaminating the tissue underneath. This prevents suture tract infection)

Question 33

T/f An attached tissue is hard to get through the needle  The needle gets into the tissue contacting the bone at 90 degrees

Answer 33

T

Question 34

T/f THE BASE SHOULD BE WIDER THAN THE FREE END  The free end is at the gingival sulcus area  The base is at the alveolar mucosa

Answer 34

T

Question 35

The blood runs in an ____ manner

Answer 35

axial

Question 36

T/f Do not cut on the lingual side of the mandible.  There are a lot of vital structures and blood vessels  Do not make any releasing incisions on the mandible

Answer 36

T

Question 37

THE SUTURE SHOULD NOT BE TOO LOOSE OR TOO TIGHT  Closing it too tight would lead to tissue ____  Lack of oxygenation to the particular part of the tissue  Any tissue that lacks oxygenation becomes ___

Answer 37

ischemia non-vital

Question 38

T/f OCHSENBEIN LUEBKE FLAP This gives the best access and visibility as tissues are reflected all way  More access and visibility with four- cornered compared to three

Answer 38

T

Question 39

T/f OCHSENBEIN LUEBKE FLAP, is dif􏰀cult to back in place

Answer 39

T

Question 40

T/f Three-cornered, four-cornered full thickness mucoperiosteal sulcular incision has lesser bleeding during the surgical procedure

Answer 40

T

Question 41

T/f Three-cornered, four-cornered full thickness mucoperiosteal sulcular incision gives full access and feasibility

Answer 41

T

Question 42

T/f Sulcular incisions are avoided  It causes gingival recession after bleeding

Answer 42

T

Question 43

T/f The problem is that in Ochsenbein Luebke Flap it is cutting directly over the attached gingiva. There is scarring

Answer 43

T

Question 44

T/f Ochsenbein Luebke Flap In suturing, the knot should not be placed on the incision line because it has weight  It will gout there

Answer 44

T

Question 45

T/f Healing occurs across the incision line not along the incision line

Answer 45

T

Question 46

Soft tissue in the oral cavity is made up of _____ ___ epithelium

Answer 46

strati􏰀ed squamous

Question 47

T/f and jagged edges will heal by secondary intention not by primary intention

Answer 47

T

Question 48

T/f ENVELOPE FLAP  Simplest incision

Answer 48

T

Question 49

T/f SEMILUNAR INCISION  Done at the alveolar mucosa  Said to be ideal for endodontic surgery (but not indicated)

Answer 49

T

Question 50

T/f SEMILUNAR INCISION Easy to do but problematic since it is a horizontal incision

Answer 50

T

Question 51

T/f SEMILUNAR INCISION Easy to do but problematic since it is a horizontal incision

Answer 51

T

Question 52

T/f Ochsenbein Luebke and semilunar flap will lead to perfused bleeding because it is cut it along a blood vessel

Answer 52

T