Surgery3 Flashcards
dead space in a wound is ?
any area that remains devoid of tissue after closure of the wound, usually fills in with blood, which creates a hematoma with a high potential for infection
Which of the following are ways of eliminating dead space? Select all that apply.
• close the wound in layers to minimize the postoperative void
• apply pressure dressings
• use drains to remove any bleeding that accumulates
• allow the void to fill with blood so that a blood clot will form
- close the wound in layers to minimize the postoperative void
- apply pressure dressings
- use drains to remove any bleeding that accumulates
whenever a muco-periosteal flap is elevated for a surgical extraction, there is a possibility for a sub-periosteal abscess. Thus, all surgical flaps should be ? prior to closing with sutures
irrigated liberally
Which of the following is the primary direction of luxation for extracting maxillary deciduous molars? • buccal • palatal • mesial • distal
palatal (As opposed to the buccal direction in adults. This is because the deciduous molars are more palatally positioned and the palatal root is strong and less prone to fracture)
Do not use the “cowhorn” forceps for extraction of lower primary molars because ?
the sharp beaks of these forceps could cause damage to the unerupted permanent premolar teeth
During extraction of a maxillary third molar, you realize the tuberosity has also been extracted. What is the proper treatment in this case?
• remove the tuberosity from the tooth and reimplant the tuberosity
• smooth the sharp edges of the remaining bone and suture the remaining soft tissue
• no special treatment is necessary
• none of the above
smooth the sharp edges of the remaining bone and suture the remaining soft tissue
During extraction of a maxillary third molar, if the tuberosity is fractured but intact, What is the proper treatment ?
it should be manually repositioned and stabilized with sutures
“Beware of the lone molar”— it is often ?
ankylosed to the bone. Remember: The ankylosed tooth emits an atypical, sharp sound on percussion
if tuberosity fractures occur, when should it be treated ?
at the time of surgery. If the operator is unable to do this, he/she must arrange an immediate referral
for denture construction, at the correct vertical dimension, the distance from the crest of the tuberosity to the retromolar pad should equal at least ?
1 cm
Which of the following can be safely excised in preparing the edentulous mandible for dentures? Select all that apply. • labial frenum • lingual frenum • mylohyoid ridge • genial tubercles • exostosis
• labial frenum • lingual frenum • mylohyoid ridge • exostosis (If the genial tubercles were removed, the tongue would be flaccid)
when removing a mandibular exostosis (mandibular torus), it is recommended that ? flap design, which has no vertical components, be used
an envelope
The ideal time to remove impacted third molars is:
• when the root is fully formed
• when the root is approximately two-thirds formed
• makes no difference how much of the root is formed
• when the root is approximately one-third formed
when the root is approximately two-thirds formed (at this time, age 17-21, the bone is more flexible and the roots are not formed well enough to have developed curves and rarely fracture during extraction)
When would you place a suture over a single extraction socket?
• routinely
• never
• if the patient requests it
• when there is severe bleeding from the gingiva or if the gingival cuff is torn or loose
when there is severe bleeding from the gingiva or if the gingival cuff is torn or loose
If bleeding persists for some time following an extraction, it may be helpful to instruct the patient to ?
bite on a tea bag. The tannic acid in the tea bag will help promote hemostasis
The most common cause of postextraction bleeding is ?
the failure of the patient to follow postextraction instructions
The most commonly impacted teeth are the mandibular third molars, maxillary third molars, and the: • maxillary canines • maxillary lateral incisors • mandibular first molars • mandibular premolars
maxillary canines
For impacted mandibular third molars, place the following in their correct order from the least difficult to most difficult to remove. • vertical • horizontal • distoangular • mesioangular
• mesioangular - 43% of mandibular impactions
• horizontal - 3% of mandibular impactions
• vertical - 38% of mandibular impactions
• distoangular - 6% of mandibular impactions
(Important: This is the exact opposite of impacted maxillary third molars)
All of the following are cardinal signs of a localized osteitis (dry socket) EXCEPT one. Which one is the EXCEPTION? • throbbing pain (often radiating) • bilateral lymphadenopathy • fetid odor • bad taste • poorly healed extraction site
bilateral lymphadenopathy
dry socket is most common following extraction of ?
the mandibular molars
Before removing a palatal torus: • an intraoral picture should be taken • a mandibular torus, if present, should be removed • a stent should be fabricated • a biopsy should be taken
a stent should be fabricated
? is the most common complication seen after the surgical removal of a mandibular molar
dry socket
The maxillary torus should not be excised en masse to prevent ?
entry into the nose (the palatine bone will come out with torus)
Which two major forces are used for routine tooth extractions? • rotation • pulling • pushing • luxation
- rotation
* luxation
A Class ? lever is used during tooth extractions
II (fulcrum is close to the apex)
The root of which tooth is most often dislodged into the maxillary sinus during an extraction procedure?
• palatal root of the maxillary first premolar
• palatal root of the maxillary first molar
• palatal root of the maxillary second molar
• palatal root of the maxillary third molar
palatal root of the maxillary first molar
The Caldwell-Luc procedure eliminates blind procedures and facilitates the recovery of large root tips or entire teeth that have been displaced into the maxillary sinus. When performing this procedure, an opening is made into the facial wall of the antrum above the: • maxillary tuberosity • maxillary lateral incisor • maxillary premolar roots • maxillary third molar
maxillary premolar roots
in which situation a root tip can be left in maxillary sinus ?
- root tip is small (2 or 3 mm),
- noninfected,
- cannot be removed through the small opening in the socket apex
If a root tip of a mandibular third molar disappears from site while trying to retrieve it, its most likely location is ?
the submandibular space
Which suture grading below is the thickest? • 2/0 • 3/0 • 4/0 • 5/0
2/0 (intraoral suturing require the use of 3/0- or 4/0, but on extraoral skin surfaces finer gauge is preferred such as 6/0 or even finer. This helps reduce scar visibility)
Because suture material is foreign to the human body, ? should be used
the smallest-diameter suture sufficient to keep the wound closed properly
Which of the following events are correctly paired with the stages of wound healing? Select all that apply.
• fibroblasts lay a bed of collagen / proliferative phase
• platelet aggregation / inflammatory phase
• contraction of the wound / remodeling phase
• thromboplastin makes a dot / inflammatory phase
- inflammatory 2. proliferative 3. remodeling phases
• fibroblasts lay a bed of collagen / proliferative phase
• platelet aggregation / inflammatory phase
• thromboplastin makes a dot / inflammatory phase
contraction of the wound occurs during the proliferative phase
? is the agent of choice for the debridement of intraoral wounds
3% hydrogen peroxide
Sutures placed intraorally are normally removed: • 1-2 days postoperatively • 5-7 days postoperatively • 9-11 days postoperatively • 13-15 days postoperatively
5-7 days postoperatively
Regardless of the flap design used, certain principles should be followed while incising and reflecting the gingiva. With this in mind, the termination of a vertical incision at the gingival crest must be:
• midbuccal of the tooth
• at the line angle of the tooth
• midlingual of the tooth
• beyond the depth of the mucobuccal fold
at the line angle of the tooth
types of incisions used in oral surgery and their indications?
- Linear: for apicoectomies.
- Releasing: for extractions, augmentations, etc.
- Semilunar: for apicoectomies
While attempting to remove a grossly decayed mandibular molar, the crown fractures. What is the recommended next step to facilitate the removal of this tooth?
• use a larger forcep and luxate remaining portion of tooth to the lingual
• separate the roots
• irrigate the area and proceed to remove the rest of the tooth
• place a sedative filling and reschedule patient
separate the roots
When luxating a tooth with forceps, the movements should be firm and deliberate, primarily to ? with secondary movements to ?
- the facial
* the lingual
it is recommended to use ? when removing mandibular teeth to diminish pressure on the contralateral TMJ
a bite block
While extracting a mandibular third molar, you notice that the distal root tip is missing. Where is it most likely to be found? • in the infratemporal fossa • in the submandibular space • in the mandibular canal • in the pterygopalatine fossa
in the submandibular space
