Surgical Techniques Flashcards
1
Q
What are the basic principles of surgical technique?
A
- risk assessment
- good planning
- medical history
- aseptic technique
- minimal trauma to hard and soft tissues
2
Q
What are the general surgical principles?
A
- maximal access with minimal trauma
- scalpel used in one firm continuous stroke
- minimal trauma to dental papilla
3
Q
What are the stages of surgery?
A
- anaesthesia
- access
- bone removal as necessary
- tooth division as necessary
- debridement
- suture
- achieve haemostasis
- post-operative instruction
- post-operative medication
4
Q
What is the purpose of flaps?
A
- allowing access to the area being operated on
- maximal access with minimal trauma
- preserves adjacent soft tissues
5
Q
What size and shapes should flaps be?
A
- big
- bigger flaps heal just as quickly as smaller ones
- smaller are more likely to result in tears
- wide based incision
- lots of blood vessels
- reduces chance of necrosis
- no sharp angles
- reduced blood flow to area
6
Q
What kind of flap should be raised?
A
- mucoperiosteal
- periosteum must be lifted to reduce trauma caused
7
Q
What is an envelope flap?
A
- also called a 2 sided flap
- relieving incision and incision around teeth
8
Q
Why should trauma to dental papillae be kept to a minimum?
A
- papilla can shrink after surgery
9
Q
How should a flap be managed during surgery?
A
- do not crush the flap
- keep the tissue moist
- irrigate tissue
10
Q
How should flaps be replaced?
A
- ensure flap margins and sutures will lie on sound bone
- do not close wounds under tension
- can break open
- must be passive
- tissue should not be blanched when replaced
- aim for healing by primary intention to minimise scarring
- edges of flap heal to each other
11
Q
How and why should soft tissue be retracted?
A
- improves access to the operative field
- protects soft tissue
- flap design should facilitate retraction
- Howarth’s periostea elevator
- Bowdler-Henry retractor (rake)
12
Q
What is a three sided flap?
A
- mesial and distal relieving incisions
- incision around teeth
- distal relieving incision should not be lingual if on lower arch
- close to lingual nerve
13
Q
How are teeth divided and bone removed?
A
- may not be necessary for all cases
- electric straight handpiece
- saline cooled bur
- not turbine hand piece (surgical emphysema)
- 40 revs per minute
- round or fissure tungsten carbide burs
- can divide crowns and roots
- keep as big pieces as possible
14
Q
What is surgical emphysema?
A
- when air is forced into the soft tissues during surgery
- can feel crackly
- can spread to neck and chest becoming airway risk
- can become infected and cause sepsis
15
Q
What are the principles of use for elevators?
A
- mechanical advantage
- avoid excessive force
- support instrument to avoid injury
- in case of slipping
- ensure applied force is directed away from major structures
- antrum
- inferior alveolar canal
- mental nerve
- floor of mouth
- used under direct vision
- do not use adjacent tooth as fulcrum
- unless also being extracted
- keep sharp and in good shape
- discard if blunt or bent
- establish effective and logical point of application
- careful debridement after use
- remove any bony fragments created
