Third Molars - L4 Flashcards

1
Q

for surgical removal of 8’s, what is needed?

A
  • Anaesthesia
  • Access
  • Bone removal as necessary
  • Tooth division as necessary
  • Debridement
  • Suture
  • Achieve haemostasis
  • Post-op Instructions
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2
Q

types of anaesthesia that can be used for surgical removal of 8s?

A
  • LA
  • IV Sedation & LA
  • GA

[Depends on Pt & difficulty of XLA]

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3
Q

Key points in surgical removal of 8s when gaining ACCESS?

A
  • Access to tooth gained by raising buccal mucoperiosteal flap
  • MAX ACCESS with minimal trauma
  • Large flaps heal just as quickly as small ones
  • scalpel in 1 firm continuous strokes
  • MINIMISE TRAUMA TO PAPILLAE
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4
Q

Surgical Removal: Reflection

A
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5
Q

Surgical Removal: Retraction

A
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6
Q

Surgical Removal: Bone removal

A
  • electrical straight handpiece with saline cooled bur
  • AIR DRIVEN HANDPIECE = EMPHYSEMA
  • Round/fissure stainless steel & tungsten carbide burs
  • Protection of soft tissues
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7
Q

Goals of surgical bone removal?

A
  • intention to create a DEEP, NARROW gutter around crown of wisdom tooth
  • bone should be removed to allow application of elevators
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8
Q

If tooth cannot be removed with bone removal, what happens?

A

Tooth division

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9
Q

what is tooth division during surgical removal?

A
  • most commonly crown is sectioned from roots to be removed separately
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10
Q

Debridement in surgical removal?

A

Physical:
- bone file/handpiece to remove sharp edge
- mitchell’s trimmer

Irrigation:
- Sterile saline into socket & under flap

Suction:
- Aspirate under flap to remove debris

must irrigate under flap & removal of all DEBRIS before repositioning it

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11
Q

Purpose of suturing in surgical removal of teeth?

A
  • Approximate tissues
  • Compress blood vessels
    Aims:
  • reposition tissues
  • cover bone
  • prevent wound breakdown
  • haemostasis
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12
Q

when is coronectomy carried out and what is it?

A
  • alternative to surgical removal of ENTIRE tooth where appears to be increase risk of nerve damage with full removal
  • crown removed with deliberate intention to leave root
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13
Q

Coronectomy main points?

A
  • flap design to gain access
  • horizontal cut of crown 3-4mm below CEJ
  • elevate/lever crown off without mobilising roots
  • Pulp left in place
  • untreated

Review pt

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14
Q

what must you warn a pt for a coronectomy in regards to the roots?

A
  • IF root is mobilised during crown removal, entire tooth must be removed
  • leaving roots could result in infection
  • can get slow healing/painful socket
  • roots may migrate upwards and require XLA
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15
Q

key points regarding maxillary 8s?

A
  • generally easier to remove
  • bayonet/upper 8s forceps
  • support tuberosity with thumb+finger
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