Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

SX #2 > thirds > Flashcards

thirds Flashcards

1
Q

t/f: all unerupted teeth are impacted

A

false

impacted tooth = fail to erupt within expected developmental time period

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

4 theories behind impacted thirds

A

mesial/distal roots grow differently

inadequate arch space

dental development lags skeletal development

obstruction secondary to cyst, tumor, supernumerary

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

which is slower: dental or skeletal development

A

dental

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

winters classification based on..

A

inclination of tooth to long axis of 2nd molar

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

percentage mesioangular

A

43%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

easiest angulation to extract

A

mesioangular

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

distoangular percentage

A

6%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

most difficult to extract

A

distoangular

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

horizontal impaction percentage

A

3%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

vertical impaction percentage

A

38%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

can you use winter’s classification for maxillary teeth

A

yes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

maxillary vertical impaction %

A

63%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

maxillary distoangular impaction %

A

25%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

maxillay mesioangular impaction %

A

12%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

what impaction is rarely seen in maxillary

A

horizontal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

D7220

A

soft tissue

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

D7320

A

partial bony

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

D7240

A

full bony impaction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

D7241

A

complex full bony

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

2 indications for third molar removal

A

therapeutic or prophylactic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

t/f: asymptomatic means disease free

A

false

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

t/f: pathology is always present before symptoms appear

A

true

once damage has occurred, it is not always treatable

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

7 year study

A

Advised that even most 3rds that are asymptomatic and free of disease are at risk for chronic oral infections and tooth decay and should be considered for removal in young adulthood

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

AAOMS advocacy white paper

A

supports elective, prophylactic removal of impacted thirds

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

12 indications for removal

A 
pericoronitis
caries
pathologic resorption
pathology
eruption pain
crowding
post-ortho 
orthognathic sx
in line of mn fx
perio dz
lack of attached gingica
crowding
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

crown formation of 3rds

A

14 yrs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

50% root formation

A

16 yrs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

after 25 years, third molars…

A

position does not change much

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

ideal pt selection: root formation?

A

2/3 root formation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

ideal pt selection: age?

A

18-25

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

if pt has a job restriction to “numb lip” (like professional musician or something)

A

contraindication to 3rd removal

32
Q

why is young age a contraindication to 3rd removal

A

jaw may grow to accomodate

33
Q

what is the most common contraindication

A

old age

34
Q

why should you not remove 3rds on ppl over 40

A 
calcified bone
less flexible bone
slow healing
mn fx
parasthesia
osteomyelitis
35
Q

first step in 3rd molar consutl

A
  1. gather data in systematic fashion

CC, HPI, Med hx

36
Q

second step in consult

A
  1. physical exam

IVSA/GA?, erupted?, decay/perio?, probe depths, operculum?

37
Q

third step in consult

A

pano

condylar anatomy, pathology, level of impaction, must be w/i 1 yr

38
Q

how current must pano be

A

less than one year old

39
Q

fourth step in consult

A

start with basics–explain why they need surgery, show them the X-rays

explain IV sedation, NPO, escorts

post-op concerns

40
Q

how long is expected recovery period

A

3-4 days

41
Q

expected level of post op pain

A

mild-moderate

42
Q

when does swelling peak

A

day 3

43
Q

discuss risks or benefits of sx first?

A

benefits! then explain risk

44
Q

what do you need to DOCUMENT!

A

probing depths
detailed clinical/radiographic findings
pt education (risks, benefits, indications)
consent (AAOMS vidos, written, verbal)

45
Q

where is the no man’s zone

A

lingual to mandibular 3rd

46
Q

mesioangular impaction: you separated the mesial/distal roots, which should you elevate out first? according to pics

A

get distal root out first

47
Q

vertical impaction: where to section

A

make weird oblique line on crown? look at pic

48
Q

horizontal impaction: where to section

A

section M/D roots, then try to take the one out on top first

49
Q

distoangular impaction: where to section

A

take off crown, then separate roots, then get most distal root

50
Q

proper elevation technique

A

be judicious; employ controlled arts of force along the long axis of the tooth

51
Q

what if you meet a lot of resistance when trying to elevate or path or withdrawal does not exist

A

remove more bone or divide tooth into small segments

52
Q

what should you never do when elevating

A

use excessive force

53
Q

after extracting roots you should

A

inspect to make sure you got the tips

inspect socket for retained fragments

54
Q

if you hear a snap or crack..

A

a root has failed until proved otherwise

55
Q

socket care immediately after ext:

A

remove bone remnants
remove soft tissue with poor vascularity
curvetted socket and remove follicle

56
Q

who’s responsibility is it to make sure there is no debris in socket or under flap

A

yours, not assistant

57
Q

excessive suturing leads to..

A

swelling

58
Q

intraoperative complications (5)

A 
hematoma
gingival compromise
injury to adjacent teeth and osseous structures
lacerations
burns
59
Q

maxillary complications

A

loose tooth in infratemopral fossa

tuberosity removal oops

oroantral communication

60
Q

mandibular complications

A

root tip in lingual iplate

submadnibular/lingual nerve injury

mandible fracture

61
Q

intraoperative bleeding management

A

give local

bone wax

gelfoam

surgicel

pressure pack if needed

62
Q

sinus perforation tx

A 
antibiotic
decongestants
afrin nasal spray
written and verbal instruction
suture TIGHT
follow up
63
Q

nerve injury protocol

A 
DOCUMENT!!
steroid dose pack
neurosensory testing
when to refer?
malpractice?
64
Q

post operative complications (5)

A 
dry socket
secondary bleeding
subperiosteal abscess 
retained root tips
infection (RARE)
65
Q

dry socket symptoms

A

fetid breath
very bad pain that radiates to ear
3-5 days post op

66
Q

when does dry socket pop up

A

3-5 days post op

67
Q

who is most at risk for dry socket

A

female older than 40 who has taken steroids, had a prior infection or had a long operative time

68
Q

secondary bleeding management

A 
suction oral cavity
examine site
apply pressure for 5 mins
local anesthetic
curettage 
identify bleeding
69
Q

how long to monitor patient with secondary bleeding before discharge

A

15 mins

70
Q

when does a subperiosteal abscess occur

A

2-3 weeks post op

71
Q

subperiosteal abscess management

A

flap and irrigate
abtcs

will be difficult to get good LA

72
Q

when to take post op pano

A

pt comes back after more than a week, suddenly worse…potential for retained tip or foreign object

73
Q

what is osteomyelitis, what does it result in

A

odontogenic bacteria invade bone marrow

results in ischemia and bone necrosis

presents with inflammation and edema

74
Q

where is osteomyelitis most likely to occur

A

mandible

75
Q

why does osteomyelitis occur

A

smokers

end stage of long wound healing

immunocompromised

76
Q

acute OM symptoms/signs

A

duration of less than 1 month
painful
minimal to no radiographic changes

77
Q

chronic OM symptoms/signs

A

greater than one month
dull discomfort
parasthesia
moth eaten appearance of bone

SX #2 (6 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions