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3rd yr- CSB- Oral surgery > Tooth extractions in locals > Flashcards

Tooth extractions in locals Flashcards

1
Q

What is oral surgery

A

The diagnosis and management of pathology of the mouth and jaws that requires surgical intervention

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2
Q

List some indications for exodontia

A
  1. Caries
  2. Pulpal necrosis
  3. Periodontal disease
  4. Orthodontic treatment
  5. Infection
  6. Trauma
  7. Radiotherapy
  8. Pathology
  9. Dental anomalies
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3
Q

List soem contra indications for exodontia

A
  1. Suspicious lesions
  2. No diagnosis
  3. Acute inflammation
  4. Infection
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4
Q

What patient factors do we need to consider when looking at a patient who needs teeth extracted

A
  1. Age
  2. General health
  3. Anxiety
  4. BMI
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5
Q

Why do we need to consider age when thinking about extraction teeth

A

Increased age increases chances of complications
Neoplasia
Medical complexities more prevalent in elderly patients

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6
Q

List some drugs that may make us hesitant to carry out exodontia

A
  1. Anticoagulants
  2. Steroids
  3. Biphosphonates
  4. Immunosuppressants
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7
Q

What operator factors do we need to consider before carrying out an extraction

A
  1. Competence
  2. Experience
  3. Environment
  4. Assistance
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8
Q

What surgical factors do we need to consider before carrying out an extraction

A
  1. Access- does the mouth open sufficiently
  2. Imagining of the bone, tooth, surrounding structures and surgical anatomy
  3. Associated pathology
  4. Clinical picture of the tooth
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9
Q

During an extra oral assessment what do we need to look for

A
  1. Cervical lymphadenopathy
  2. Mouth opening
  3. TMJ
  4. Facial asymmetry
  5. Facial swelling
  6. VII and V nerves
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10
Q

During an intra oral assessment what do we need to look for

A
  1. Soft tissues (tongue, FOM, buccal mucosa etc)
  2. Hard tissues ‒ dentition
  3. Focus on area in question
  4. Special tests
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11
Q

When carrying out an exam what other factors may you find that may be a contra indication for exodontia

A
  1. Thick dense bone
  2. Short clinical crowns
  3. Signs of attrition
  4. Hyper cementosis
  5. Long divergent roots
  6. Extensive caries, root caries, large amalgom restorations
  7. Deciduous teeth in permanent dentition
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12
Q

List some red flags we might see on an X-ray

A

Loss of symmetry
Distorted anatomy
Bone erosion
Teeth floating in air

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13
Q

Name the 2 chemical structures that LA can have

A
  1. Esters

2. Amides

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14
Q

What are LA usually made up of

A

A drug and vasoconstrictor

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15
Q

What is the benefit of having a vasoconstrictor

A

Increased speed of onset
Extends duration
Increased depth of anaesthesia
Reduction of intra operative haemorrhage

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16
Q

Name a Sympathomimetic Amine

A

Adrenaline

17
Q

What does adrenaline do

A
  1. Increases rate and force of contraction of
  2. Increase sBP and C.O.
  3. Vasoconstrictor
18
Q

Name a Synthetic Polypeptide

A

Felypressin

19
Q

What does Felypressin do

A
  1. Vascualr smooth muscle contraction
  2. Coronary artery vasoconstriction
  3. Oxytocic effects on uterus
20
Q

Name the most common LA we use

A

2% Lidocaine with 1:80,000 Adrenaline

21
Q

What is the max dose of 2% Lidocaine with 1:80,000 Adrenaline we can give

A

Maximum dose 4.4mg per kg

22
Q

What is 2% Lidocaine with 1:80,000 Adrenaline made up of

A

44mg lidocaine

27.5 micrograms adrenaline

23
Q

Give example of another LA type we could use

A

4% article with 1:100,000 Adrenaline

24
Q

What is the max dose of4% article with 1:100,000 Adrenaline we can give

A

7mg per kg

25
Q

What is 4% article with 1:100,000 Adrenaline made up of

A

88mg articane

22 micrograms adrenaline

26
Q

Describe what happens in the first week as the tooth socket is healing

A
  1. White blood cells remove bacteria and break down debris
  2. Fibroplasia begins
  3. Ingrowth of fibroblasts and capillaries
  4. Epitheiulm migrates down socket wall
  5. Osteoclast accumulate along crestal bone
27
Q

Name the 4 phases of acute wound healing

A
  1. Hemostasis
  2. Inflammatory phase
  3. Proliferative phase
  4. Remodelling phase
28
Q

When extracting a tooth what structures do we need to be aware of

A
  1. Periodontal ligament
  2. Bone
  3. Socket expansion
29
Q

How do we carry out extraction

A
  1. Expansion of the alveolar socket
  2. Separation of attachment of periodontal ligament
  3. Controlled force
    Luxators, Elevators, Forceps
  4. Expand (fracture) alveolar socket
  5. Avoid damage to the adjacent structures / local anatomy
30
Q

What do we need to check after extracting a tooth

A
  1. Check apices
  2. Check socket
  3. Gain haemostasis
31
Q

What post operative instructions should we give to patients following an extraction

A
  1. Expect pain and severe throbbing could occur
  2. Bleeding is normal
  3. No exercise for 24 hours
  4. No smoking or vaping
  5. No alcohol
  6. No rinsing or mouth washing
  7. Use a warm salt water rinse 24 hours post op

3rd yr- CSB- Oral surgery (4 decks)

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