W Ch 40 Flashcards
Strand of material used to control bleeding, stabilize wound edges in proper position, protect wound, and aid in pt comfort
Suture
Ideal suture has adequate _____ strength
This strength is the amount of strength the material will ___ _____ ____
Wound gains strength and suture loses strength
Tensile
Retain throughout healing
Functions of sutures (6)
Close periodontal wounds and secure grafts
Maintain hemostasis (end bleeding)
Reduce posttx discomfort
Promote primary intention healing
Prevent bone exposure
Protect wound from debris and trauma
Characteristics: (science class vs PE)
Biologic
Physical
Bio:
Sterile
Reabsorption
Minimal inflammatory reaction in tissue
Physical:
Tensile strength
Flexible
Plasticity (maintain shape)
Elasticity
Maneuver
Fluent through tissue w min trauma
Length and diameter
What material type?
Animal origin- catgut and silk
Vegetal origin- cotton and linen
Vs
Developed to reduce tissue reactions and unpredictable absorption
Natural
Synthetic
Natural absorbable: (absorbed in…)
Monofilamentous, derived from purified collagen of sheep/cattle and lasts about 8 days before degrading
Chromatic salts to delay enzyme resorption for 18 days
Plain gut
Chromic gut
Synthetic resorbable sutures: (hydrolysis breakdown)
All these types begin with prefix
Poly
(Water makes you P!… Poly)
If suture is non absorbable pt returns removal after
1 week
Non absorbable
Natural (1)
Synthetic (5)
Silk - can cause inflammation
-Nylon
-All the polys (polyester, polypropylene, polytetrafluoroethylene
-Coated sutures (antibacterial agents)
Number of strands :
-Typical of gut, nylon, PYFE and other synthetic sutures
-Typical of silk, nylon, polyglycolic, polyester, and other synthetics
Monofilament
Multifilament
Most suture types used for perio flaps and closure?
What is used for extraction socket, bone grafting, free gingival grafting?
What is preferred for implant flap closure? If swelling and pain anticipated?
Gut, absorbable
Absorbable
Non absorbable
Allows suture material and needle to act as one unit
Swayed end (eyeless)
What is weakest part of body of swaged needle?
Swaged end
Extends from tip to widest part of needle
Point
2 opposing cutting edges for difficult to penetrate tissue like skin
Sharpest
Reverse
3rd cutting edge on concave curve of needle
Conventional
Most frequently used knot in dentistry
Easiest and most reliable
Square knot
3 to 4 mm suture tail is left to assist in locating for removal
True or false
False 2-3mm tail
Each stitch brought over a loop of preceding one
Forms series of loops on one side of incisor and stitches over incision
Used after alveolectomy (removing alveolar bone)
Blanket (Continuous)
Stripes of interrupted sutures
One knot per incision
Interrupted
Series of stitches tied at one or both ends
Can include sling, suspension , and blanket sutures
Continuous uninterrupted
EnCIRCLES tooth for suspension and retention of a flap
Circumferential
Flaps are both the lingual and facial sides
Joined by passing suture through each interdental area
Coverage accomplished by coapting papillae (edges not touching)
Interdental
Flap is on one side facial or lingual and sutures pass through interdental papilla, around tooth, and into adjacent papilla
Suture adjusted two flap can be positioned for correct healing
Sling or Suspension
Suture removal. How long after surgery? No longer than? Why?
7 days after surgery
No longer than 14 days to prevent tissue infection
Who requires a consult with cardiologist?
Pts with valvular heart disease
Record! deviations in color, size, shape, adaption of flap or coaptation of healing
If a suture is placed without a dressing what should the cotton tip be dipped in to aid in debris removal?
0.12% chlorhexidine mouth rinse or 3% peroxide
Steps to suture removal
- Check notes, locate sutures
- Caution when removing dressing and tearing suture
- When exposed remove debris by irrigation by water or chlorhexidine on cotton tip
- Grasp end of suture above knot with pliers in non dominant hand and gently draw up, golf with slight tension (finger rest for control)
- Scissors in dominant hand and insert blade just under knot
- Gently pull suture out opposite of where it was cut7. Place on gauze
- Count total removed
9*irrigate with water or antiseptic10 post removal instructions written and verbal
11.obeserve tissue and note any adverse reactions or bleeding
Periodontal dressings are based on personal preference and judgment of clinician
True or false
True
Dressing needs to have a _____ surface to resist accumulation of biofilm
Should adhere to self, teeth, tissues
Smooth
Types of dressings (5)
Zinc oxide with Eugenol
Chemical cured
Visible light cured
Collagen dressing
Alternative material for periodontal dressing.
Ex- Kirkland periodontal pack
Advantages:
Firm and heavy-support for tissues and flap
Slow setting
Produced in quantity and stored (frozen) in work sized pieces
Disadvantages:
Shape unpleasant taste
Irritating, hypersensitive
Rough hard and brittle. Encourages Biolfim retention
Zinc Oxide with Eugenol Dressing
Ex- PerioCare- metal oxides and CoePak-zinc oxides (2 paste systems)
Advantages:
Pliable easy to place with light pressure
Resists biofilm and debris
Easy often comes off in 1 piece
Chemical Cured Dressing
Advantages:
Color is like gingiva compared to others, preferred for anteriors
Easy removal, often in 1 piece
Visible Light Cure Dressing
(VLC)
Same light cure for composites and sealants
Absorbable
Decreased inflammation and reduces discomfort
Special use in perio surgery (grand site on palate)
Bullet shape for deep biopsy sites
Can be placed on clean moist or bleeding wounds
Collagen Dressing
Anti inflammatory and antioxidant properties
Reduces edema
Topical application
Ex curcumin (turmeric) gel
Not the norm, seasoning used often in diff culture
Alternative Material for Periodontal Dressing
A well placed dressing locks _____ _____ and cannot be displaced
Mechanically
Interdentally
Epithelium begins to cover a wound in _____ days
Complete healing _____ days
5-6
7-14
If needed is dressing replaced in entirety or patched?
In entirety
Smooth instrument can be inserted under the border and gentle pressure applied. This instrument material can be?
Plastic
Pt can return to normal oral care after how many days?
With what and how often should they rinse their mouth?
3-4
0.12% chlorhexidine twice daily during healing period
Follow up visit should be rescheduled?
1-2 weeks
Can the pt take aspirin post surgery?
NO. anticoagulant
