XLA

Question 1

Why is smoking an issue regarding extraction?

Answer 1

Reduced blood flow to the healing socket -
- causes problems with post-op healing
- higher risk of alveolar osteitis

Question 2

What is alveolar osteitis?

Answer 2

dry socket - local inflammation of alveolus due to increased finbrinolysis and loss of blood clot.

Question 3

5 predisposing factors to a pt developing alveolar osteitis:

Answer 3

1. traumatic extraction
2. female (4x more likely)
3. smoker
4. increased age
5. immunosuppressions

Question 4

Symptoms of alveolar osteitis:

Answer 4

• dull pain 3 days post XLA
• bad taste / smell
• poorly responsive to analgesia
• localised to the XLA site
• food debris / absent clot in the site

Question 5

How is alveolar osteitis treated?

Answer 5

irrigation and dress with alvogyl

Question 6

What are the 3 components making up alvogyl?

Answer 6

1. butamen (anaesthesia)
2. iodoform (antimicrobial)
3. eugenol (analgesic)

Question 7

When can alvogyl NOT be used?

Answer 7

if the pt has an allergy to idodine/seafood.

Question 8

How long is the average canine root?

Answer 8

17mm

Question 9

What type of forceps are used to extract wisdom teeth?

Answer 9

bayonets
(think, you’re going to war to get those bastards out)

Question 10

Which teeth have the primary movement of rotation?

Answer 10

1. upper 1s
2. lower second premolars (5s)

Question 11

Why is the primary movement of the majority of teeth buccal-palatal?

Answer 11

• oval roots don’t rotate
• expands the socket so the tooth can be rotated as a secondary movement

Question 12

Which teeth have oval roots?

Answer 12

All except upper 1s and lower 5s

Question 13

Name the 3 types of sutures:

Answer 13

1. resorbable vs non-resorbable
2. natural vs synthetic materials
3. brained vs monofilament

Question 14

4 types of suturing techniques:

Answer 14

1. interrupted
2. horizontal mattress
3. vertical mattress
4. continuous

Question 15

Which of the following conditions does NOT pose a bleeding risk?
- atrial fibrillation
- previous coronary artery bypass
- pulmonary embolism 6 months ago
- prosthetic heart valve
- deep vain thrombosis 2 years ago

Answer 15

DVT 2 years ago

Question 16

What is the minimum safe level for platelet count when removing a tooth?

Answer 16

50,000 cells / mm3

Question 17

How do bisphosphonates reduce bone healing?

Answer 17

• reduce osteoclast activity
• reduce bone nibbling (dead bone not removed)
• reduced blood flow into the bone

Question 18

What does not increase the risk of alveolar osteitis?
(think normal RF)

Answer 18

alcohol intake

Question 19

What would be the maximum XLA socket healing time before you suspect MRONJ?

Answer 19

8 weeks

Question 20

MRONJ risk for pts taking bisphosphinates for less than 5 years OR taking denosumab.

Answer 20

low risk

Question 21

MRONJ risk for:
- pt taking bisphosphinates for more than 5 years
- IV bisphosphinates
- denosumab with systemic glucocorticoid

Answer 21

high risk

Question 22

What is dehiscence?

Answer 22

A separation of the wound incision.

Question 23

What medication can be given before tx for an anxious pt?
- it’s not IVS.

Answer 23

5mg diazepam
(think planes)

Question 24

If an OPT shows close proximity to the ID canal, what oral surgical technique can be undertaken on the 3rd molar?

Answer 24

coronectomy
(after this, the roots will be removed when they have migrated mesially)

Question 25

An operculectomy is rarely done because it grows back and can cause damage to which nerve?

Answer 25

lingual nerve

Question 26

Which lymph nodes does pericoronitis drain to?

Answer 26

submandibular