XLA Flashcards
Why is smoking an issue regarding extraction?
Reduced blood flow to the healing socket -
- causes problems with post-op healing
- higher risk of alveolar osteitis
What is alveolar osteitis?
dry socket - local inflammation of alveolus due to increased finbrinolysis and loss of blood clot.
5 predisposing factors to a pt developing alveolar osteitis:
- traumatic extraction
- female (4x more likely)
- smoker
- increased age
- immunosuppressions
Symptoms of alveolar osteitis:
- 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
How is alveolar osteitis treated?
irrigation and dress with alvogyl
What are the 3 components making up alvogyl?
- butamen (anaesthesia)
- iodoform (antimicrobial)
- eugenol (analgesic)
When can alvogyl NOT be used?
if the pt has an allergy to idodine/seafood.
How long is the average canine root?
17mm
What type of forceps are used to extract wisdom teeth?
bayonets
(think, you’re going to war to get those bastards out)
Which teeth have the primary movement of rotation?
- upper 1s
- lower second premolars (5s)
Why is the primary movement of the majority of teeth buccal-palatal?
- oval roots don’t rotate
- expands the socket so the tooth can be rotated as a secondary movement
Which teeth have oval roots?
All except upper 1s and lower 5s
Name the 3 types of sutures:
- resorbable vs non-resorbable
- natural vs synthetic materials
- brained vs monofilament
4 types of suturing techniques:
- interrupted
- horizontal mattress
- vertical mattress
- continuous
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
DVT 2 years ago
What is the minimum safe level for platelet count when removing a tooth?
50,000 cells / mm3
How do bisphosphonates reduce bone healing?
- reduce osteoclast activity
- reduce bone nibbling (dead bone not removed)
- reduced blood flow into the bone
What does not increase the risk of alveolar osteitis?
(think normal RF)
alcohol intake
What would be the maximum XLA socket healing time before you suspect MRONJ?
8 weeks
MRONJ risk for pts taking bisphosphinates for less than 5 years OR taking denosumab.
low risk
MRONJ risk for:
- pt taking bisphosphinates for more than 5 years
- IV bisphosphinates
- denosumab with systemic glucocorticoid
high risk
What is dehiscence?
A separation of the wound incision.
What medication can be given before tx for an anxious pt?
- it’s not IVS.
5mg diazepam
(think planes)
If an OPT shows close proximity to the ID canal, what oral surgical technique can be undertaken on the 3rd molar?
coronectomy
(after this, the roots will be removed when they have migrated mesially)
An operculectomy is rarely done because it grows back and can cause damage to which nerve?
lingual nerve
Which lymph nodes does pericoronitis drain to?
submandibular
