Third Molars 4 Flashcards

1
Q

what are the basic principles of surgical removal

A

risk assessment
aseptic technique
minimal trauma to hard and soft tissues

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2
Q

what are the steps of a surgical procedure

A

anaesthesia
access
bone removal
tooth division
debridement
suture
haemostasis
post op instructions

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3
Q

what type of flap is raised in a surgical

A

buccal mucoperiosteal flap

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4
Q

where do you relieve the flap from

A

base of relieving incision

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5
Q

how do you reflect a flap

A

reflect with periosteal elevator firmly on bone

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6
Q

what instruments are useful in flap reflection

A

mitchells trimmer
howarths periosteal elevator
ash periosteal elevator
curved warwick james

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7
Q

what does retraction allow

A

access to operative field
protection of soft tissues

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8
Q

what instruments are used for retraction

A

howarths periosteal elevator
rake retractor
minnesota retractor

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9
Q

how do you retract

A

rest retractor firmly on bone
be aware of adjacent structures

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10
Q

what is used to remove bone

A

electric straight handpiece with saline cooled bur
round or fissure tungsten carbide burs

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11
Q

where is bone removal done

A

buccal aspect of tooth and distal aspect of impaction

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12
Q

how do you remove bone

A

create a deep narrow gutter around the crown

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13
Q

why would you remove bone

A

to allow correct application of elevators on mesial and distal aspects of the tooth

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14
Q

what is a horizontal crown section

A

section the crown off of the roots horizontally above the ACJ

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15
Q

when you are doing a coronectomy where do you section the tooth

A

below the ACJ

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16
Q

what is a vertical section

A

section the roots and elevate separately

17
Q

what are the 3 steps of debridement

A

physical
irrigation
suction

18
Q

what is used to physically debride

A

bone file
mitchells trimmer
victoria curette

19
Q

how do you irrigate

A

sterile saline into socket and flap

20
Q

how do you suture

A

approximate tissues
compress blood vessels

21
Q

what are the aims of suturing

A

prevent wound breakdown
achieve haemostasis

22
Q

when would you do a coronectomy

A

as an alternative to surgical removal when there is a risk of IAN damage

23
Q

what is the process of a coronectomy

A

flap design
transection of tooth
elevation of crown
potential further reduction of roots
irrigate socket
replace flap
follow up

24
Q

what must you warn the patient with a coronectomy

A

if root is mobilised during crown removal the entire tooth must be removed
leaving roots can result in infection
can get slow healing/painful socket
roots can migrate and begin to erupt

25
Q

how do you remove an upper third molar

A

elevation only
or elevation and then forceps
support the tuberosity

26
Q

what instrument is used to extract an upper 8

A

straight or curved warwick james