Oral Surgery & Orthodontics

Question 1

What soft tissue oral surgeries may orthodontics ask oral surgery to perform?

Answer 1

• frenectomy
• expose impacted canines
• expose impacted premolar exposures

Question 2

How can impacted canines be exposed?

Answer 2

• buccal apically repositioned flap
• palatal open exposure

Question 3

What hard tissue oral surgeries may orthodontics ask oral surgery to perform?

Answer 3

• extraction of impacted canines
• exposure of impacted canines with bone removal
• XLA of premolars
• exposure of impacted premolars with bone removal
• submerged retained primary teeth
• implants
• mini-implants
• orthognathic surgery

Question 4

What treatment options are there for patients presenting with impacted canines?

Answer 4

• leave alone & monitor
• extract the canine (unlikely)
• surgical exposure & orthodontic alignment (mini-implants & corticotomy)
• transplant

Question 5

What are some indications for canine transplant?

Answer 5

• we cannot reasonably get a result by exposure & traction
• there is a potential for damage to other teeth
• space is available or can be made available without premolar extraction
• the older pt who is seeking a quick solution

Question 6

What is the problem with tooth transplant procedures?

Answer 6

Damage to PDL
- leads to ankylosis after transplantation

Question 7

What dental treatment option provides the qualities of an ideal orthodontic anchor?

Answer 7

Implant

Question 8

Why are implants an ideal orthodontic anchor?

Answer 8

• absolute anchorage as there is not periodontal ligament
• easilt used under a variety of treatment modalities
• easily placed
• removable if necessary

Question 9

What can occur after having palatal flap raising surgery to extract impacted canines?

Answer 9

Nasopalatine nerve bundle affected
- numbness of gingiva of anterior maxillary teeth

Question 10

If a canine transplant is carried out, what must the patient use afterwards?

Answer 10

Splint (titanium trauma splint)
- 2 weeks
- then RCT

Question 11

What tends to happen after teeth are transplanted?

Answer 11

Ankylosis (no matter how careful you are)

Question 12

Why do oral surgeons avoid luxating impacted teeth?

Answer 12

causes ankylosis

Question 13

What is a ‘kissing canine’ ?

Answer 13

when a canine tooth is impacted and reach across arch to reach other canine

Question 14

Why should relieving incisions be broad based?

Answer 14

Increased blood supply to flap

Question 15

What is an open exposure?

Answer 15

cut a hole & leave it open (commonly done palatally)

Question 16

What is a closed exposure for impacted canine?

Answer 16

• raise large flap
• remove surrounding bone
• gold chain attached to tooth
• flap returned & sutured, but chain remains outside flap & stitch the chain out the way

Question 17

Why are frenectomies carried out nowadays?

Answer 17

• aesthetic concerns
• hygiene concerns (hard to clean)

Question 18

Give an example of a type of frenoplasty?

Answer 18

V to Y frenoplasty

Question 19

What are mini-implants made of & why?

Answer 19

Stainless steel
- does not fuse to bone

Question 20

What are normal implants made of & why?

Answer 20

Titanium
- fuses to bone

Question 21

what is a corticotomy?

Answer 21

make surrounding cortical bone weaker (drill holes into bone) to facilitate tooth movement