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LAST ACTUAL FINAL > B9 cysts and shit > Flashcards

B9 cysts and shit Flashcards

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1
Q

basic surgical goals when managing b9 cysts

A

eradication of pathological condition

funcitonal rehab

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2
Q

what is imperative prior to definitive tx

A

histological diagnosis

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3
Q

PA cyst vs ameloblastoma…which would require more aggressive tx

A

tumor (ameloblastoma)

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4
Q

when should you plan reconstruction? what types of things should you plan for

A

plan while planning the excisions surgery

grafting, fixation, soft tissue, dental rehab, PATIENT PREPARATION

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5
Q

a true cyst….

A

contains an epithelial lining

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6
Q

types of inflammatory cyst (2)

A

periapical

residual

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7
Q

types of developmental cysts (5)

A 
dentigerous
OKC
lateral periodontal
glandular odontogenic cyst
calcifying odontogenic cyst
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8
Q

4 strategies for managing cysts

A
  1. enucleation
  2. enucleation and curettage
  3. marsupialization
  4. staged marsupialization and enucleation
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9
Q

what is the decompression technique

A

staged marsup/enucleation

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10
Q

what is the treatment of choice for cystic lesions

A

enucleation

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11
Q

define enucleation

A

remove entire cystic lesions without rupture

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12
Q

what allows a cleavage plane between lesion and bony cavity during enucleation

A

fibrous connective tissue

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13
Q

indication for enucleation

A

any cyst that can be removed in entirety and safely without harming adjacent structures

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14
Q

how would you treat a dentigerous or PA cyst

A

enucleation

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15
Q

advantages of enuc

A

history examination of entire cystic wall

initial biopsy/treatment is curative in certain situations

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16
Q

disadvantages of enuc

A

possible pathologic fracture

devitalization of teeth

injury to nerve

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17
Q

enuc technique

A

access

aspirate

use largest curette

visualize bony cavity for soft tissue remnants

smooth bony margins/obtain water tight primary closure

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18
Q

what type of curette/how should you use curette for enuc

A

largest curette that defect will allow

cleavage plane
concave surface toward bone

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19
Q

post op for enuc

A

modify diet/activity

OHI

panorex every 6 mos

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20
Q

how long will it take for bony fill after enuc, will this bone recontour over time?

A

6-12 mos

yes it will recontour

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21
Q

E&C steps

A

enucleate cyst

remove 1-2 mm of bone with burs on entire periphery of cavity

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22
Q

is outcome better with mechanical (burs) or curette during e&c

A

you can use curette aggressively, but burs are more effective

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23
Q

e&c indications

A

aggressive cyst with high recurrence (OKC)

secondary surgery after recurrence when 1st surgery (enucleation) was deemed curative

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24
Q

advantage of e&c

A

gets rid of all epithelial remnants, decreasing chance of recurrence

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25
disadvantage of e&C
damage to neurovascular bundle dental pulps stripped
26
define marsupialization
open a cystic lesion and maintain latency to an adjacent cavity decreases intracystic pressure (cyst shrinks, bone fills)
27
what are examples of spaces that you can leave patency to during marsup
oral cavity, max sinus, nasal cavity
28
is marsup a final treatment
not usually, normally have to enucleate later
29
marsup indications
adjacent vital structures at risk with enuc difficult surgical access to all portions of cyst (increasing recurrence) medical compromise
30
marsup advantages
simple to perform spare vital structuers either completely resolves lesion or makes it much smaller and easier to treat
31
marsup disadvantages
can't histo examine the entire cystic wall (stuff you leave behind might be more aggressive) patient inconvenience with home care occasional secondary infections
32
marsup technique
aspirate 1 cm elliptical incision in soft tissue create bony window piece of cystic lining removed and submitted for path cystic contents evacuated keep window into cyst patent
33
marsup: thick cystic lining?
to keep window open, suture to oral mucosa
34
marsup: thin, friable cystic lining?
to keep window open, pack cavity for 10-14 days to prevent oral mucosa from healing over
35
post op for marsup
pt responsible for irrigating cystic cavity cavity might get infection routine follow up with radiographs
36
how long do you leave cavity open during marsup
until goals for choosing marsup have been met
37
why do you marsup before enucleation in some cases
allow time for bony coverage of vital structures increases strength of jaw
38
indications for decompression
concern for injury to adjacent strucrures size of lesion marsup alone does not resolve need to examine entire lesion histopatholgically
39
advantages of decompression
thickened cyst lining reduces morbidity, accelerates complete healing (all the other same as marsup alone)
40
disadvantages of decompression
same as marsup
41
periodical cyst tx
remove underlying process (RCT or ext) enucleate +/- curettage abx if needed
42
residual cyst tx
e&c
43
dentigerous cyst tx
ext of affected tooth e&c if larger, consider decompression
44
OKC tx
e&c with potential extraction if large, consider decompression
45
lateral periodontal cyst tx
enucleation with preservation of tooth
46
glandular odontogenic cyst tx
e&c some advocate resection
47
calcifying odontogenic cyst (gorlins) tx
e&c
48
epithelial jaw tumors (4)
ameloblastoma adenomatoid odontogenic tumor calcifying epithelial odontogenic (pindborg) squamous odontogenic tumor
49
mixed jaw tumors (3)
ameloblastic fibroma ameloblstic fibroma-odontoma odontoma
50
ectomesenchymal jaw tumors (3)
odontogenic fibroma odontogenic myxoma cementoblastoma
51
which has poorer prognosis: tumor in mx or mn
maxilla due to undetected growth
52
t/f: tumors within bone have a better prognosis
true
53
indications for E&C jaw tumors
slow growing, non aggressive tumors most odontogenic tumors medically compromised
54
types of tumors tx with E&C
odontoma ameloblstic fibroma/fibro-odontoma AOT cementoblastoma odontogenic fibroma
55
indications for resection for tx of jaw tumors
aggressive lesions either by histopath/clinical behavior tumors that would be difficult to remove in entirety/by e&c alone
56
types of jaw tumors indicated for resection
ameloblastoma myxoma CEOT squamous odontogenic tumor
57
resection technique
lesion is removed with a 1 cm margin of uninvolved tissue
58
marginal resection
maintains continuity at inferior border
59
segmental resection
full thickness portion removed
60
total resection
remove entire jaw

LAST ACTUAL FINAL (2 decks)

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