disjbaiofg midterm Flashcards
(29 cards)
Radiographic Markers on Pano
Horizontal inclination is the most dangerous
what is Microneurosurgery ?
o Can help repair damaged nerves (from trauma or iatrogenic
injury)
o Ideally performed 6-12 months following trauma
o >12 months cant really help them
timeline of Microneurosurgery?
o If nerve shows no signs of improving - refer to specialist
within early stages (~3 mo)
o If no sharp sensation at 3 weeks – start worrying
Microneurosurgery procedures?
o Use sharp 15 blade to cut nerve in half and approximate back
together
o Use cadaver nerves
o Fair success rates if between 3-6 months (the earlier the
better)
Nerve Injury Classifications
1) Sunderland Grade (1-5)
2) Seddon Grade (Neurapraxia, Axonotmesis, Neurotmesis)
3) Tissue Damage (Myelin, Axon, Endoneurieum, Perineurium,
Epineurium)
Sunderland Grade (1-5)
1 = better 5= worst
Seddon Grade (Neurapraxia, Axonotmesis, Neurotmesis)
Neurapraxia = better Nerotmesis = worst
Tissue Damage (Myelin, Axon, Endoneurieum, Perineurium, Epineurium)
If through all layers = No recovery
Dry Socket AKA
fibrinolytic alveolitis or alveolitis sicca dolorosa
Dry Socket definition
o Increases in severity between day 1 and 3
o Accompanied by partial or total disintegration of the clot
o Can be with or without halitosis
o Looks like exposed bone (or a bony head?)
Dry Socket Etiology
o Trauma, esp to the bone (crushed with elevators, not cooled)**
o Bacteria – systemic not as efficacious
o Smoking
o Fibrinolytic diathesis (birth control, high estrogen, genetics)
o PDL injections?
Dry Socket Incidence
o More common in females esp if on birth control with high estrogen
o 3-4% following routine extractions
o 45% on mandibular 3rds
Dry Socket Prevention
o Antiseptic rinse – pre-op
o Atraumatic surgery – keep bone cool and don’t crush
o Intra-socket Ab – tetracycline, clindamycin
o Operate during low estrogen phase?
o No smoking
o Don’t operate during acute infection
o Copious irrigation
Dry Socket Longevity
Usually gets better within about 7-10 days
Dry Socket Treatment
o Systemic Ab NOT indicated
o Saline irrigation of socket (have pt do the same 2x daily for 7 days)
- Diluted CHX, gently brush area
o Analgesics + NSAIDS + narcotics
- NSAIDS are best
- Be careful when prescribing narcotics
o Packing, eugenol with radiopaque strip
- Topical analgesic that numbs exposed bone
- Will delay healing
MX 3rd Molar Treasure Hunt
May slip into the infratemporal fossa; Send to the hospital
Long Standing 3rd Molar in Function = RED FLAG
1) Bone is harder and more dense
2) Inflammation may cause condensing osteitis
3) Upon extraction may fracture MX tuberosity
Third Molar Extraction
- Take out when 1/3 to 7/8 root formation
- Epithelium hides on the distal of the 3rd molar, need to remove
- Important to remove follicle – contains pluripotent stem cells
Primary intention wound healing
Minimal scar and Wound sutured without complications
secondary intention wound healing
Infection, ischemia, tension or tissue loss and Generates excess scar tissue
Wound Healing
Proper surgical technique promotes primary intention healing
**applies to bone and soft tissue (scaring can occur between bone and implant upon heat formation = all bad)
Primary Bone Healing
- Minimal fibrous callus formation
- Achieved by using bone plates or compression screws
- Allows short duration of MXMD fixation (wiring jaw shut)
- Critical to success of dental implants
sutures
• All are foreign bodies, remove as soon as possible (5-7 days in
mouth)
• Resorbable sutures produce some inflammation, therefore some
scarring
o Some resorb really quickly and the wound may open up faster
• Goal: obtain hemostasis and promore primary healing
Suture Types Know adv and disadv of each
• Monofilament, Resorbable • Monofilament, Nonresorbable o Esthetics bc wont cause scarring • Braided, Resorbable o + Last longer, stronger o - Can cause inflammation, hurts, can be a source of infection • Braided, Non-Resorbable o Strength
