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Flashcards in ghiesiytgfv midterm Deck (22)
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1

Orally Admined Bisphosphonates

o Actonel
o Boniva
o Didronel
o Fosamax
o Skelid

<3 years IV agent – probably OK

2

IV Admin Bisphosphonates – more potent/problematic

o Aredia**
o Bonefos
o Zometa**

<3 months IV agent – probably OK

3

Risk Factors for BRON

CC PADAS
-chemo
-corticosteroids
-Poor OH
-alcohol
-diabetes
-age
-smoking

4

Prolia (denosumab)

rank L inhibitor

5

Agents other than Warfarin
o Pradaxa –
o Xarelto –
o Eloquis –
o Leeches –

o Pradaxa – direct thrombin inhibitor
o Xarelto – factor Xa inhibitor (treat DVT, pump embolism)
o Eloquis – for atrial fib
o Leeches – have naturally occurring direct thrombin inhibitors
in their saliva

6

Hypertension

Diazepam vs. Catopril (ACE-I)
o Systolic BP dropped 30 mmHg, and diastolic 25 mmHg
o Can be used to lower BP for nervous patients and allow Tx

7

10 OS Risks

1) Nerve damage (IAN, lingual, mental, palatine, incisive) ----Even worse = diasthesia = pain not numbness
2) Vessel damage (IA, lingual, palatine, incisive, facial)
3) Damage to teeth/restorations
4) Bleeding, swelling, infection
5) TMJ damage (often when sedated therefore use bite block!)
6) MX sinus issues
7) Alveolar osteitis (dry socket)
8) Fracture of alveolus or MD
9) Soft tissue trauma
10) Osteonecrosis

8

Pre-Op Summary

• 1. Treatment modifications employed
• 2. Stress diagnosed and treated (Sedation)
• 3. Consent signed and witnessed
• 4. Vitals taken
• 5. Antiseptic rinse
• 6. Proper imaging

9

Surgical Extraction Elective vs Non-Elective

Elective
o Remove bone and section roots
o Prevent damage to sinus, adjacent teeth, alveolus
o No excessive force

Non-Elective
o Crown gone due to caries
o Endo
o Tooth prep
o Trauma
o Fracture during extraction

10

Lose about ____ of BONE by just elevating and re-approximating the flap

0.5-1mm

11

Do NOT Flap When

• Bony cyst or void is present
• BV or N will be damaged
• Caution with: smokers due to ischemia and decreased vascularity

12

MX Forceps

o Ant = 1, 99-C
o PM = 150-A, 150
o 1st and 2nd molars = 90, 88L, 53L
o 3rd molar = 210-S

13

MN Forceps

o Ant = 203, 74
o PM= 151-A, 151
o 1st molar = 17, 23
o 2nd and 3rd molar = 222

14

Apical Retention Forceps

o Sharpened beak
o Parallel gouge
o Atraumatic
o Tapered profile
o Serrated

15

order to remove bone

1) Interradicular
2) Interdental
3) Lingual
4) Labial (VERY VALUABLE, TRY TO REMOVE LEAST AMT)

16

Root Tip Removal Options

• Thin elevator
• Endo file #30
• Drill at apex
• Drill to oblivion if ankylosed

17

Class 1

o Proven efficacy and effectiveness
o Supported by 1 or more randomized controlled trials
o Results of trials are consistently excellent
o Intervention is safe and recommended

18

Class 2A

o Multiple studies with good results
o Considered intervention of choice by majority of dentists
o Acceptable and useful

19

Class 2B

o Fewer studies generally, but not always positive
o Considered optional or alternative treatment by most experts
o Acceptable and useful but within a standard of care

20

Class 3

o Positive evidence absent or studies suggest harm
o Intervention may be worse than doing nothing at all
o Unacceptable, no benefit

21

Class Indeterminate

o Promising but few studies
o Contradictory results
o No harm, but benefit uncertain
o “More research needed”

22

Graft Materials

1) Autogenous
o Fresh and warm
2) Allogenic
o Other humans
3) Xenogenic
o Other species ex. bovine/cow
4) Alloplastic
o Bioglass, Ca-Sulfate, Methacrylates, Calcium Phosphate
5) Biologics
o Bone Morphogenic Protein , Protein Rich Fibrin
6) Combinations