Oral Surgery Flashcards by Gavin Kallabat

What should be done before a patient undergoes radiation therapy?

***BOARDS***

Questionable teeth should be extracted before radiation therapy.

note: this is to reduce the risk of osteoradionecrosis

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Review some of the indications for extractions:

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Patients undergoing head and neck radiation may benefit from ______ before (and after) extractions.

hyperbaric oxygen

Note: for the BOARD exam, pts who are at risk of osteoradionecrosis will benefit from hyperbaric oxygen

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Review the contraindications for Extractions:

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List the order of teeth that are most like to be impacted (to least likely)

***GAURENTEED BOARD Q***

Mandibular 3rds > Maxillary 3rds > Maxillary Canines

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What is the primary reason for impacted teeth?

Inadequate arch length

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List from most likely to least likely, congenitally missing teeth:

***BOARDS***

Third molars > Maxillary laterals > Mandibular 2nd molars

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List each of the following from most likely teeth to least likely teeth:

Impacted teeth
Congenitally missing teeth

***BOARDS***

Impacted teeth: Mandibular 3rds > Maxillary 3rds > Maxillary canines

Congenitally missing: 3rd molars > Maxillary laterals > Mandibular PMs

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Discuss the Nature of Overlying Tissue in regards to each of the following:

Soft tissue impaction = ? (Easiest or hardest to EXT)
Hard tissue impaction = ? (Easiest or hardest to EXT)

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Discuss the Winter’s Classification in regards to each of the following:

What teeth does the Winter’s Classification classify?
Based on position of ______ in relation to the _______.
Mesioangular = ?
Distoangular = ?
Which of the following is harder to EXT?
- A. Mesioangular
- B. Distoangular

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Discuss the Pell and Gregory Classification in regards to each of the following:

What teeth are looked at in this classification?
Class A-C = ?
Class I-III = ?
Which of the A-C classes are the most difficult to EXT?
Which of the I-III classes are the most difficult to EXT?

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Discuss Subperiosteal Abscess in regards to each of the following:

Possibe whenever a ______ is elevated for surgical extraction.
_______ to remove fractured tooth or bone spicules below the soft tissue.

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Discuss Oro-Antral Communication (OAC) in regards to each of the following:

What is it?
Most common with what teeth?
You can prevent with good _______ and avoid ________.
Tx?

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Discuss Alveolar Osteitis in regards to each of the following:

What is it?
What causes it?
Antibiotics?
Tx?

Note: you can use Eugenol as a dry socket paste

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Discuss Nerve Injury in regards to each of the following:

Most common with __________ and ______.
Tx?
Patients with numbness lasting more than ______ should be referred for microneurosurgical evaluation.

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Which of the following is most commonly displaced into the infratemporal fossa?

A. Maxillary 1st molar

B. Maxillary 2nd molar

C. Maxillary 3rd molars

D. Mandibular 2nd molars

E. Mandibular 3rd molars

***MOST COMMON BOARD Q***

C. Maxillary 3rd molars

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Which of the following is most commonly displaced into the Maxillary Sinus?

A. Mandibular 1st molar

B. Maxillary 2nd molar

C. Maxillary 3rd molars

D. Mandibular 2nd molars

E. Mandibular 3rd molars

***BOARDS***

B. Maxillary 2nd molar

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Which of the following is most commonly displaced into the Maxillary Sinus?

A. Maxillary 1st molar

B. Mandibular 1st molar

C. Maxillary 3rd molars

D. Mandibular 2nd molars

E. Mandibular 3rd molars

***BOARDS***

A. Maxillary 1st molar

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Which of the following is most commonly displaced into the Submandibular Space?

A. Mandibular 1st molar

B. Mandibular 2nd premolars

C. Mandibular 1st premolars

D. Mandibular 2nd molar

E. Mandibular 3rd molars

***BOARDS***

E. Mandibular 3rd molars

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Discuss Tooth Displacement in regards to EXT:

What teeth are most likely to get displaced into the maxillary sinus?
What teeth are most likely to get displaced into the infratemporal fossa?
What teeth are most likely to get displaced into the submandibular space?
What should you do if a tooth is lost into the oropharynx?

***WHOLE SLIDE - BOARDS***

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Discuss Bite Blocks in regards to each of the following:

What is it?
Used to keep patient’s mouth open which provides ________.
Stabilized the ______ which provides comfort for patients.

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Which of the following is a soft tissue Suction Tip?

A. Yankauer suction

B. Frazier suction

A. Yankauer suction

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Which of the following is a hard and soft tissue Suction Tip?

A. Yankauer suction

B. Frazier suction

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Discuss Towel Clips in regards to each of the following:

What does it do?
What does it look like?
Careful not to ______ patient.

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Which of the following is a heart shaped tissue retractor used to protect and retract the tongue? A. Austin retractor B. Minnesota retractor C. Weider retractor D. Seldin retractor

C. Weider retractor

Which of the following tissue retractors is used for small flaps? A. Austin retractor B. Minnesota retractor C. Weider retractor D. Seldin retractor

A. Austin retractor

Which of the following tissue retractors is used for elevating down to floor of mouth as in mandibular tori removal? A. Austin retractor B. Minnesota retractor C. Weider retractor D. Seldin retractor

D. Seldin retractor

Which of the following tissue retractors is used for cheeks and flaps? A. Austin retractor B. Minnesota retractor C. Weider retractor D. Seldin retractor

B. Minnesota retractor

Discuss each of the following Periosteal Elevators: * Woodson periosteal = ? * #9 Molt periosteal = ?

Which of the following elevators is used for removing a **broken root** w/ **wheel and axle** movements? A. #9 Molt periosteal B. Straight elevator (#301) C. Triangular elevator (Cryer) D. Pick elevator **\*\*\*BOARDS\*\*\***

C. Triangular elevator (Cryer) Straight elevator (#301) = Lever Triangular elevator (Cryer) = Wheel and Axle Pick elevator = Wedge

Which of the following elevators is used for removing retained or broken roots w/ **wedge** movements? A. #9 Molt periosteal B. Straight elevator (#301) C. Triangular elevator (Cryer) D. Pick elevator

D. Pick elevator Straight elevator (#301) = Lever Triangular elevator (Cryer) = Wheel and Axle Pick elevator = Wedge

Which of the following elevators is the most commonly used and is used as a **lever**? A. #9 Molt periosteal B. Straight elevator (#301) C. Triangular elevator (Cryer) D. Pick elevator

B. Straight elevator (#301) Straight elevator (#301) = Lever Triangular elevator (Cryer) = Wheel and Axle Pick elevator = Wedge

Which of the following Universal Forceps is used on the upper arch? A. #150 B. #151

A. #150 Hint: you start counting teeth on the upper arch... 150 comes before 151

Which of the following is forceps is used for **upper molars**? A. #151 B. #23 cowhorn C. #88R/L cowhorn D. #74 Ash E. #65

C. #88R/L cowhorn

Which of the following is forceps is used for **Lower molars**? ## Footnote A. #150 B. #23 cowhorn C. #88R/L cowhorn D. #74 Ash E. #65

B. #23 cowhorn

Which of the following is forceps is used for **Upper Roots**? ## Footnote A. #151 B. #23 cowhorn C. #88R/L cowhorn D. #74 Ash E. #65

E. #65

Which of the following is forceps is used for **Mandibular Premolars**? ## Footnote A. #150 B. #23 cowhorn C. #88R/L cowhorn D. #74 Ash E. #65

D. #74 Ash

Which of the following blades is the most common for intraoral surgery? A. #10 B. #11 C. #12 D. #15

D. #15

Which of the following blades is used as stab incisions for incision and drainage? ## Footnote A. #10 B. #11 C. #12 D. #15

B. #11

Which of the following blades is used for large skin incisions? ## Footnote A. #10 B. #11 C. #12 D. #15

A. #10

Which of the following blades is used for _Mucogingival surgery_ because the curved shape enhances ease of access to the sulcus? A. #10 B. #11 C. #12 D. #15

C. #12

Discuss **Irrigation** during EXT in regards to each of the following: * Use steady stream of sterile _____ or _____ during bone removal. * What does irrigation prevent? * Increases efficiency of \_\_\_\_\_\_.

Discuss **Curettes** in regards to each of the following: * ______ end for scraping away soft tissue * **Always ______ once you remove the tooth to get rid of soft tissue.**

Which of the following bone removers removes bone for _final smoothing_ with **pull strokes**? A. Rongeurs B. Bone file C. Osteotome D. Surgical handpiece

B. Bone file

What bur is used in a surgical handpiece?

Straight fissure burs (#701)

Which of the following bone removers is used to trim interradicular bone? A. Rongeurs B. Bone file C. Osteotome D. Surgical handpiece

A. Rongeurs

Which of the following bone removers is used to remove tori? A. Rongeurs B. Bone file C. Osteotome D. Surgical handpiece

C. Osteotome

(T/F) Use an air-driven surgical handpiece if a tooth needs to be sectioned for extraction.

False

Discuss **Hemostats** in regards to each of the following: * Designed for ______ = ? * Useful for \_\_\_\_\_ * Shape?

Discuss **Needle Holders** in regards to each of the following: * Shape of the beaks? * Face of needle holder been is \_\_\_\_\_\_\_\_, which allows for positive grasp of suture needle unlike hemostat

Discuss **Sutures** in regards to each fo the following: 1. What does a suture refer to? 2. **What is the primary purpose of sutures?** 3. **Suture should be placed from ______ to _______ tissue.** 4. **\_\_\_\_\_\_ is the easiest and most common technique. \*\*\*BOARDS\*\*\*** 5. **Silk has ______ property that allows bacteria to invade. \*\*\*BOARDS\*\*\***

Discuss Forceps in regards to each of the following: * Adson Tissue Forceps * Utility Forceps

Which of the following Forceps is NOT for handling soft tissue? A. Toothed Adson forceps B. Non-toothed Adson forceps C. Utility forceps D. All of the above

C. Utility forceps

Which of the following Forceps is used for fascia, mucosa, and pathological tissue for biopsy? A. Toothed Adson forceps B. Non-toothed Adson forceps C. Utility forceps D. All of the above

B. Non-toothed Adson forceps

Toothed Adson Tissue Forceps are used on all of the following EXCEPT: A. Periosteum B. Mucosa C. Muscle D. Aponeurosis

B. Mucosa

Which of the following forceps is used for picking up items from a tray or preparing packing material? A. Toothed Adson forceps B. Non-toothed Adson forceps C. Utility forceps D. All of the above

C. Utility forceps

Which of the following Scissors is used for cutting sutures? A. Dean scissors B. Mayo scissors

A. Dean scissors

Which of the following Scissors is used for cutting fascia and dissecting soft tissue? ## Footnote A. Dean scissors B. Mayo scissors

B. Mayo scissors

Review the preparation for extraction:

Discuss each of the following Extraction types: * Simple extraction: * Surgical extraction:

What are the 3 main steps in an extraction in the simplest way of explaining it?

1. Sever soft tissue attachment 2. Luxate tooth with elevator 3. Deliver tooth with forceps

Discuss the first step in dental Extractions in regards to each of the following: * **Loosen ____ and ______ attached to tooth.** * Confirms good \_\_\_\_\_\_. * Allows \_\_\_\_\_\_\_\_.

Discuss the _second_ step of tooth extractions in regards to each of the following: * Face of blade against \_\_\_\_\_\_\_\_. * Back of blade against \_\_\_\_\_\_\_\_. * Lever = ? * Causes ________ of bone and tearing fo PD:

Discuss the **3rd** step of tooth extraction in regards to each of the following: * _____ and ______ force * Tooth should be moved first, then removed * Outward (buccal/labial) = ? * Inward (lingual/palatal) = ? * Rotary = ? * Apical = ?

Discuss what is done after is tooth is removed in regards to each of the following: * Bend the bone back unless _____ or ______ are planned in the future. * What does the acronym **CSI** help us remember?

Discuss **Flap Design** in regards to 4each of the following: * ______ base to ensure adequate blood supply * Incision over \_\_\_\_\_\_, not over bony defects or eminences. * ______ corners. * Vertical releases at \_\_\_\_\_\_\_\_. * Avoid _____ structures. * Post-operative plaque control is the most important procedure after _____ surgery.

Discuss each of the following Types of **Mucoperiosteal Flaps**: * Envelope flap = how many vertical releases? * Three-Cornered flap = how many vertical releases? * Trapezoidal flap = how many vertical releases?

Which of the following flaps is used for **apicoectomy**? A. Semilunar incision B. Apically displaced flap C. Double Y incision D. Three-Cornered flap **\*\*\*BOARDS\*\*\***

A. Semilunar incision

Which of the following flaps is used for **palatal tori removal**? A. Semilunar incision B. Apically displaced flap C. Double Y incision D. Three-Cornered flap **\*\*\*BOARDS\*\*\***

C. Double Y incision

Which of the following flaps is **impossible in the maxillary palate**? **\*\*\*BOARDS\*\*\*** A. Semilunar incision B. Apically displaced flap C. Double Y incision D. Three-Cornered flap **\*\*\*BOARDS\*\*\***

B. Apically displaced flap

Review the factors predicting a difficult extraction:

What are the 3 Surgical Handpiece uses?

Discuss Removal of buccal bone in regards to surgical extractions:

Discuss removal of interradicular bone in regards to surgical extractions:

Discuss the sectioning of lower molars:

Discuss the sectioning an upper molar in regards to surgical extractions:

Discuss the removal of root tip in regards to surgical extraction:

What is an indication for implants?

All of the following are **contraindications** for **implants** EXCEPT: A. Immunocompromised patients B. History of head/neck radiation C. Bruxism D. 75 year old patients an older E. Adolescents F. Cleft palate **\*\*\*BOARDS\*\*\***

D. 75 year old patients an older

Review each of the following Implant Types: * Subperiosteal * Transosteal * Endosteal

What are the 4 components of implants?

Discuss the **Body** of implants in regards to each of the following: * Also called _____ or \_\_\_\_\_\_. * Usually \_\_\_\_\_\_ * **Sequentially enlarge the \_\_\_\_\_\_.** * reduces ____ generated * Helps to maintain axis with \_\_\_\_\_\_\_\_\_\_\_. * Usually inserted into \_\_\_\_\_\_\_.

Discuss each of the following Abutments in regards to Implants: * One-Piece abutment * Two-Piece abutment

Which of the following is better for **restricted restorative space**? A. Screw-retained implant crown B. Cement-retained implant crown

A. Screw-retained implant crown

What is a major issue associated with Cement-retained implant crowns? **\*\*\*BOARDS\*\*\***

**Cement may be trapped subgingivally and cause peri-implantitis**

Review One vs Two-Piece Implants:

Discuss the **antirotation component** of implants: * Prevents rotation of \_\_\_\_\_\_\_. * Provides ______ of abutment.

Discuss the different types of Integration of Implants: * Osseointegration = ? * Fibrousintegration = ?

**Osseointegration** of implants is known as which of the following? A. Primary stability B. Secondary stability

B. Secondary stability

Which of the following has the **lowest implant success** rate? A. Type I bone quality B. Type II bone quality C. Type III bone quality D. Type IV bone quality **\*\*\*BOARDS\*\*\***

D. Type IV bone quality

Which of the following has the **HIGHEST implant success** rate? A. Type I bone quality B. Type II bone quality C. Type III bone quality D. Type IV bone quality **\*\*\*BOARDS\*\*\*** **\*\*\*BOARDS\*\*\***

A. Type I bone quality

Which of the following is the type of bone quality found in the **posterior maxilla**? A. Type I bone quality B. Type II bone quality C. Type III bone quality D. Type IV bone quality **\*\*\*BOARDS\*\*\***

D. Type IV bone quality

Which of the following is the type of bone quality found in the **posterior mandible**? ## Footnote A. Type I bone quality B. Type II bone quality C. Type III bone quality D. Type IV bone quality

B. Type II bone quality

Which of the following is the type of bone quality found in the **anterior mandible**? A. Type I bone quality B. Type II bone quality C. Type III bone quality D. Type IV bone quality **\*\*\*BOARDS\*\*\***

A. Type I bone quality

Which of the following is the type of bone quality found in the **anterior maxilla**? A. Type I bone quality B. Type II bone quality C. Type III bone quality D. Type IV bone quality **\*\*\*BOARDS\*\*\***

C. Type III bone quality

Which of the following following has the **best** bone quality for the placement of implants? A. Anterior maxilla B. Posterior maxilla C. Anterior mandible D. Posterior mandible **\*\*\*BOARDS\*\*\***

C. Anterior mandible

Which of the following has the **worst** bone quality for implant placement? A. Anterior maxilla B. Posterior maxilla C. Anterior mandible D. Posterior mandible **\*\*\*BOARDS\*\*\***

B. Posterior maxilla

Discuss Bone Quality in regards to Implant success: * What is the trend I figured out in regards to bone quality and location in the oral cavity? * Type I = ? * Type II = ? * Type III = ? * Type IV = ? **\*\*\*BOARDS\*\*\***

**Best to worst = front of mandible to back and then front of maxilla to back** ## Footnote Note: bone quality gets worse as you go posterior

Which of the following is the minimum distance an implant can be placed to the **IAN**? A. 1mm B. 1.5mm C. 2mm D. 3mm E. 5mm **\*\*\*MOST VALUBLE INFO FOR BOARDS\*\*\***

C. 2mm

Which of the following is the minimum distance an implant can be placed to the **mental nerve**? A. 1mm B. 1.5mm C. 2mm D. 3mm E. 5mm **\*\*\*MOST VALUBLE INFO FOR BOARDS\*\*\***

E. 5mm

Which of the following is the minimum distance an implant can be placed to an **adjacent implant**? A. 1mm B. 1.5mm C. 2mm D. 3mm E. 5mm **\*\*\*MOST VALUBLE INFO FOR BOARDS\*\*\***

D. 3mm

Which of the following is the minimum distance an implant can be placed to an **adjacent natural tooth**? A. 1mm B. 1.5mm C. 2mm D. 3mm E. 5mm **\*\*\*MOST VALUBLE INFO FOR BOARDS\*\*\***

B. 1.5mm

Implant placement must be a minimum of **1mm** away from each of the following EXCEPT: A. Buccal plate B. Maxillary sinus C. Nasal cavity D. Lingual plate E. IAN **\*\*\*MOST VALUABLE INFO FOR BOARDS\*\*\***

E. IAN

Which of the following is associated with placement of a **healing abutment** on first appointment instead of a cover screw? A. One stage implant surgery B. Two stage implant surger

A. One stage implant surgery

Discuss **Socket Preservation** in regards to implant placement: * Used to maintain ______ and ______ of alveolar ridge after extraction. * **Need to have an _______ extraction.** * Irrigate extraction site thoroughly, remove granulation tissue, place graft material, cover with resorbable collagen membrane. * Primary closure is \_\_\_\_\_\_.

Discuss each of the following Stages in implant surgery: * One Stage: * Two Stage

Discuss Biological Width of implants in regards to each of the following: * Roughnened surface for bone, smooth surface for \_\_\_\_\_\_. * **Gingival fibers orient next to implant ____ with \_\_\_\_\_. \*\*\*BOARDS\*\*\***

Gingival fiber run ______ with the implant \_\_\_\_\_. **\*\*\*BOARDS\*\*\***

Discuss Surgical Stent in regards to implants: * What does LAD stand for?

What are the 4 main characteristics of implant success?

\_\_\_\_\_\_ degrees Celsius for 1 minute or 40 degrees Celcius for 7 minutes is enough to compromise Osseointegration. This can result in an implant failure. **\*\*\*BOARDS\*\*\***

47 degrees celcius for 1 minute

Discuss Implant Failure in regards to each of the following: * What type of bacteria is involved in implant failure? * **What temperature of heating the bone can cause implant failure? \*\*\*BOARDS\*\*\***

Discuss Mandibular Fractures in regards to each of the following: * **Best evaluated with what type of x-ray?** * **List from most frequent to least what parts of the mandible fracture.** * Greenstick = ? * Comminuted = ? * Simple = ? * Compound = ?

Which of the following is the correct order from most frequent to least in regards to mandibular fractures? A. Angle \> Condylar \> Symphysis B. Condylar \> Symphysis \> Angle C. Condylar \> Angle \> Symphysis D. Angle \> Symphysis \> Condylar

C. Condylar \> Angle \> Symphysis

Which of the following is best evaluated with a **CBCT**? A. Mandibular Fractures B. Midface Fractures

B. Midface Fractures

Which of the following is best evaluated with a **Panoramic** x-ray? A. Mandibular Fractures B. Midface Fractures

A. Mandibular Fractures

Discuss **Midface Fractures** in regards to each of the following: * **Best evaluated with a \_\_\_\_\_\_\_** * Le Fort I = ? * Le Fort II = ? * Le Fort III = ? * **Zygomaticomaxillary complex fractures = ?**

Which of the following Midface Fractures is associated with **pyramidal**? A. Le Fort I B. Le Fort II C. Le Fort III D. Zygomaticomaxillary complex fracture

B. Le Fort II

Which of the following Midface Fractures is associated with **bleeding under the conjunctiva** (eyes)? A. Le Fort I B. Le Fort II C. Le Fort III D. Zygomaticomaxillary complex fracture **\*\*\*BOARDS\*\*\***

D. Zygomaticomaxillary complex fracture

Which of the following Midface Fractures is **horizontal across maxilla**? A. Le Fort I B. Le Fort II C. Le Fort III D. Zygomaticomaxillary complex fracture

A. Le Fort I

Which of the following Midface Fractures is a **complete craniofacial disjunction**? A. Le Fort I B. Le Fort II C. Le Fort III D. Zygomaticomaxillary complex fracture

C. Le Fort III

(T/F) Mandible fractures are ideally treated with open reduction and external fixation. **\*\*\*BOARDS\*\*\***

False

(T/F) Mandible fractures are ideally treated with closed reduction and internal fixation. **\*\*\*BOARDS\*\*\***

False

(T/F) Mandible fractures are ideally treated with open reduction and internal fixation. **\*\*\*BOARDS\*\*\***

True **open** reduction and **internal** fixation (**ORIF**)

Discuss **trauma surgery** in regards to each of the following: * Reduction = ? * Open reduction = ? * Closed reduction = ? * Internal fixation = ? * Intermaxillary fixation (IMF) = ? * **Mandibular fractures are ideally treated with ______ reduction and ______ fixation. \*\*\*BOARDS\*\*\***

Discuss Skeletal Discrepancies in regards to each of the following: * Retrognathic mandible = skeletal class \_\_\_\_? * Prognathic mandible = skeletal class \_\_\_\_? * Apertognathic = ? * Vertical maxillary excess = ? * Horizontal transverse discrepancy = ? * Macrogenia = ? * Microgenia = ?

Which of the following is associated with **anterior open bite**? A. Retrognathic mandible B. Prognathic mandible C. Apertognathic D. Macrogenia E. Horizontal transverse discrepancy

C. Apertognathic

Which of the following is associated with a **class II skeletal**? A. Retrognathic mandible B. Prognathic mandible C. Apertognathic D. Macrogenia E. Horizontal transverse discrepancy

A. Retrognathic mandible

Which of the following is associated with a **class III skeletal**? A. Retrognathic mandible B. Prognathic mandible C. Apertognathic D. Macrogenia E. Horizontal transverse discrepancy

B. Prognathic mandible

Which of the following is associated with a **gummy smile**? A. Retrognathic mandible B. Vertical maxillary excess C. Apertognathic D. Macrogenia E. Horizontal transverse discrepancy

B. Vertical maxillary excess

Which of the following is associated with a **posterior crossbite**? A. Retrognathic mandible B. Vertical maxillary excess C. Apertognathic D. Macrogenia E. Horizontal transverse discrepancy

E. Horizontal transverse discrepancy

Which of the following is associated with an **extra large chin**? A. Retrognathic mandible B. Vertical maxillary excess C. Apertognathic D. Macrogenia E. Horizontal transverse discrepancy

D. Macrogenia

\_\_\_\_\_\_\_ are the main images used in treatment planning orthognathic surgery. **\*\*\*BOARDS\*\*\***

Lateral cephs

Which of the following is best evaluated with a **Lateral Ceph**? A. Mandibular fractures B. Midface fractures C. Orthognathic surgery

C. Orthognathic surgery **Mandibular fractures = Pano** **Mid face fractures = CBCT** **Orthognathic surgery = Lateral Ceph**

Discuss Orthognathic Surgery in regards to each of the following: * Orthognathic Surgery is used to correct severe \_\_\_\_\_\_\_\_\_\_\_\_. * **\_\_\_\_\_\_\_ are the main images used in tx planning these cases** * Acrylic splint used \_\_\_\_\_\_. * Le Fort I osteotomy = ? * BSSO = ? * Genioplasty = ?

Which of the following Orthognathic surgeries is done to move the **mandible**? A. Le Fort I Osteotomy B. BSSO C. Genioplasty

B. BSSO

Which of the following Orthognathic surgeries is done to move the maxilla? A. Le Fort I Osteotomy B. BSSO C. Genioplasty

A. Le Fort I Osteotomy

Which of the following Orthognathic surgeries is done to move the **chin**? A. Le Fort I Osteotomy B. BSSO C. Genioplasty

C. Genioplasty

Discuss **Le Fort I Osteotomy** in regards to each of the following: * Used for _____ maxilla or \_\_\_\_\_\_\_\_.

Discuss Bisagittal Split Osteotomy (BSSO) in regards to each of the following: * Used for ______ or _______ mandible * **\_\_\_\_\_\_\_ is the most common post-op complication.** * ________ position should be unaltered.

Discuss Distraction Osteogenesis (DO) in regards to each of the following: * What is it? * What is it used for? * First phase is \_\_\_\_ * Second phase is \_\_\_\_\_\_ * Third phase is \_\_\_\_\_\_

Which of the followin is a "**psychosocial**" influence of interaction between thalamus, cortex and lambic structures; **chronic** pain? A. Axis I B. Axis II

B. Axis II

Which of the following is a "**bio**" _nociceptive_ input from _somatic tissue_ and is characterized as **acute** pain? A. Axis I B. Axis II

A. Axis I

Which of the following is associated with a **limitation of flow of pain information**? A. Transduction B. Transmission C. Modulation D. Perception

C. Modulation

The human experience of pain is the sum total of these physiologic process and the psychological factors of higher thought and emotion: A. Transduction B. Transmission C. Modulation D. Perception

D. Perception

Which of the following is defined as pain information traveling from **PNS to CNS**? A. Transduction B. Transmission C. Modulation D. Perception

A. Transduction

Which of the following is defined as pain information traveling from **CNS to thalamus and higher cortical centers**? A. Transduction B. Transmission C. Modulation D. Perception

B. Transmission

Discuss the **Pain Pathway** in regards to each of the following: * **Transduction** = ? * **Transmission** = ? * **Modulation** = ? * **Perception** = ?

Discuss **Somatic Pain** in regards to each of the following: * Increased stimulus yields \_\_\_\_\_\_ * Musculoskeletal = ? * Visceral = ?

Discuss **Neuropathic Pain** in regards to each of the following: * What is Neuropathic pain? * What are examples of Neuropathic pain? **\*\*\*BOARDS\*\*\***

All of the following are examples of Neuropathic pain EXCEPT: A. Trigeminal neuralgia B. Pulpal pain C. Trauma D. Stroke

B. Pulpal pain

Which of the following pain pathways is **independent of stimulus intensity**? A. Somatic pain B. Neuropathic pain

B. Neuropathic pain Note: Somatic pain = increased stimulus yields increased pain

Discuss **Trigeminal Neuralgia** in regards to each of the following: * Aslo called ___ \_\_\_\_\_\_\_\_\_. * **Who does Trigeminal Neuralgia most commonly affect?** * Trigger point = ? * **What does this feel like for the patient?** * Refractory period? * Unilateral or bilateral pain? * **Tx?** **\*\*\*GAURENTEED BOARD Qs\*\*\***

Discuss Atypical Odontalgia (AO) in regards to each of the following: * **Secondary to ________ (removal of part of the neural pathway) as a result of endodontic therapy or extraction.** * _______ toothache. * example?

Discuss **Postherpetic Neuralgia (PHN)** in regards to each of the following: * **Potential sequels of _______ infection.** * What are the 3 symptoms associated with PHN? * Tx?

Discuss **Burning Mouth Syndrome** (**BMS**) in regards to each of the following: * **Who does this most commonly affect?** * Associated with \_\_\_\_\_\_\_\_, ______ and \_\_\_\_\_\_ * What type of symptoms to patients experience?

Who is most commonly affected by Trigeminal Neuralgia?

Post menopausal women

What **medication** is used to treat **Trigeminal Neuralgia**?

Cabamezepine (anticonvulsants)

Discuss Chronic Headache in regards to each of the following: * Also referred to as ________ pain. * **Migraine = ?** * Tension type = ? * Cluster = ? * Tx = ?

Which of the following is Facial pain of unknown cause/diagnosis pending? A. Somatic pain B. Neuropathic pain C. Psychogenic pain D. Atypical pain

D. Atypical pain

Define Psychogenic pain:

Trigeminal Neuralgia is an example of which of the following? A. Somatic pain B. Neuropathic pain C. Psychogenic pain D. Atypical pain

B. Neuropathic pain

Postherpetic Neuralgia is an example of which of the following? A. Somatic pain B. Neuropathic pain C. Psychogenic pain D. Atypical pain

B. Neuropathic pain

All of the following are examples of Neuropathic Pain EXCEPT: A. Postherpetic Neuralgia B. Atypical Odontalgia C. Trigeminal Neuralgia D. Chronic Headache E. Musculoskeletal pain

E. Musculoskeletal pain

**Burning Mouth Syndrome** is an example of which of the following? A. Somatic pain B. Neuropathic pain C. Psychogenic pain D. Atypical pain

B. Neuropathic pain

Discuss the TMJ Bony Anatomy in regards to each of the following: * What three things articulate with the TMJ?

Which of the following TMJ spaces is responsible for **rotational** movement? A. Lower joint space B. Upper joint space **\*\*\*BOARDS\*\*\***

A. Lower joint space

Which of the following TMJ spaces is responsible for **translational** movement? A. Lower joint space B. Upper joint space **\*\*\*BOARDS\*\*\***

B. Upper joint space

Which of the following muscles work to **open the mandible**? A. Lateral pterygoid B. Masseter C. Temporalis D. Medial pterygoid

A. Lateral pterygoid

What are the 4 ligaments associated with the TMJ?

Which of the following TMJ ligaments prevents **posterior displacement**? A. Capsular ligament B. Discal/collateral ligament C. Posterior ligament D. Lateral ligament

D. Lateral ligament

Which of the following TMJ ligaments prevents **anterior displacement**? ## Footnote A. Capsular ligament B. Discal/collateral ligament C. Posterior ligament D. Lateral ligament

C. Posterior ligament

Which of the following TMJ ligaments covers the TMJ? A. Capsular ligament B. Discal/collateral ligament C. Posterior ligament D. Lateral ligament

A. Capsular ligament

Which of the following TMJ ligaments attaches to the medial and lateral poles of the condyle? A. Capsular ligament B. Discal/collateral ligament C. Posterior ligament D. Lateral ligament

B. Discal/collateral ligament

What are the 4 arteries the supply blood to the TMJ? **\*\*\*BOARDS\*\*\***

**"MADS"**

Which of the following results in **clicking sounds**? A. Internal Derangement with reduction B. Internal Derangement without reduction

A. Internal Derangement with reduction

Which of the following results in **Lock** of the condyle resulting in a limited range of motion? A. Internal Derangement with reduction B. Internal Derangement without reduction

B. Internal Derangement without reduction

Which of the following opening patterns is characterized by: the jaw deviates toward one side then returns back to midline at maximum opening? A. Deflection B. Deviation

B. Deviation

Which of the following opening patterns is characterized by: the jaw deviates toward the side that is stuck at maximum openeing? A. Deflection B. Deviation

A. Deflection

Discuss each of the following opening patterns: * Deflection = ? * Deviation = ?

Discuss Recurrent Dislocation in regards to each of the following: * Mandibular condyle translates anterior to the articular eminence and requires \_\_\_\_\_\_. * Tx?

All of the following are true regarding **Ankylosis** EXCEPT: A. Union between condyle and skull B. Can be either bony or fibrous C. Pathology is the most common cause D. Surgery, radiation therapy and infection can cause ankylosis E. Severely restricted range of motion

C. Pathology is the most common cause

All of the following is true regarding **Bruxism** EXCEPT: A. Clenching and/or grinding teeth B. Diurnal and/ or nocturnal C. Usually caused or exacerbated by stress D. Reducing stress is the recommended treatment E. All of the above are true **\*\*\*BOARDS\*\*\***

D. Reducing stress is the recommended treatment

Discuss each of the following **Nonsurgical** therapies for TMJ problems: * Counseling = ? * Medical therapy = ? * Physical therapy = ? * Occlusion = ? * Athrocentesis = ?

\_\_\_\_\_\_ is the nerve most commonly damaged in TMJ surgery. **\*\*\*BOARDS\*\*\***

Facial nerve (CNVII)

Which of the following TMJ surgeries is associated with a vertical ramus osteotomy and NOT fixated in order to reposition the condyle and disc into a better position? A. Athroscopy B. Arthroplasty C. Disectomy D. Condylotomy E. Total joint replacement

D. Condylotomy

Which of the following TMJ surgeries is associated with two cannulas, and instrumentation within the superior joint space? A. Athroscopy B. Arthroplasty C. Disectomy D. Condylotomy E. Total joint replacement

A. Athroscopy

Which of the following TMJ surgeries is associated with disc repair or removal when it is severely damaged? A. Athroscopy B. Arthroplasty C. Disectomy D. Condylotomy E. Total joint replacement

C. Disectomy

Which of the following TMJ surgeries is associated with disc repositioning surgery, **for painful persistent clicking or closed lock**? A. Athroscopy B. Arthroplasty C. Disectomy D. Condylotomy E. Total joint replacement

B. Arthroplasty

Which of the following TMJ surgeries is indicated for severely pathological joints like in osteoarthritis or rheumatoid arthritis.? A. Athroscopy B. Arthroplasty C. Disectomy D. Condylotomy E. Total joint replacement

E. Total joint replacement

**Myofascial Pain Syndrome** is an example of which of the following? A. Somatic pain B. Neuropathic pain C. Psychogenic pain D. Atypical pain

A. Somatic pain

A patient has **crepitus** (clicking in the TMJ), **trigger points** of tenderness in the temporalis muscle, limited opening or **limited range of motion** and pain at rest. All of these are symptoms of \_\_\_\_\_\_\_\_\_. **\*\*\*BOARDS\*\*\***

Myofacial Pain Syndrome

All of the following are associated w/ **Myofascial Pain Syndrome** EXCEPT: A. Chronic muscular pain disorder B. Most common cause of masticatory pain (pain in temporalis, masseter, medial pterygoid etc) C. Trigger points of the muscles of facial expression D. Diffuse pain in Preauricular region E. Tx: physical therapy, stress management, splint therapy and medications **\*\*\*BOARDS\*\*\***

C. Trigger points of the muscles of facial expression

When is a biopsy indicated for a lesion? **\*\*\*HIGH YIELD BOARDS\*\*\***

After two weeks of observation of the lesion

Which of the following type of biopsy is indicated for a **small \< 1cm benign** lesion? A. Cytology/Brush biopsy B. Fine Needle Aspiration C. Incisional biopsy D. Excisional biopsy

D. Excisional biopsy

Which of the following type of biopsy is indicated for a **large \> 1cm malignant** lesion? A. Cytology/Brush biopsy B. Fine Needle Aspiration C. Incisional biopsy D. Excisional biopsy

C. Incisional biopsy

Which of the following is indicated for a lesion with presence of fluid, ascertaining type of fluid, or exploration of intraosseous lesions? A. Cytology/Brush biopsy B. Fine Needle Aspiration C. Incisional biopsy D. Excisional biopsy

B. Fine Needle Aspiration

Which of the following is indicated for the monitoring of large tissue area for dysplastic changes? A. Cytology/Brush biopsy B. Fine Needle Aspiration C. Incisional biopsy D. Excisional biopsy

A. Cytology/Brush biopsy

Review each of the following Biopsy Types: * Cytology biopsy * Fine Needle Aspiration * Incisional biopsy * Excisional biopsy

Which of the following Biopsy types is done for a lesion suspicious of **malignancy**? A. Cytology/Brush biopsy B. Fine Needle Aspiration C. Incisional biopsy D. Excisional biopsy

C. Incisional biopsy

A biopsy taken from a patient should be stored in \_\_\_\_\_\_. **\*\*\*BOARDS\*\*\***

What type of anesthesia is recommended for taking a biopsy?

Large white patch on buccal mucosa that wipes off with gauze presumed to be candidiasis. What type of biopsy is indicated? A. Cytology biopsy B. Fine Needle Aspiration C. Incisional D. Excisional

A. Cytology biopsy

Firm rough 2x3cm white lesion on lateral surface of tongue that does not wipe off with gauze. What type of biopsy is indicated? A. Cytology biopsy B. Fine Needle Aspiration C. Incisional biopsy D. Excisional biopsy

C. Incisional biopsy

Denture wearer presents with red swelling in buccal vestibule. Which of the following type of biopsy is indicated? A. Cytology biopsy B. Fine Needle Aspiration C. Incisional biopsy D. Excisional biopsy E. Relieve denture and see them again in 2 weeks

E. Relieve denture and see them again in 2 weeks

Discuss the surgical management of each of the following: * Cysts = ? * Tumors = ?

Removal of tissue by scraping or scooping refers to which of the following? A. Enucleation B. Marsupialization C. Curettage D. Resection

C. Curettage

Surgical removal of a mass without cutting into or rupturing it refers to which of the following? A. Enucleation B. Marsupialization C. Curettage D. Resection

A. Enucleation

Cut a slit into an abscess or cyst and suture the edges of the slit to keep it open so it can drain freely: A. Enucleation B. Marsupialization C. Curettage D. Resection

B. Marsupialization

Surgical removal of a cyst or tumor and normal tissue around it is referred to as which of the following? A. Enucleation B. Marsupialization C. Curettage D. Resection

D. Resection

What is the acryonym for medical emergencies in a dental office?

SPORT

All of the following are true regarding Syncope EXCEPT: A. Most common medical emergenciy in dental chair B. Orthostatic hypotension is the most common syncope caused by needle anxiety C. Trendelenburg position should be applied if the patient is not preganant D. Left lateral decubitus if the patient is pregnant E. All of the above are true

B. Orthostatic hypotension is the most common syncope caused by needle anxiety

Discuss **Syncope** in regards to each of the following: * **How common in dental chair?** * **Vasovagal syncope = ?** * **Trendelenburg = ?** * **Left lateral decubitus = ?** * **Orthostatic hypotension = ?**

Review Epinephrine overdose:

Discuss **Angina** in regards to each of the following: * Stable vs **unstable** * _____ without necrosis * **ONA** = ? * NTG = ?

Discuss **Myocardial Infarction (MI)** in regards to each of the following: * **Sudden occlusion of major coronary vessel, usually \_\_\_\_\_\_\_\_\_\_.** * Ischemia with \_\_\_\_\_ * **MONA** = ?

Compare and contrast each of the following: * Angina * Myocardial infarction

Discuss **Hypoglycemia**/Diabetes in regards to dental emergencies: * If patient is **conscious** = ? * If patient is **unconscious** = ?

Discuss **Hyperventilation** in regards to dental emergencies: * **Give oxygen?** * Seating position? * **What should you give the patient?**

Discuss **Asthma** in regards to dental emergencies: * Constriction and inflammation of the \_\_\_\_\_\_\_. * **Weezing. = ?** * **2 puffs from emergency inhaler = what medication is this?** * Avoid _____ and \_\_\_\_\_\_

Discuss **Airway obstruction** in regards to dental emergencies: * **Clear the \_\_\_\_\_\_** * **Check for \_\_\_\_\_** * **Tilt \_\_\_\_\_** * Protrude \_\_\_\_\_

Discuss Seizures/convulsions in regards to dental emergencies: * What should you do for a patient experiencing this in the dental chair? * Which of the followin is the most common type of seizure? * A. Grand mal seizure * B. Status epilepticus * **Grand mal seizure tx = ?** * **Status epilepticus tx = ?**

Discuss **Stroke** in regards to dental emergencies: * **TIA** = ? * **CVA** = ? * what should you do if a patient experiences a stroke in the dental chair? * **Caused by _________ \*\*\*BOARD\*\*\*** * How can you tell if a patient is having a stroke?

Discuss **Anaphylactic Shock** in regards to dental emergencies? * What does **AEIOU** stand for?

Discuss **Anticoagulation** in regards to each of the following: * Check blood tests below: * CBC = ? * Bleeding time = ? * PT = ? * **INR = ?** * **PTT = ?** * **What are the 4 G's?**

Oral Surgery Flashcards

(225 cards)