Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Final Flashcards > Oral Surgery > Flashcards

Oral Surgery Flashcards

(83 cards)

Start Studying
1
Q

A 25 year olf patient presents with an impacted lower wisdom tooth. Name a set of published guidelines for the removal of wisdom teeth.

A

SIGN

NICE

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What complications could arise in a patient requiring the extraction of an unerupted premolar if they wear a -/f and the mandibular denture bearing area is very resorbed and the patient has osteoarthritis?

A

Pain, swelling, bleeding, bruising, infection, dry socket (alveolar osteitis), mandibular fracture (atrophic mandible), MRONJ, immunosurpressed and elderly = increased infection risk, nerve damage

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

When working through a surgical sieve to reach a diagnosis, what does VITAMIN D stand for?

A

Vascular, Infective/Inflammatory, Traumatic, Autoimmune, Metabolic, Idiopathic, Neoplastic, Degenerative

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

List three reasons for the removal of impacted lower wisdom teeth

A

Pericoronitis

Caries

Systemic symptoms

Pathology

Periodontal disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is the incidence of i) temporary and ii) permanent loss of sensation following the removal of wisdom teeth?

A

i) 10% (anywhere from 5-30% accepted)
ii) less than 1%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

List four post op complications of removing wisdom teeth

A

Pain

Bruising

Swelling

Limited mouth opening/trismus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Other than pain, bruising and swelling, list 6 signs and symptoms of a body of madible fracture

A

* Bleeding

* Limitation of function

* Mobile teeth

* Lower lip numbness

* Occlusal derangement/step deformity

* Facial asymmetry

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What 2 radiographic views would you want to assess a mandibular fracture?

A

OPT and PA mandible

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What factors would cause a mandibular fracture to be displaced?

A

Pull of attached muscle (unfavourable)

Angulation of fracture line

Magnitude of force

Opposing occlusion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

List 3 management options for a mandibular fracture?

A

Do nothing

ORIF

IMF (inter maxillary fixation)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

How does a bite splint for TMD work?

A

Acts as a habit breaker to reduce parafunctional habits.

Reduces load on TMJ

Decreases abnormal activity

Stabilises occlusion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is artherocentesis and mechanism of action?

A

Sterile saline injected into TM joint space. Breaks fibrous adhesions and flushes away inflammatory exudate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Bleeding wont stop following an extraction. How do you manage this?

A

Take a quick history. Apply pressure. Give LA with vasocontrictor. Suture. Diathermy. If doesnt stop, refer to A&E

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What are some local risk factors for delayed onset of bleeding?

A

LA with vasoconstrictor wears off.

Loosening of sutures

Patient traumatises area with tongue, finger, food

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Name 2 congenital conditions that cause prolonged bleeding

A

Haemophilia A

Haemophilia B

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Name 2 aquired conditions that can cause prolonged bleeding?

A

Warfarin

Aspirin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

SIRS (systemic inflammatory response syndrome), 4 criteria with parameters

A

Temperature equal or greater than 38 degrees, or equal or lower than 36 degrees

Heart rate equal or more than 90 BPM

Respiratory rate equal or greater than 20 breaths per minute

WBC count equal or greater than 12,000 mL, or equal to or less than 4,000 mL. 10% immature nutrophils

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

How many criteria must be met to get a diagnosis of SIRS?

A

2 out of 4

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

List 4 things to take note of with a facial swelling

A

* Airway compromise

* Fever

* Malaise

* Duration

* Colour

* Size

* Location

*Palpation (firm/mobile)

* Pus

* Heat

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Why is written consent gained prior to sedation process?

A

Patient doesnt have capacity to consent during procedure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What drug is commonly used for IV sedation and what preparation would this drug be?

A

Midazolam 5mg/5ml IV

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What 3 vital signs would you monitor before, during and after sedation?

A

Oxygen saturation.

Heart rate

Respiratory rate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What drug is used to reverse the effect of midazalam?

A

Flumazenil

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Give 3 pieces of advice you would give to a patient following sedation?

A

No driving.

Avoid the internet

Dont sign any legal documents

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
What are the indications for inhalation sedation?
Conditions aggrevated by stress; epilepsy, hypertension, asthma, ischemic heart disease. Social; anxiety, gagging Dental; unpleasant or traumatic procedures
26
What are the advantages of inhalation sedation vs midazolam?
Quicker onset. Quicker recovery. Recovery time independent of dose. No needles. No amnesia. Nitrous oxide not metabolised so very safe. No chaperone required for adults. Less side effects
27
What are the contraindications of inhalation sedation?
Unable to nose breathe; mouth breather/poor cooperation, cold, tonsilitis. First trimester of pregnancy Severe COPD
28
List the safety features of the quantiflex machine.
\* Oxygen flush buttong. \* Reservoir bag. \* Scavenger system. \* Coloured cylinders (black o2, blue NO) \* Pin index so the gases cant be mixed \* Minimum O2 set at 30% \* NO stops if O2 stops O2 fail safe at 40 psi \* O2 monitor \* One way expiratory valve
29
When might a referral for GA be made?
When a patient is uncooperative. When a patient is anxious/phobic Complex or long procedures Multiple extractions Benefits must outweigh risks Procedure/dentist requires complete stillness MH contraindicates sedation
30
What are the 4 stages of anaesthesia?
1. Induction 2. Excitement 3 Surgical anaesthesia 4 Overdose
31
What needs to be included in a referral for GA?
Patient name, DOB, address and contact details. Medica history GMP details Justification for GA Radiographs Treatment plan GDP name and contact details
32
What is the definition of conscius sedation?
Use of drugs to depress the CNS to allow treatment. The patient must be able to maintain verbal contact, remain conscious, retain protective reflexes and is able to understand and respond to verbal commands Margin of safety is wide enough so that unintended loss of consciousness is unlikely
33
What is GABA?
Gamma-aminobutiyric acid
34
What is the function of GABA?
Inhibitory neurotransmitter in the CNS
35
What is the half life of midazolam?
90-150 minutes
36
What are the contraindications for IV sedation
Severe systemic disease. Severe special needs. Severe psychiatric problems COPD Pregnancy/breastfeeding Taking erythromycin. Uncooperative pt No chaperone Under 12 yo or elderly
37
Give 6 things you assess a patient for before IV sedation
ASA class Heart rate Blood pressure Weight MH any drugs? Cooperation level
38
What is the ASA classification?
1. Fit and well 2. Mild systemic disease 3. Severe systemic disease 4. Severe systemic disease with threat to life 5. Moribund 6 Braindead
39
What do you monitor in a sedated patietn?
Hb level -\> O2 saturation. Heart rate
40
Pt attends practice c/o pain on biting. o/e 9mm suppurating pocket with vertical body defect radiographically tooth 15. Give 3 differential diagnosis
Symptomatic periapical periodontitis Periodontal abscess Periapical abscess
41
Pt attends practice c/o pain on biting. o/e 9mm suppurating pocket with vertical body defect radiographically tooth 15. What special investigations would you carry out to help determine diagnosis?
Sensibility testing. EPT. TTP
42
Pt attends practice c/o pain on biting. o/e 9mm suppurating pocket with vertical body defect radiographically tooth 15. Explain one suitable initial treatment you would carry out
Draining of pus Removing the source of infection; RCT or extraction
43
What two local factors would you check for suitability for an implant?
Alveolar bone levels. Space available, need 7mm between two crowns
44
What two general factors woul dyou check for suitability for an implant?
If there are any medical contraindications such as bisphosphonates. Patients smoking status
45
As per SIGN guidelines, when are impacted 3rd molars not advisable to be removed?
8's predicted to erupt healthily. MH precludes extraction. Deeply impacted with no pathology. High risk of surgical complications Risk of madibular fracture
46
As per SIGN guidelines, when is it advisable to remove and impacted 3rd molar?
Pt is experiencing significant infection associated with unerupted 8. In patients with predisposing risk factors where occupation/lifestyle make accessing dental care difficult. Patients whose medical history carries more risk from retention than possible complications of removal ie radiotherapy, cardiac surgery. In patients who have agreed to a tooth transplant procedure, orthognathic surgery or other relevant local surgical procedure. When patient is having GA for removal of 8, consideration should be given to removing the others
47
What are some stong indications for the extraction of a lower 8?
Previous episodes of infection such as pericoronitis, cellulitis, abscess formation, or untreatable pulpal/periapical pathology Caries in the 8 with little chance of useful restoration Caries present in adjacent 7 that cannot be restored without removal of 8 Perio disease due to position of 8 Dentigerous cyst formation or other pathology External resorption of 8 or 7, where it appears to be caused by the 8
48
what are the principles of a flap design?
Wide based incision with own blood supply Cut in a continuous stroke Reflect flap down to bone Avoid interdental papilla Keep moist No sharp angles Margins on sound bone Do not crush tissues Do not close under tension Aim for healing by primary intention
49
What are some other indications for the extraction of a lower 8?
Autogenous transplantation into a 6 socket Cases of fracture in the mandible in the 8 region, or for a tooth involved in tumour resection UE 8 in atrophic mandile Prophylactic removal of PE 8, where specific medical conditions are present Acute exacerbation of symptoms such as operculitis while patient is on waiting list, extraction of upper 8 to relieve symptoms PE or UE 8 close to alveolar ridge when patient is having denture constructed or is close to a planned implant
50
What is assessed on a radiograph before removing an 8?
Type and orientation of impaction and access to the tooth - working distance Crown size and condition (caries, size, shape) Root number and morphology, presence of any apical hooks Alveolar bone level, including depth and the point of elevation and density Follicular width Perio status along with that of the adjacent tooth Relationship or proximity of upper 8s to maxillary sinus, lower 8s to IAC
51
Briefly describe the surgical removal of a lower 8
LA (+/- Inhalation/IV sedation/GA) Gain access - flaps/bone removal as necessary Tooth division as necessary Tooth removal Debridement Suture Achieve haemostasis Post op instructions and medication
52
What is the use of iodine in extractions?
Found in alvogyl, used in the management of dry sockets
53
Name 3 types of nerve damage
Neurapraxia Axonotmesis Neurotmesis
54
What are 5 presenting symptoms of an OAC?
Bubbling from tooth socket when patient breathes Bone at trifurcation of roots Direct vision Blunt probe Nose holding test Nasal voice
55
Describe the surgical closure of an OAC
Buccal advancement flap If smaller than 2mm, encourage bleeding of the socket and close with suture ABs Post op instructions Use of steam inhalation, avoid anything that forms pressure; sneeze/cough etiquitte
56
Give 4 signs indicating tooth proxiity to IAC
Defleciton of IAC Darkening of root crossing canal Deflection of root Narrowing of IAC
57
Pt has swelling around UE lower 8, facial swelling and is feeling unwell. 6 things from history and investigation to note before looking at region in mouth
Pain history Temperature Breathing rate Heart rate How long has swelling been present How quickly has it increased in size?
58
Pt has swelling around UE 8, facial swelling and feels unwell, what is your initial management?
LA Irrigate under operculum Incise and drain Can extract upper 8 if irritating operculum Extract lower 8
59
What two nerves are at risk of damage when ext lower 8s and what tissues do the supply
Lingual nerve - tongue IAN - chin and lip
60
What might a patient c/o if they have a sialolith?
Fluctuant swelling at meal times Pain Dry mouth Bad taste Thick saliva
61
What gland/duct is most commonly affected by sialolith and why?
Submandibular gland Duct has a tortuous and uphill path
62
If you suspect a sialolith, what investigations can be done?
Palpation of gland and duct Lower occlusal radiograph Sialography
63
How can a sialolith be managed?
Surgical removal - LA, secure gland and stone, make an incision and remove, suture, POIG Sialoendoscopic removal by basket retrieval Shockwave lithotripsy
64
What are the risk factors for an OAC?
Roots in antrum Maxillary molars Cyst Hypercementosis Large maxillary antrum Ankylosis Divergent roots
65
What is the juxta apical area?
A well circumscribed radiolucent area lateral to the root rather than the apex
66
What is warfarin and how does it work?
An anticoagulant A vitamin K agonist Inhibits clotting factors 2, 7, 9, 10
67
A patient is taking warfarin, do you manage the extraction differently?
Check INR no more than 48 hours before ext, ideally less than 24 esp if uncontrolled INR must be below 4. Check local guidelines Atraumatic technique Suture socket Can use oral tranexamic acid Ensure HA Emphasise post op instructions; verbal and written Review
68
Pt has swelling around unerupted lower 8, facial swelling and feeling slightly unwell. What 6 things from history and investigation should be noted before looking at the mouth?
Pain history Temperature Breathing rate Heart rate How long swelling has been present/how quickly it has increased in size
69
You are planning to extract a tooth from a patient on bisphosphonates. What are they and what conditions are they used for?
Reduce bony turnover by inhibiting osteoclast recruitment, function and formation. Used for osteoperosis, Pagets disease, osteogenesis imperfecta, malignant metastasis
70
How is MRONJ diagnosed?
Must be on bisphosphonates or similar ie anti angeogenesis drugs, RANKL inhibitors No history of head and neck radiotherapy Exposed bone for more than 8 weeks
71
Following a recent extraction, a patient attends with a dry socket. What is this?
Alveolar osteitis. Not an infection Exposed and inflammed lamina dura usually due to loss of clot following extraction
72
When should an extraction site have healed?
Within 2 to 3 weeks
73
Name four types of sutures and give examples
Monofilament resorbable - monocryl Polyfilament resorbable - Vicryl Monofilament non resorbable - Prolene Polyfilament non resorbable - Mersilk
74
What is osteomyelitis?
Bilateral infection of bone. Results in inlammation causing necrosis
75
What are the risk factors for osteomyelitis?
Immunocompromised patients Mandible more than maxilla Mandibular fracture
76
What is haemophillia A?
Clotting factor VIII deficiency
77
What is haemophillia B?
Clotting factor IX deficiency
78
What is Von Willebrand disease?
Affects Factor VIII
79
How is haem A/B and Von Willebrands managed\>
Factor replacement Desmopressin Tranexamic acid
80
What are the steps that should be followed when carrying out oral surgery
Gain consent Surgical pause/safety checklist Anaesthesia Access Bone removal as necessary Tooth division as necessary Debridement/wound management Suture Achieve haemostasis Post op instructions Post op medication Follow up
81
Identify this flap design
3 sided flap design
82
Identify this flap design
Envelope
83
What are the aims of suturing?
Reposition the tissues Cover bone Prevent wound breakdown Achieve hamostasis Encourage healing by primary intention

Final Flashcards (13 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions