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Module 8 > Oral Surgery > Flashcards

Oral Surgery Flashcards

1
Q

What is the definition of a cyst?

A

a pathological cavity with fluid or semi-fluid contents, which has not been created by the accumulation of pus

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2
Q

Name 12 signs and symptoms of cysts

A
  1. asymptomatic
  2. boney expansion
  3. fluctuant swelling
  4. missing teeth
  5. carious, discoloured, fractured teeth
  6. tilted/displaced teeth
  7. discharge/sinus
  8. loose teeth
  9. mental hypoaethesia
  10. hollow percussion note
  11. pain and swelling if secondarily infected
  12. pathological fracture
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3
Q

what investigations can be used for cysts?

A
  1. vitality test
  2. radiology
  3. aspiration of cyst contents
  4. biopsy
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4
Q

what are the management aims for cyts?

A

eradicate pathology
minimise surgical damage
restore function quickly

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5
Q

what are the treatment options for cysts?

A

marsupialisation
enucleation
marsupialisation & enucleation
enucleation and curettage/excision
en bloc resection-jaw continuity maintained
partial resection-continuity lost

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6
Q

how do you decide between enucleation and marsupialisation?

A

depends upon:
type
size
site
medical status

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7
Q

what can be done alongside enucleation if teeth are to be preserved?

A

peri-radicular surgery

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8
Q

what is enucleation?

A

complete removal of the cyst lining

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9
Q

when would enucleation be contraindicated?

A

large cysts
involving a number of vital teeth
in difficult anatomical site
involving potentially useful unerupted tooth

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10
Q

why is elimination of dead space important?

A

reduce reactionary haemorrhage
reduce post-op infection

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11
Q

how can dead space be eliminated?

A

drain placement - sucks out stuff
saucerisation? - collapse walls of cavity
pack with pts own bone (autograft) or allograft or xenograft
layered soft tissue close (suture muscle etc into area)
secondary intention (packing with sedative dressing but needs visits to change it - uncomfortable)

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12
Q

what are the advantages of enucleation?

A

complete removal for histology
cavity heals without complications

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13
Q

what are the disadvantages of enucleation?

A

infection
incomplete removal of lining
damages to adjacent teeth or antrum
weakening of bone

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14
Q

what is marsupialisation?

A

creation of a window in the cyst lining, suturing the flap to the remaining lining to allow shrinkage of the lesion which may become self cleansing or by subsequently removed

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15
Q

when would you choose marsupialisation over enucleation?

A

large cyst involving healthy useful teeth
older frail ppl
when tooth can erupt through - incisors and canines

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16
Q

what kind of healing in marsupialisation?

A

secondary - granularion tissue `

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17
Q

what are the advantages of marsupialisaton?

A

avoids pathological fracture
tx for medically compromised pts -avoids GA
avoids damage to adjacent structures
allows potentially useful teeth to erupt

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18
Q

what are the disadvantages of marsupialisation?

A

orifice closes and cyst reforms
repeat visits
manual dexterity and compliance
complete lining not available for hisotology

19
Q

what is a radicular cyst

A

inflammatory in origin associated with a non-vital tooth

20
Q

what % of dental cysts are radicular

A

60

21
Q

what are the 2 collateral cysts

A

paradental
mandibular buccal bifurcation cyst

22
Q

what is the incidence of dentigerous cyst

A

10-15%

23
Q

what is the incidence of keratocyst

A

5-10%

24
Q

what is the incidence of paradental cyst

A

3-5%

25
Q

what is the incidence of gingival/lateral periodontal cyst

A

<1%

26
Q

what is the incidence of nasopalatine cyst

A

5-10%

27
Q

what is the treatment for radicular/lateral/residual cysts

A

enucleation with either extraction of associated tooth or apicectomy following endodontic treatment

28
Q

what are the developmental cysts

A

dentigerous
eruption
odontogenic keratocyst
lateral periodontal
gingival

29
Q

how do u tell if its lateral periodontal/gingival rather than radicular

A

theyre associated with vital teeth

30
Q

what is the tx for dentigrous csyts

A

enucleation with removal of associated teeth (wisdom teeth)
marsupialisation if unerupted tooth is potetially functional and can be alligned othodonticaly (maxillary canines)

31
Q

what is keratocyst treatment?

A

enucleation, paying particular attention to ensure removal of intact lining to reduce recurrence + tooth removal

32
Q

why is enucleation of keratocysts hard

A

thin lining and finger like projections

33
Q

why do keratocysts often recur

A

daughter cells

34
Q

what is gorlin syndrome

A

multiple basal cell carcinomas of the skin

35
Q

what is commonly found in gorlin sydrome?

A

odontogenic keratocysts - 75%

36
Q

what is a staphne’s idiopathic bone cyst

A

developmental anomaly
ectopic salivary tissue in concavity in the medial aspect of the mandible

37
Q

what is the tx for staphne’s idioapthic bone cyst

A

no active tx required

38
Q

name 2 bone cysts

A

aneurysmal bone cyst
solitary (haemorrhagic) bone cyst

39
Q

what is the histopathology of aneurysmal bone cysts

A

mass of blood-filled spaces with scattered giant cells

40
Q

how does a solitary bone cyst looks

A

large radiolucency arching up between roots of teeth

41
Q

what is the radiographic appearance of ameloblastomas?

A

uni or multilocular, defined or diffuse edges, usually displaced adjacent structures

42
Q

what does ameloblastoma arise from

A

remnants of dental lamina

43
Q

what are the 3 subtypes of ameloblastoma epithelium

A

luminal
intraluminal
mural

44
Q

what types of ameloblastoma can be treated constervatively

A

luminal and intraluminal

Module 8 (7 decks)

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