oral surgery Flashcards
questions to ask if potentially cancerous lesion
any unintentional weightloss
any swallowing difficulties
any fluid or bleeding from it
how long has it been there
has it changed over time
any other similar lesions
name 3 soft tissue lesions associated with HPV
veruccous vulgaris
condyloma acuminatum
squamous cell papilloma
LA for a biopsy
either 3-4 sites around a lesion
OR
lift lesion and insert needle at angle to bas
haemostasis in palate
electrocautery
pressure with damp gauze
suture in surgicel
(sutures alone wont aid haemostasis due to tight tissue)
what is surgicel
cellulose based meshwork that aids clot formation
resorbable so doesnt need removed
what are the aims of peri radicular surgery
achieve apical seal
remove existing infection (excision of apex, curettage)
indications for peri radicular surgery
- obstruction to instrumentation
- root filler error e.g over/under filled
-poor host response - apical cyst
how much apex is removed in peri radicular surgery
around 3mm
what is peri radicular surgery
term that encompasses entire process of removing apex of tooth, root filling, and process etc
process of peri radicular surgery
- mucoperiosteal flap (semi, lunar, relieving
- bone removal and creation of a window
- apicectomy (3mm)
- retrograde root filling
- closure
materials for retrograde root filling
MTA
causes of peri radicular surgery failure
inadequate apical seal
inadequate support (too much apex removed, perio)
poor healing
3 characteristic features of keratocyst epithelial lining
- palisading basal cells
- parakeratinised stratified squamous epithelium
- no rete ridges
3 characteristic features of keratocyst aspirate
- contains epithelial cells
- white or creamy semi solid
- low soluble protein content (less than 4g/dl)
features of gorlin goltz syndrome
multiple odontogenic keratocysts
multiple basal cell carcinomas
skin pigmentation
skeletal abnormalities
