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Pedo 1 > Oral Surgery > Flashcards

Oral Surgery Flashcards

1
Q

True or false.. you use the same instruments to extract primary teeth as you do to extract permanent teeth

A

False.

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2
Q

What are some differences between primary and permanent teeth?

A

Smaller teeth

Crowns are more bulbous

Root furcations are more cervical

Roots are thinner and flare more

Roots of primary teeth naturally resorb

The alveolus is much more elastic

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3
Q

What are the differences in the types of forceps you use to extract primary teeth in comparison to permanent teeth?

A

Beaks and handles are smaller to accommodate a more bulbous crown

Beaks are more curved in forceps

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4
Q

What do you have to do to compensate for the wide splaying of primary molar roots?

A

More expansion of the socket

Strong apical pressure!

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5
Q

What are some modifications to extraction technique that you use in children?

A

Don’t plunge deeply with beaks around primary molars because the bifurcation is very cervical (dont want to hit underlying tooth)

Avoid blind investigation of primary socket (avoid hitting underlying tooth)

Because of physiological resorption it is often preferable to leave small fragments in situ if root fractures

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6
Q

Why dont you typically section primary teeth for extraction?

A

Don’t want to risk hitting the permanent tooth. You’re not going to cause problems if you leave some tooth behind. The primary root tips behind wil either be resorbed or erupted.

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7
Q

True or false.. you should NEVER leave a primary root tip behind

A

False. It is preferable to leave the tips in to avoid damage to underlying tooth

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8
Q

What are the indication for extraction of deciduous teeth?

A

Badly carious teeth

Preventing eruption of permanent teeth

Periapical infection

For Orthodontics purposes

Supernumerary teeth

Vertical fracture

Ankylosed primary teeth

Impacted teeth

Ectopically positioned teeth

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9
Q

Why cant you extract a tooth of a 17 yo if they come in alone?

A

Any one under the age of 18 is considered a minor and requires parental consent before procedure

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10
Q

What are the five steps to extract a pediactric tooth?

A

Parental consent before the procedure

Instruct the parent not to discuss with the child what the dentist will do

Armamentarium should be kept out of site of child

Before giving the LA, explain to the child sensation of pinching or an ant biting feeling

Extraction with controlled force in a deliberate fashion

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11
Q

What is the most common tooth extraction?

A

Third molars

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12
Q

True or false… the younger you are the higher the risks of extracting third molars

A

False.. the older you get the higher the risks are

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13
Q

True or false… ALL third molars need to be removed.

A

False

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14
Q

True or false.. third molars must be removed for orthodontic purposes.

A

Maybe maybe not. The literature isn’t consistent

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15
Q

Why is the extraction of third molars the most common surgical procedure in dentistry?

A

Limit progression of periodontal disease (perio pathology initiates in the 3rd molar region. Perio disease associated with systemic disase)

Absence of symptoms does not indicate absence of diseases or pathology

Dental crowding

Removal prior to 25 minimizes risk

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16
Q

True or false.. abscess of symptoms does not indicate absence of diseases or pathology

A

True

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17
Q

What is the most reliable thing to examine when determining if the third molar is ready to be extracted, age or root development?

A

Root development

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18
Q

What are the 2 main risks when extracting third molars?

A

Sinus perforation

Damage to IA

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19
Q

What are some possible complications of third molar extraction?

A

Lingual nerve injury

IAN injury (temporary or permanent (typically from not performing the surgery correctly)

Damage to adjacent teeth

Alveolar osteitis (dry socket)

Subperiosteal injection

Mandibular fracture

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20
Q

What are the 5 treatment options for impacted canine?

A

Observation

Extraction

Surgical exposure and assisted eruption

Surgical uprighting

Auto-transplantation

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21
Q

What is the third most commonly impacted tooth after maxillary and mandibular 3rds?

A

Maxillary canine

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22
Q

What is the ideal age to extract maxillary impacted canines?

A

11

18 or older is high risk

23
Q

Name 7 factors to consider when determining whether or not to extract an impacted maxillary canine.

A

Age

Past medical hx

Potential pathology

Location to adjacent teeth

Angulation

Risk of surgery

24
Q

Surgical exposure of an impacted maxillary canine requires coordination between ___ and ___. There needs to be ___. And the orthodontic appliances are placed __ to exposure.

A

Surgeon and orthodontist

Adequate space

Prior

25
Q

What is a risk when the impacted canines are angled?

A

It can burn the roots out of adjacent teeth when you pull the canine down.

If the pt is over 12 surgical assisted eruption is NOT recommended. Better to extract them

26
Q

75% of the time, maxillary canine teeth are impacted towards the ___

A

Palate

Not labial

27
Q

Canines are impacted labially __% of the time. In this case, it is critical to….

A

15%

Critical to maintain the cervical margin of attached mucosa on the erupted impacted tooth

28
Q

What are the treatment options of a labially impacted canine?

A

Apical positioned flap

Closed technique

29
Q

What is the apical flap? How is it used in treating a labially impacted canine?

A

Attach gingiva to CEJ, then pulll the tooth down.

30
Q

What is the most frequently occurring odontogenic tumor in pediatric pts?

A

Odontoma

31
Q

What is the average age of finding someone with an odontoma?

A

Second decade of life (teenagers)

32
Q

What are the clinical features of an odontoma?

A

Interfere with eruption of permanent teeth

Begin to develop as normal dentition start to develop and cease when the teeth develop ends

There is no sex predilection

33
Q

True or false… odontomas must be removed

A

True

34
Q

What is the difference between compound and complex odontomas?

A

Compound: represents tooth like structures

Complex: look solid-like. In posterior mandibles. Irregularly shaped masses

35
Q

Odontomas are treated by ___. Prognosis is ___. They [often/do not] recur.

A

Enucleation and curettage

Excellent

Do not recur

36
Q

How can you tell if a bone cyst is empty by a radiograph?

A

You can’t tell if it empty by radiograph, CT, or MRI. You must open it up surgically

37
Q

What is a traumatic bone cyst?

A

Empty intrabony cavity that lacks an epithelial lining

The designation of pseudocyst relates to the cystic radiograph appearance and gross surgical presentation of this lesion is seen mostly in the mandible

38
Q

What causes traumatic bone cysts?

A

Pathogenesis is not known. In some cases seem to be associated with antecedent trauma

Hypothesized that a traumatically induced hematoma forms within the intramedullary portion of bone, rather than organizing, the clot breaks down, leaving an empty bone cavity.

39
Q

___ are mostly affected by traumatic bone cysts.. the most common site of occurrence is the ___. Swelling is occasionally seen with pain [frequently/infrequently] noted.

A

Teenagers

Mandible

Infrequently

40
Q

What is the differential when you see something that looks like a traumatic bone cyst?

A

Traumatic bone cyst

Aneurysmal bone cyst

OKC

Giant cell granuloma (expansion/root resorption)

41
Q

What does a traumatic bone cyst look like radiographically?

A

Well-delineated area of radiolucency

Area with scalloping borders between the roots of teeth

42
Q

What is the first thing you do when you see a radiolucency of a mandible?

A

Do a needle aspiration to see if its filled with blood

43
Q

What is the treatment of a traumatic bone cyst?

A

They do not go away on their own

Curettage (scrape bone until it bleeds a lot). Then close it up.

44
Q

If you find a mucocele that is not on the lower lip, what must you do?

A

Biopsy. It could be mucoepidermoid carcinoma

45
Q

75% of cases of mucoceles are found where?

A

Lower lip

46
Q

If you see a pediactric pts has a head and neck infection, you need to obtain a detailed history of the present illness, including what 6 things?

A

Onset

Rate or progression

Hx of odontogenic pain

airway compromise

Trismus

Ophthalmic complaints

47
Q

If you are examining a pediactric pt with an odontogenic infection what is the first thing you examine?

A

Airway

48
Q

What is the order in the things you examine in a pedo pt with a head and neck infection?

A

Airway

Swelling severity

Palpation of tissues

Maximal mouth opening

Examination of dentition

49
Q

What is the plan of intervention of a pedo head and neck infection in order? (4 things)

A

Urgent airway intervention

Outpatient vs. inpatient

Antibiotics

Surgical intervention

50
Q

What are the warning signs you should look for when evaluating a pedo pt with a head and neck infection?

A

Temp >101.5 F

Elevated WBC

Lymphadenopathy

Poor oral intake

Dehydration

General appearance** (if they look lethargic you should get them into an inpatient setting quickly)

51
Q

Where is the most common location for a mandibular fracture in pedo pts?

A

Subcondylar fracture

52
Q

What are four questions you should ask when obtaining the history of a mandibular fracture?

A

Where does it hurt and what makes it hurt?

Can you open your mouth?

Do you have any loose teeth?

Do your lips feel different? (Numbness is often the first sign of a fracture in the mandible)

53
Q

What you do when you suspect a mandibular fracture?

A

Take a panorex

CBCT

If there is a mandibular fracture.. refer to OMS!!!**

54
Q

Why do condyles tend to rotate medially in a subcondylar fracture?

A

Lateral pterygoid muscle

Pedo 1 (14 decks)

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