Oral Surgery II - Kalamchi's Child Flashcards Preview

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Flashcards in Oral Surgery II - Kalamchi's Child Deck (101):
1

What are the most commonly impacted teeth?

Followed by the...

*Mx and Mn for each

Mx and Mn 3rd molars

Mx canines, Mn premolars

2

T/F
It is necessary to remove all impacted teeth

False

3

The angulation of the Long Axis of the impacted 3rd molar is relative to what?

*clinical classification

2nd molar

4

The relationship of the impacted 3rd Molar to the __________ describes the Procedural Classifications

Occlusal Plane

*depth

5

5 types of impaction (of 3rd molar in relation to long axis of the 2nd molar)

Vertical

Horizontal

Mesio-angular

Disto-angular

Inverted/Ectopic

6

What is the most common type of 3rd Molar Impaction?

Mesio-angular

7

What is the 1st Radiographic choice for wisdom teeth diagnosis and removal absent associated pathology?

Panoramics

8

T/F
The ideal age to remove wisdom teeth is 16-18 y/o, when root is around 1/3 developed

True

9

Recurrent Pericornitis (swelling of gingival tissue around 3rd molar) is indication for what?

Wisdom teeth removal

10

3 Contraindications for the removal of Impacted Teeth:

Extremes of Age

Compromised Medical Health

Adjacent Structures imperiled

11

The infection of the soft tissue surrounding the crown of partially impacted tooth caused by normal oral flora

Pericornitis

12

When is it recommended to Surgically deal with Acute Pericoronitis?

If Abscessed

13

Bilateral, submandibular, sublilngual, submental space Abscess that must be treated aggressively:

What is important to consider with these cases?

Ludwig's Angina (Mn Space Abscesses)

Airway compromise

14

Admit pt to hospital/observe airway

IV antibiotic

Analgesic

IV steroid

Incision/Drainage

What disease am I?

Ludwig's Angina

15

Flap Design - Base _____ that free margin.

Suture _____ mm away from bony defect

broader

6-8 mm

16

T/F
Flaps can be cut Bucally or Lingually

False

*never Lingual!

17

After removal of Wisdom Teeth, what 4 effects are normal?

Pain

Swelling

Bleeding

Trismus

18

Swelling peaks ___ hrs after removal of wisdom teeth

48 hrs

19

Infection, prolonged numbness, iatrogenic injury, fractured mandible, oral antral fistula are all Uncommon complications of wisdom teeth removal

True

20

4 indications for removal of wisdom teeth:

Overcrowding

Caries

Associated pathology

Recurrent pericoronitic (acute/chronic)

21

In Fracture Management bone must be Closed to ___mm , otherwise will not heal

1 mm

22

3 types of Crown Fracture:

Ellis Class I - confined to enamel

Ellis Class II - enamel and dentin

Ellis Class III - enamel/dentin/pulp exposed

23

What type of Root Fracture has the best prognosis?

Tx is reduction and splint for ___ months

Apical 1/3

3

24

Tooth Concussion:

Tooth Subluxation:

hemorrhage/edema into PDL

PDL ruptured, tooth not displaced

25

Concussion/Suluxation Tx:

soft foods, maybe relieve occlusion

26

Extrusion, only ____ tissues retain tooth

Lateral Luxation, what is injured?

gingival

some apical fibers

27

Tx for Extrusion/Lateral Luxation:

Reduce/Splint 3-4 weeks

28

Intrusion extensively injures the PDL and ____ tissues

Tx for immature teeth:

Tx for Mature teeth:

pulpal

spontaneous re-eruption

ortho extrusion (2-3 weeks)

29

What's happened to the tooth with Avulsion?

Tx?

tooth out

Reimplant/Splint 7-10 days

30

Alveolar Fracture:

Tx:

alveolar, PDL, pulpal injuries, often multiple teeth

Reduce/Splint 4-6 weeks

31

How long to immobilize Mobile Tooth:

Displaced:

Root Fracture:

Replanted tooth (mature):

Replanted tooth (immature):

3-4 weeks

3-4 weeks

2-4 months

7-10 days

3-4 weeks

32

What type of tooth injury has a survival rate of 100%

90%

50-90%

30-90%

10-50%

0-40%

Concussion

Subluxation

Extrusion

Lateral Luxation

Intrusion

Avulsion

33

Hemorrhage and edema in PDL:

100% survival rate

Concussion

34

PDL ruptured, tooth NOT displaced:

90% survival

Subluxation

35

PDL, neurovascular tissue damaged, only gingival tissue retains tooth:

50-90% survival

Extrusion

36

Apical PDL fibers compressed (some), PDL and pulpal tissues damaged:

30-90% survival

Lateral Luxation

37

Tooth knocked inward:

10-50% survival

Intrusion

38

Tooth out:

0-40% survival

Avulsion

39

3 types of Soft Tissue Injuries:

Abrasion

Contusion

Laceration

40

Best bone graft must have what 3 characteristics?

Osteocinductive

Osteoinductive

Osteogenic

41

What does it mean to be Osteoconductive?

Scaffolding

42

3 characteristics of Alloplastic material?

osteoconductive

low cost

no disease transmission risk

43

2 types of Alloplastic materials?

Hydroxylapatite

ceramics

44

What grafting material is osteoconductive only?

Alloplastic material

45

What type of material is Ostioconductive and Osteoinductive?

Allograft

46

Allografts are increased in expense why?

Bone from same species

47

What material is osteoconductive, osteoinductive, and osteogenic?

Autograft

48

What is the only Grafting source of osteogenic properties (osteoblasts)?

Autograft

(autogeneous bone graft)

49

Indications for Bone Grafting are loss of bone following traumatic injury, after extraction with alveolar atrophy, after resection of a Benign tumor, or pneumatized maxillary sinus for future implant placemnt

True

50

How long should you wait after a bone graft to place an implant?

4-6 months

51

What can fill the extraction socket and maintain bone height?

*helps stabilize marginal soft tissue at extraction site

Socket grafting

*extraction socket and site preservation

52

In Fracture Management you Reduce/Fix/Immobilize/Prevent infection

True

53

What is the most important preventable cause of early death after maxillofacial trauma?

Resp obstruction

54

What technique/sequence should be used to assure the airway is protected?

Chin thrust

Chin lift

Definitive airway

55

A Definitive Airway requires what?

tube in trachea

cuff inflated

56

What is the Gold Standard in the surgical airway?

Tracheostomy

57

Tracheostomy is used for ventilation in Lefort ____ fractures.

II and III

58

What is the edentulism rate for entire US?

65 and older?

10%

35%

59

The Alignment of the jaws is knows as ______ surgery

Orthognathic

60

T/F
In an Intraseptal Alveoplasty, Alveolar Width is lost

true

61

T/F
Always design flaps to preserve attached gingiva

True

62

The Rxn of the body to trauma from physical, chemical, or microbial means:

Inflammation

63

The accumulation of leukocytes, etc

Abscess

64

Spreading infection at the cellular level - needs to be taken care of immediately (ABx)

Cellulitis

65

Acute inflammation: Redness, Swelling, Heat, Pain and ______

loss of function

66

Chronic Inflammation is a prolonged process between what 2 processes?

Tissue destruction

Healing

67

The collection of fluid matl (pus) w/in a cavity lined by a wall:

Abscess

68

Spreading infection with poor localizing tendency

Cellulitis

69

The ability of an organism to spread throughout the tissue:

*and cause damage w/ toxins

Virulence

70

A large ____ produces a severe spreading lesion, and a small one leads to minor lesion

dose

71

Salmonella typhi contracted through...

Strep pneumo...

Staph aureus and Strep pyogenes...

ingestion

inhalation

direct contact

72

Cellulits is a _____ process

Abscess is a _____

Aerobic

anaerobic

73

% aerobic infections (cellulitis):

% anaerobic (abscess):

25%

75%

74

Acute pericornitis, should you do surgery?

defer UNLESS abscess has developed

75

T/F
the Pterygomandibular Space can be affected by the mandibular molar/premolar

True

76

The Masseteric Space is affected by what tooth?

Mn 3rd Molar

77

The Lateral pharyngeal space can deviate the _____

The Retropharyngeal space can cause _____

uvula

airway obstruction

78

Inflammation of the Bone Marrow:

Osteomyelitis

79

2 types of Osteomyelitis:

Acute-suppurative

Chronic-suppurative

80

Strep pneumo, H influenza, strep, staph aureus, etc... cause what?

Acute/Chronic sinusitis

81

4 situations in which use of ABx is not necessary:

Chronic well-localized abscess

Minor vestibular abscess

Dry socket

Chronic pericoronitis

82

When should swelling/pain be considered an infection?

3 days post op

83

Post op Ecchymosis is very common in the elderly

True

84

Antibiotics are not indicated for pts undergoing OS procedures unless...

2 scenarios

Active spreading infection

Medically compromised (immunodeficiency )

85

Acute infections do not develop in less the ____ days after extraction

2-3 days

86

300 mg Acetaminophen + 30 mg codeine

Tylenol III

87

325 mg Aceteminophen + 5 mg Hydrocodone

Norco

88

325 mg Acetaminophen + Oxycodone (2.5/5/7.5mg)

Percocet

*no proven value

89

Post Op Pain: Aspirin/Acetaminophen dose

Ibuprofen:

Codeine:

Propoxyphene:

Oxycodone:

Hydrocodone:

500-1000 mg

400 - 800 mg

30-60 mg

100 mg

5-10 mg

5-10 mg

90

Post op pain peaks when?

12 hrs

91

Pain decreases initially but increases 3-4 days in, unaccompanied by swelling, non-resopnsive to analgesics:

Dry Socket

92

Dry Socket - place dressing on it containing ______

eugenol

93

Post-op Trismus is more common in what procedure?

impacted Mn 3rd molars

94

Uninfected root tips less than ___ mm can be left in

2-3 mm

95

It is best to close Oral Antral communication as it occurs

True

96

The most common cause of IAN injury is what teeth roots in close proximity?

Wisdom

97

Seddon classification of nerve injury

Neuropraxia

Axonotmesis

Neurotmesis

98

T/F
extracting the wrong tooth is the 2nd most common insurance claim

true

99

Mn fractures are a recognized side effect of 3rd molar surgery

True

100

Dry socket happens mainly in the Mn and what demographic is at risk?

Females on oral contraceptives

101

Irrigation, CHX rinse, and ABx in extraction site all decrease Dry Socket incidence

True

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