Surgical removal of impacted/buried teeth and roots Flashcards
1
Q
Aside from wisdom teeth, what are teeth are most often impacted?
A
Canines (especially upper) and second premolars, mesiodens
2
Q
What are indications for surgical removal of teeth?
A
- Impacted teeth (symptomatic/orthodontic)
- fractured/retained/buried root (pathology, denture construction, patient who is immunocompromised)
- unusual root pattern/hypercementosis
- grossly carious (esp in older patients) which are likely to fracture
- teeth with deep investing bone
- RCT teeth- cracked
- previous history of difficult extraction
- buried/displaced tooth
3
Q
What are medical conditions that patient must be cleared of before surgical removal
A
- Poorly controlled diabetes
- Blood disorders
- Irradiation to jaws
- Mucosal diseases
- Psychoses
- Substance abuse (tobacco and alcohol
- Medications - bisphosphonates
4
Q
Principles of flap design
A
- Avoid damage to vital structures
- Wide base for good blood supply
- Margins of flap away from operation site
- Wound margins resting on undamaged bone
- Adequate visibility and access
- minimal tension
5
Q
What maxillary anatomical structures may be encountered
A
- Air sinuses
- Nasopalatine canal
- Floor of nose, ANS
- Palatine and pterygoid vessels
6
Q
What mandibular anatomical structures may be encountered
A
- Mental nerve
- IDN
- Incisive nerves
- Sublingual vessels
- Genial tubercles
7
Q
Are silk sutures resorbable
A
no, remove at 5-10 days
8
Q
Are vicryl sutures resorbable
A
yes
9
Q
Advantage of prolene sutures
A
Monofilament hence easy to clean
10
Q
What is an envelope flap
A
Sulcular incision with distal relieving incision
11
Q
Disadvantage of sulcular incision
A
May lead to periodontal damage. Total loss of attached gingiva
