Third Molars 4 Flashcards
what are the basic principles of surgical removal
risk assessment
aseptic technique
minimal trauma to hard and soft tissues
what are the steps of a surgical procedure
anaesthesia
access
bone removal
tooth division
debridement
suture
haemostasis
post op instructions
what type of flap is raised in a surgical
buccal mucoperiosteal flap
where do you relieve the flap from
base of relieving incision
how do you reflect a flap
reflect with periosteal elevator firmly on bone
what instruments are useful in flap reflection
mitchells trimmer
howarths periosteal elevator
ash periosteal elevator
curved warwick james
what does retraction allow
access to operative field
protection of soft tissues
what instruments are used for retraction
howarths periosteal elevator
rake retractor
minnesota retractor
how do you retract
rest retractor firmly on bone
be aware of adjacent structures
what is used to remove bone
electric straight handpiece with saline cooled bur
round or fissure tungsten carbide burs
where is bone removal done
buccal aspect of tooth and distal aspect of impaction
how do you remove bone
create a deep narrow gutter around the crown
why would you remove bone
to allow correct application of elevators on mesial and distal aspects of the tooth
what is a horizontal crown section
section the crown off of the roots horizontally above the ACJ
when you are doing a coronectomy where do you section the tooth
below the ACJ
what is a vertical section
section the roots and elevate separately
what are the 3 steps of debridement
physical
irrigation
suction
what is used to physically debride
bone file
mitchells trimmer
victoria curette
how do you irrigate
sterile saline into socket and flap
how do you suture
approximate tissues
compress blood vessels
what are the aims of suturing
prevent wound breakdown
achieve haemostasis
when would you do a coronectomy
as an alternative to surgical removal when there is a risk of IAN damage
what is the process of a coronectomy
flap design
transection of tooth
elevation of crown
potential further reduction of roots
irrigate socket
replace flap
follow up
what must you warn the patient with a coronectomy
if root is mobilised during crown removal the entire tooth must be removed
leaving roots can result in infection
can get slow healing/painful socket
roots can migrate and begin to erupt
