Third Molars 4

Question 1

what are the basic principles of surgical removal

Answer 1

risk assessment
aseptic technique
minimal trauma to hard and soft tissues

Question 2

what are the steps of a surgical procedure

Answer 2

anaesthesia
access
bone removal
tooth division
debridement
suture
haemostasis
post op instructions

Question 3

what type of flap is raised in a surgical

Answer 3

buccal mucoperiosteal flap

Question 4

where do you relieve the flap from

Answer 4

base of relieving incision

Question 5

how do you reflect a flap

Answer 5

reflect with periosteal elevator firmly on bone

Question 6

what instruments are useful in flap reflection

Answer 6

mitchells trimmer
howarths periosteal elevator
ash periosteal elevator
curved warwick james

Question 7

what does retraction allow

Answer 7

access to operative field
protection of soft tissues

Question 8

what instruments are used for retraction

Answer 8

howarths periosteal elevator
rake retractor
minnesota retractor

Question 9

how do you retract

Answer 9

rest retractor firmly on bone
be aware of adjacent structures

Question 10

what is used to remove bone

Answer 10

electric straight handpiece with saline cooled bur
round or fissure tungsten carbide burs

Question 11

where is bone removal done

Answer 11

buccal aspect of tooth and distal aspect of impaction

Question 12

how do you remove bone

Answer 12

create a deep narrow gutter around the crown

Question 13

why would you remove bone

Answer 13

to allow correct application of elevators on mesial and distal aspects of the tooth

Question 14

what is a horizontal crown section

Answer 14

section the crown off of the roots horizontally above the ACJ

Question 15

when you are doing a coronectomy where do you section the tooth

Answer 15

below the ACJ

Question 16

what is a vertical section

Answer 16

section the roots and elevate separately

Question 17

what are the 3 steps of debridement

Answer 17

physical
irrigation
suction

Question 18

what is used to physically debride

Answer 18

bone file
mitchells trimmer
victoria curette

Question 19

how do you irrigate

Answer 19

sterile saline into socket and flap

Question 20

how do you suture

Answer 20

approximate tissues
compress blood vessels

Question 21

what are the aims of suturing

Answer 21

prevent wound breakdown
achieve haemostasis

Question 22

when would you do a coronectomy

Answer 22

as an alternative to surgical removal when there is a risk of IAN damage

Question 23

what is the process of a coronectomy

Answer 23

flap design
transection of tooth
elevation of crown
potential further reduction of roots
irrigate socket
replace flap
follow up

Question 24

what must you warn the patient with a coronectomy

Answer 24

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

Question 25

how do you remove an upper third molar

Answer 25

elevation only
or elevation and then forceps
support the tuberosity

Question 26

what instrument is used to extract an upper 8

Answer 26

straight or curved warwick james