Oral surgery > Topics 1-113 summary > Flashcards

Topics 1-113 summary Flashcards

(228 cards)

Study These Flashcards
1
Q

1. Asepsis and antiseptics in oral and maxillofacial surgery.

Basic methods used for sterilizing instruments in oral and maxillofacial surgery

A
  • Dry heat
  • Moist heat (autoclave)
  • Chemical
  • Sterilization with ethylene oxide
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

1. Asepsis and antiseptics in oral and maxillofacial surgery.

Procedure for sterilizing instruments that are not heat resistant

A
  • Certain plastics or metals, can be sterilized with ethylene oxide
  • Allows the sterilization of heat-sensitive instruments
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

1. Asepsis and antiseptics in oral and maxillofacial surgery.

Antiseptics and how they differ from antibiotics and disinfectants

A
  • Antimicrobial substances applied to living tissue to reduce infection, sepsis, or putrefaction
  • Differ from Antibiotics, which are transported through the lymphatic system to destroy bacteria within the body
  • Disinfectants=> destroy microorganisms on non-living objects but do not kill bacterial spores
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

1. Asepsis and antiseptics in oral and maxillofacial surgery.

list of common antiseptics used in surgical procedures

A
  • Alcohols
  • Quaternary ammonium compounds
  • Boric acid
  • Brilliant green
  • Chlorhexidine gluconate
  • Hydrogen peroxide
  • Iodine
  • Phenol
  • Sodium chloride (salt)
  • Sodium hypochlorite
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

1. Asepsis and antiseptics in oral and maxillofacial surgery.

[CORE] What is the standard method for sterilizing reusable surgical instruments?

A

Autoclaving at 134ºC for 3 minutes or 121ºC for 15 minutes.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

1. Asepsis and antiseptics in oral and maxillofacial surgery.

[CORE] What sterilization method is used for delicate instruments?

A

Ethylene oxide sterilization, though it takes up to 24 hours.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

1. Asepsis and antiseptics in oral and maxillofacial surgery.

[CORE] What sterilization method is often used for alloplastic grafts like bone grafts?

A

Radiation.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

2. Topographic anatomy of the maxillofacial region: nerve supply, blood

Function of the facial nerve (CN VII) and what happens when it is damaged

A
  • Controls the muscles of facial expression
  • Damage=>facial palsy, person cannot move muscles on one or both sides of their face
  • Bell’s palsy common temporary condition associated with facial nerve damage
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

2. Topographic anatomy of the maxillofacial region: nerve supply, blood

Functions of the glossopharyngeal nerve (CN IX)

A
  • Innervates the stylopharyngeus muscle
    🦴⬆️🗣️
  • Sensory innervation to the oropharynx and back of the tongue
  • Parasympathetic innervation to the parotid gland
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

2. Topographic anatomy of the maxillofacial region: nerve supply, blood

How damage to the vagus nerve (CN X) manifests clinically

A
  • Loss of parasympathetic innervation=>increased blood pressure and heart rate
  • Symptoms=>hoarse voice and difficulties in swallowing
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

2. Topographic anatomy of the maxillofacial region: nerve supply, blood

Signs of hypoglossal nerve (CN XII) damage

A
  • Fasciculations (muscle twitching) and atrophy of the tongue muscles
  • Upper motor neuron damage=>muscle weakness without atrophy or fasciculations
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

2. Topographic anatomy of the maxillofacial region: nerve supply, blood

Arteries that primarily supply the maxillofacial region

A
  • Branches of the external carotid artery
  • Including the facial artery, maxillary artery, and lingual artery
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

2. Topographic anatomy of the maxillofacial region: nerve supply, blood

Venous drainage of the maxillofacial region

A
  • Mainly through the facial vein, which drains into the internal jugular vein
  • Pterygoid plexus also contributes to venous drainage=>
  • Connects w/ the cavernous sinus and the maxillary vein
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

2. Topographic anatomy of the maxillofacial region: nerve supply, blood

Role of lymph nodes in the maxillofacial region

A
  • Filtering 🔍 lymphatic fluid and trapping pathogens 🦠
  • Key lymph nodes=> submandibular, submental, and cervical lymph nodes=>
  • Drain lymph from the face, mouth, and neck
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

2. Topographic anatomy of the maxillofacial region: nerve supply, blood

Primary muscles involved in facial expression

A
  • Orbicularis oculi, orbicularis oris
  • Zygomaticus major and minor
  • Buccinator, and the frontalis muscle
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

2. Topographic anatomy of the maxillofacial region: nerve supply, blood

Muscles are responsible for mastication (chewing)

A
  • Masseter, temporalis, medial pterygoid, and lateral pterygoid muscles
  • Innervated by the mandibular branch of the trigeminal nerve (V3).
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

2. Topographic anatomy of the maxillofacial region: nerve supply, blood

How muscles of facial expression innervated

A

Facial nerve (CN VII).

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

3. General surgical procedures - incisions, suturing, sewing materials

Primary purpose of surgical incisions

A

Gain access intraorally or extraorally, to site that is the object of the surgery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

3. General surgical procedures - incisions, suturing, sewing materials

Types of blades are commonly used for incisions in oral and maxillofacial surgery

A
  • The #15 blade with its rounded tip is most popular
  • # 11 blade with its pointed tip
  • # 12C blade with its smaller rounded tip are also used for specific procedures
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

3. General surgical procedures - incisions, suturing, sewing materials

Recommended technique for making an incision

A
  • One single firm movement using the palm of the hand as support for the scalpel handle=>
  • To avoid undesirable instability
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

3. General surgical procedures - incisions, suturing, sewing materials

Purpose of releasing incisions at each end of a gingival margin incision

A
  • Releasing incisions (should be divergent)=>protect the vascularity of the flap and minimize visible scarring
  • especially when placed further back in the oral cavity
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

3. General surgical procedures - incisions, suturing, sewing materials

Primary goal of suturing following a surgical incision

A
  • Close the wound=>
  • ensuring the best apposition of tissues and minimal scarring
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

3. General surgical procedures - incisions, suturing, sewing materials

Main categories of sutures based on their resorption properties

A
  • Resorbable or non-resorbable
  • Resorbable sutures dissolve over time
  • Non-resorbable sutures need to be removed
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

3. General surgical procedures - incisions, suturing, sewing materials

Monofilament sutures

A
  • Tend to stay cleaner
  • Leave fewer suture marks on tissues
  • Harder to knot=>more likely to become unknotted
  • Can irritate tongue and cheeks
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
# 3. General surgical procedures - incisions, suturing, sewing materials Multifilament Sutures
* **Easier** to knot * Lie flat, and are **less irritating** * **Harder to keep clean** * Tend to **"wick,"** attracting moisture and bacteria ## Footnote * Some synthetic sutures combine the benefits of both by being coated multifilaments
26
# 3. General surgical procedures - incisions, suturing, sewing materials Catgut suture, and its properties
* Made from sheep intestine, 🐑 * Proteinaceous product * Plain Catgut * Chromic Catgut
27
# 3. General surgical procedures - incisions, suturing, sewing materials Plain Catgut
* Monofilament * Resorbs in 5-7 days via enzymatic action, * Often causes inflammatory response
28
# 3. General surgical procedures - incisions, suturing, sewing materials Chromic Catgut
* Treated with **chromic acid** to improve handling properties=> * **Reduce inflammatory response** * Resorbs in about **2 weeks** * Considered **ideal** for many **intraoral suturing needs** * Potential concerns regarding **prion disease transmission**
29
# 3. General surgical procedures - incisions, suturing, sewing materials Polyglycolic Acid and Polyglactin Sutures
* **Synthetic** * Resorb in about **6 weeks** through hydrolysis * **Monofilament, multifilament** or **coated multifilament**
30
# 3. General surgical procedures - incisions, suturing, sewing materials Polydioxanone (PDS) and polyglyconate sutures used for
* Synthetic * Resorb in about 120 days 🕰️ * used where long-term resorption is beneficial=>alar cinch sutures for LeFort orthognathic surgery * Monofilament, multifilament, coated multifilament
31
# 3. General surgical procedures - incisions, suturing, sewing materials Characteristics and uses of silk sutures
* Natural product from silkworms * Non-resorbable * Always braided * Easy to knot * Lies flat * Needs removal * Prone to food sticking and wicking=> infection if not kept clean. ## Footnote On the skin, they leave suture marks if not removed after a few days
32
# 3. General surgical procedures - incisions, suturing, sewing materials Properties and occasional uses of cotton sutures
* Natural * Non-resorbable * Multifilament * knots easily * Occasionally used on the mucosa and tends to wick
33
# 3. General surgical procedures - incisions, suturing, sewing materials Cutting needle and its application
* **Triangular in cross-section** * **One edge sharpened** to cut through tissues * Necessary for **mucosa, skin**, and some **fascial layers** of the head and neck
34
# 3. General surgical procedures - incisions, suturing, sewing materials Difference between a forward-cutting and a reverse-cutting needle?
* Forward-Cutting Needle=>cutting edge on **inside** of circle * Reverse-Cutting Needle=>cutting edge on **outside** of circle=> * Cuts **away** from direction needle is passed=> * **Preferred** in most oral surgical procedures to **prevent cutting through tissues too often**
35
# 3. General surgical procedures - incisions, suturing, sewing materials Simple interrupted sutures, and recommended density
* Common sutures with each stitch **tied separately** * Around **three** sutures per **centimeter** of length is a good balance=> * Minimize stitch marks and infection while preventing a widened scar
36
# 3. General surgical procedures - incisions, suturing, sewing materials Horizontal and vertical mattress sutures
* Horizontal Mattress Sutures: Used for **watertight** **closure** * Vertical Mattress Sutures: Provide **watertight** **closure** and **everted** **suture** **line**=> * Ideal for suturing over **dead** **spaces** like **cyst** **cavities** or **oroantral** **fistulas**
37
# 3. General surgical procedures - incisions, suturing, sewing materials Dental procedure in which curettage used
* Teeth affected by **periodontitis**. Specifically * Gingival curretage=>**removes soft tissue lining** of the periodontal pocket w/ a curette=> * leaves only a **gingival connective tissue lining.**
38
# 3. General surgical procedures - incisions, suturing, sewing materials How drains managed post-insertion
* **Shortened over the next few days** to ensure complete drainage * **Removed when drainage stops** to avoid delaying the normal wound healing process.
39
# 4. Surgical anatomy of the areas and spaces in the maxillofacial area How fascial spaces differ from fasciae
* Fascial spaces are **potential spaces** that can form between tissues during infections * Fasciae are **bands of connective tissue** that surround and support structures like muscles
40
# 4. Surgical anatomy of the areas and spaces in the maxillofacial area What fascial spaces may contain based on their location
* Salivary glands, blood vessels, nerves, and lymph nodes * Spaces containing neurovascular tissues (nerves and blood vessels) also be termed compartments.
41
# 4. Surgical anatomy of the areas and spaces in the maxillofacial area How fascial spaces are classified in oral and maxillofacial surgery
* Primary maxillary spaces * Primary mandibular spaces * Perimandibular spaces
42
# 4. Surgical anatomy of the areas and spaces in the maxillofacial area The primary maxillary spaces
* Canine space * Buccal space * Infratemporal space
43
# 4. Surgical anatomy of the areas and spaces in the maxillofacial area The primary mandibular spaces
* Submental space * Buccal space * Submandibular space * Sublingual space * Submasseteric space
44
# 4. Surgical anatomy of the areas and spaces in the maxillofacial area The perimandibular spaces
* Submandibular space * Submental space * Sublingual space * Mental space * Buccal space * Canine space (infra-orbital space) * Submasseteric space * Pterygomandibular space * Infratemporal space
45
# 5. Examination of patients in the oral and maxillofacial surgery - Steps in treating a patient in oral and maxillofacial surgery
* Diagnostic sequence divided into five levels: 1. History taking 2. Clinical examination 3. Radiological analysis 4. Laboratory investigations 5. Interpretation to arrive at a final diagnosis
46
Steps involved in history taking
1. Obtaining general information 2. Recording the chief complaint(morbi) 3. Gathering past and present medical history (vitae) 4. Collecting personal and family history
47
# 5. Examination of patients in the oral and maxillofacial surgery What is covered in the personal history of a patient
* Habits like chewing tobacco * Alcohol consumption * Smoking, drug abuse, and exposure to commercial sex workers
48
# 5. Examination of patients in the oral and maxillofacial surgery Why family history important in patient examination
* Highlights any **hereditary** conditions=> * Epilepsy, cardiac disorders, diabetes, bleeding disorders, Tuberculosis * Relevant to the patient's diagnosis and treatment outcome
49
# 5. Examination of patients in the oral and maxillofacial surgery Purpose of routine haematological investigations in oral and maxillofacial surgery
* Overall **health status** * Detect **infections** * Assess **nutritional status** * Identify **bleeding disorders** and evaluate the **immune response** to facilitate postoperative recovery
50
# 5. Examination of patients in the oral and maxillofacial surgery What haemoglobin (Hb) indicates in a blood test
Indicates the oxygen-carrying capacity of the blood
51
# 5. Examination of patients in the oral and maxillofacial surgery Normal haemoglobin values for males and females
* Females: 12 to 16 g/dL * Males: 14 to 18 g/dL | g/dL- grams per decilitre
52
# 5. Examination of patients in the oral and maxillofacial surgery Decreased haemoglobin value suggests
* **Anaemia**=>iron deficiency * **Decreased absorption** of vitamins and minerals * Bone marrow depression, increased blood loss
53
# 5. Examination of patients in the oral and maxillofacial surgery What should be done if a patient has low haemoglobin
Referred to specialists
54
# 5. Examination of patients in the oral and maxillofacial surgery What a complete blood count (CBC) includes
* **Red** blood cell count * **White** blood cell count * **Differential** white blood cell count * **Platelet number estimation**, and a **blood smear** description
55
# 5. Examination of patients in the oral and maxillofacial surgery Benefits of performing a CBC
* Helps to determine **nutritional status** * Detect **infections** * Identify **bleeding disorders** * Evaluate the **patient's immune response**
56
# 5. Examination of patients in the oral and maxillofacial surgery Normal values for red blood cell count in males and females
* Females: **4.5 to 5.5** million cells per cu mm * Males: **4.5 to 6.2** million cells per cu mm | cu= cubic millimetres (mm3)
57
# 5. Examination of patients in the oral and maxillofacial surgery Normal values for white blood cell count in adults and children
* Adults: **5000 to 10000** cells per cu mm * Children below 7 years: **6000 to 15000** cells per cu mm
58
# 5. Examination of patients in the oral and maxillofacial surgery Normal distribution of polymorphonuclear leukocytes (neutrophils) in a differential white blood cell count
Neutrophils: 50 to 70 percent
59
# 5. Examination of patients in the oral and maxillofacial surgery Normal value for platelet count
150,000 to 400,000 cells per cu mm
60
# 5. Examination of patients in the oral and maxillofacial surgery What an elevated ESR indicates
Chronic infections, infarctions, trauma
61
# 5. Examination of patients in the oral and maxillofacial surgery Normal bleeding time by Duke’s method
3 to 5 minutes
62
# 5. Examination of patients in the oral and maxillofacial surgery Normal clotting time by Lee-White method
4 to 10 minutes
63
# 5. Examination of patients in the oral and maxillofacial surgery Normal prothrombin time
12-14 seconds
64
# 6. Investigation of disease: extra-and intraoral status. Diagnosis Initial observations made during the clinical examination of a patient
* Patient's **gait, composure**, and **speech=>** * Reflect their **general condition** and **psychological status**
65
# 6. Investigation of disease: extra-and intraoral status. Diagnosis Vital signs recorded after history taking
* Blood pressure * Pulse, temperature, and respiratory rate
66
# 6. Investigation of disease: extra-and intraoral status. Diagnosis Aspects of the face that are observed
* Signs of asymmetry * Swelling * Proportion of the upper, middle, and lower thirds of the face, and their relation to each other
67
# 6. Investigation of disease: extra-and intraoral status. Diagnosis Skin and soft tissue characteristics important to note
* **Color and texture** of the skin=> * Indicative of many underlying systemic problems
68
# 6. Investigation of disease: extra-and intraoral status. Diagnosis Important points to observe in the eyes
* Soft tissue **injury to the cornea or conjunctiva** * **Pallor** (indicative of anemia) * **Icterus** (indicative of jaundice) * **Exophthalmus** (suggestive of thyroid disorders). ## Footnote Exophthalmos=>protrusion of one or both eyes anteriorly out of orbit due to an increase in orbital contents within rigid bony orbit.=>Graves' disease ophthalmopathy.
69
# 6. Investigation of disease: extra-and intraoral status. Diagnosis Abnormalities that might be seen in the ears during inspection
* Bleeding from the ears (indicative of condyle fractures) * Signs of Goldenhar syndrome (external ear abnormalities) * Infection * Pus discharge, tinnitus, and hearing impairment
70
# 6. Investigation of disease: extra-and intraoral status. Diagnosis lesions that might be observed in the lips
* Clefts * Ulcerative and nonulcerative growths * Angular chelitis, and herpes infections
71
# 6. Investigation of disease: extra-and intraoral status. Diagnosis How the temporomandibular joints (TMJ) examined
* Placing the **index fingers** **anteroinferior** to the **tragus** of the ear * Check for **tenderness, clicking, crepitus=>** * On **opening or closing** the mouth, **range** of opening, and **left and right lateral excursions**
72
# 6. Investigation of disease: extra-and intraoral status. Diagnosis What is evaluated when palpating the lymph nodes
* Preauricular * Submandibular, submental, and cervical lymph nodes=> * for enlargement, tenderness, mobility, and consistency
73
# 6. Investigation of disease: extra-and intraoral status. Diagnosis How the tongue examined
* **Size, mobility**, and **surface** of tongue inspected * Tongue then depressed to visualize the **uvula, soft palate**, and **lateral** and **posterior pharyngeal walls**
74
# 6. Investigation of disease: extra-and intraoral status. Diagnosis Findings in the floor of the mouth that are significant
* Examined for inflammation, masses, and hematomas * A raised floor of the mouth in a patient with an abscess suggests Ludwig’s angina
75
# 6. Investigation of disease: extra-and intraoral status. Diagnosis What is looked for at salivary gland orifices
Signs of inflammation or pus discharge
76
# 7. Types of anesthesia in oral and maxillofacial surgery. Premedication Types of Anesthesia
* Local * General * Neuroleptanasthesia * Sedation
77
# 7. Types of anesthesia in oral and maxillofacial surgery. Premedication Premedication in the context of maxillofacial surgeries
* Administration of medications with **specific pharmacological actions** before surgery or anesthesia * **Enhances** patient **safety and comfort** during the surgical procedure
78
# 7. Types of anesthesia in oral and maxillofacial surgery. Premedication Routes of administration for premedication
* Enteral * Parenteral
79
# 7. Types of anesthesia in oral and maxillofacial surgery. Premedication Enteral routes of administration
* Oral * Rectal
80
# 7. Types of anesthesia in oral and maxillofacial surgery. Premedication Parenteral routes of administration
* Intranasal * Intramuscular * Intravenous
81
# 7. Types of anesthesia in oral and maxillofacial surgery. Premedication First Cranial nerve
-Olfactory nerve(smell)
82
# 7. Types of anesthesia in oral and maxillofacial surgery. Premedication Second Cranial nerve
Optic nerve (sight)
83
# 7. Types of anesthesia in oral and maxillofacial surgery. Premedication Third Cranial nerve
Oculomotor nerve (Orbital muscles for eye movement)
84
# 7. Types of anesthesia in oral and maxillofacial surgery. Premedication Fourth Cranial nerve
Trochlear nerve (Orbital muscles for eye movement)
85
# 7. Types of anesthesia in oral and maxillofacial surgery. Premedication Fifth cranial nerve
``` Trigeminal nerve( Motor: movement of the **jaws** and **muscles of mastication** Sensory: sensation of feeling for the **face, teeth, and periodontal ligaments**, and anterior two thirds of the **tongue**) ```
86
# 7. Types of anesthesia in oral and maxillofacial surgery. Premedication Sixth Cranial nerve
Abducens nerve (Orbital muscles for eye movement)
87
# 7. Types of anesthesia in oral and maxillofacial surgery. Premedication Seventh Cranial nerve
Facial Nerve ( Motor: to the **muscles of facial expression** Sensory: taste to anterior two-thirds of **tongue** Secretory: to **submandibular** and s**ublingual glands**)
88
# 7. Types of anesthesia in oral and maxillofacial surgery. Premedication Eighth Cranial nerve
Auditory Nerve(Sense of hearing, position, and balance)
89
Nineth Cranial Nerve
Glossopharyngeal nerve (CN IX) ( mixed cranial nerve-motor, sensory, and parasympathetic to throat and tongue)
90
Tenth Cranial nerve
Vagus nerve (Pharyngeal and laryngeal movements: digestive tract)
91
Eleventh Cranial Nerve
**Accessory nerve**(Neck movements: sternocleidomastoid and trapezius muscles)
92
Twelfth Cranial nerve
Hypoglossal nerve ( Motor: tongue movement (muscles)
93
# 9. Types of local anesthetics and their metabolism. Mechanism of action Method of action of Local anaesthetics
- Block **voltage gated sodium channels** - Block **depolarisation** of cell and inhibit **neural** **activity**
94
# 9. Types of local anesthetics and their metabolism. Mechanism of action Techniques of local Anaesthesia
- Topical - Infiltration - Regional block - Intraosseous - Intraligamentary - Intrapulpal
95
# 9. Types of local anesthetics and their metabolism. Mechanism of action Two types of local anaesthetics
- Esters - Amines(mostly used)
96
# 9. Types of local anesthetics and their metabolism. Mechanism of action Lidocaine
- **Gold** standard - **Plain** **solution** of **2%=>** short lasting -**Epinephrine** **vasoconstrictor** common 1:200 000 to 1:80 000(5μg/m to 12.5μg/m)
97
# 9. Types of local anesthetics and their metabolism. Mechanism of action Mepivicaine
* Concentration of **2% 1:100 000 epinephrine**→ similar to 2% epinephrine lidocaine * **3% plain** (better anaesthesia than lidocaine when vasoconstrictor free solution required)
98
# 9. Types of local anesthetics and their metabolism. Mechanism of action Prilocaine
- **4% plain** solution - **3% solution** w/ vasocontrictor **felypressin**(if epinephrine free required)
99
# 9. Types of local anesthetics and their metabolism. Mechanism of action Articaine
* **4% 1:100 000** or **1:200 000** epinephrine * **Better** **mandibular** **infiltration** anaesthesia than lidocaine
100
# 9. Types of local anesthetics and their metabolism. Mechanism of action Bupivacaine
- **long** lasting - **1:200 000** - **Supplementary** intraoral injection during general anaesthesia - Reduces number of post-op analgesics required
101
# 9. Types of local anesthetics and their metabolism. Mechanism of action Effect of Epinephrine in La
🔹Vasoconstriction 🔹Reduced bleeding 🔹Prolonged anaesthesia
102
# 9. Types of local anesthetics and their metabolism. Mechanism of action How Articaine has better penetration into tissues than lidocaine
🔸Presence of ester group in its structure 🔸Allows better diffusion
103
# 9. Types of local anesthetics and their metabolism. Mechanism of action Main effects of epinephrine in allergy
🔸Vasoconstriction (reduces swelling) 🔸Bronchodilation (improved airflow) 🔸Cardiovascular effects 🔸Suppression of inflammatory mediators
104
# 9. Types of local anesthetics and their metabolism. Mechanism of action Active ingredient of Ubistein
Articaine and epinephrine
105
# 9. Types of local anesthetics and their metabolism. Mechanism of action Active ingredient of Scandonest
Mepivicaine and epinephrine
106
# 9. Types of local anesthetics and their metabolism. Mechanism of action Active ingredient of xylodren
Lidocaine and epinephrine
107
# 9. Types of local anesthetics and their metabolism. Mechanism of action Active ingredient of dentocain
Articaine and adrenaline
108
# 9. Types of local anesthetics and their metabolism. Mechanism of action Active ingredient of septonest
Articaine and Adrenaline
109
# 9. Types of local anesthetics and their metabolism. Mechanism of action Factors that affect intensity and duration of LA’s
🔸Tissue blood flow 🔸Activity of plasma cholinesterase 🔸Vasoconstrictor use 🔸pH of tissue 🔸Dose of La
110
# 9. Types of local anesthetics and their metabolism. Mechanism of action How infection hinders effect of La
🔸Creates **acidic** environment=>**decreases** **pH** of **tissues** 🔸Alters **ionisation** and ability to penetrate nerve fibres=> 🔸Reduces the **potency** and **duration** of LAs
111
# 9. Types of local anesthetics and their metabolism. Mechanism of action Strategies to overcome resistance of LA in infected tissues
🔸Antibiotics and anti inflammatory agents (reduce inflammation and acidity) 🔸Regional nerve blocks and intravenous sedation
112
# 12. Oral and maxillofacial anesthesia features. Premedication.Guidelines Primary goals of pharmacological premedication in oral and maxillofacial anesthesia
* Anxiety relief, sedation, Analgesia * Amnesia * Antisialogogue effect (reducing saliva production) * Decrease in anesthetic requirements * Prophylaxis against allergic reactions
113
# 12. Oral and maxillofacial anesthesia features. Premedication.Guidelines Drugs commonly used as anxiolytics for premedication, and why they are important
* **Benzodiazepines** (such as midazolam, diazepam, lorazepam, and triazolam) * **Nitrous oxide** * Preoperative anxiety can increase the demand for anesthetic agents=> * Cause patient dissatisfaction w/ anesthesia
114
# 13. Local anesthesia in children and inflammatory diseases in the maxill Maximum dose per kilogram of Procaine
* Children 7mg/kg * Adults 10mg/kg
115
# 13. Local anesthesia in children and inflammatory diseases in the maxill Maximum dose per kilogram of lidocaine
* Children 4.4mg/kg * Adults 7mg/kg
116
# 13. Local anesthesia in children and inflammatory diseases in the maxill Maximum dose per kilogram of Articaine (Ubistesin)
* Children 5mg/kg * Adults 7mg/kg
117
# 13. Local anesthesia in children and inflammatory diseases in the maxill Maximum dose per kilogram of Mepivacaine (scandonest)
* Children 4mg/kg * Adults 6.6mg/kg
118
# 13. Local anesthesia in children and inflammatory diseases in the maxill Maximum dose per kilogram of Bupivacaine
Adults 2.2mg/kg
119
# 13. Local anesthesia in children and inflammatory diseases in the maxill Maximum dose per kilogram of Procaine (Novocaine)
* Children 7mg/kg * Adults 10mg/kg
120
# 15. Complications during and after local anesthesia. Types of prevention Maximum dose of local anesthetics
* Lidocaine: 7mg/kg * Mepivacaine: 6.6 mg/kg * Prilocaine: 6.0 mg/kg * Articaine: 7.0 mg/kg * Procaine: 10mg/kg * Bupivacaine: 2.2 mg/kg
121
# 15. Complications during and after local anesthesia. Types of prevention Complications during local anesthesia
* **Allergic Reactions** * **Toxic Reactions** * **Fracture** of the Injection **Needle** * **Post-Injection Pain** and **Inflammatory** **Complications:=>** * High concentration anesthetics * Periosteum injury, tissue infection, or use of non-sterile solutions.
122
# 15. Complications during and after local anesthesia. Types of prevention Anaphylaxis and how does it occurs
* **Type I hypersensitivity reaction**=>antigen binds to **IgE** antibodies on **mast** **cells** and **basophils**=> * Systemic release of immunologic mediators
123
# 15. Complications during and after local anesthesia. Types of prevention Common clinical presentations of anaphylaxis
* **Urticaria** (hives) and/or **angioedema** (swelling) * **Respiratory compromise** and **cardiovascular collapse**=> * Usual causes of death in anaphylaxis
124
# 15. Complications during and after local anesthesia. Types of prevention Common causes of anaphylaxis in a surgical practice
* Drugs such as penicillin and aspirin * Exposure to latex
125
# 15. Complications during and after local anesthesia. Types of prevention Role of epinephrine in managing anaphylaxis, and how it should be administered
* **Intramuscularly or subcutaneously** at a 1:1000 dilution (0.2–0.5 ml in adults or 0.01 mg/kg in children) * Injected into the **lateral thigh, upper arm, or sublingually=>** * Dose repeatable every **5 minutes** as needed
126
# 15. Complications during and after local anesthesia. Types of prevention Position patient placed in during anaphylaxis and why
* Trendelenburg position (lying flat with feet elevated) * Maximize cerebral blood flow
127
# 15. Complications during and after local anesthesia. Types of prevention Additional treatments that should be considered after initial epinephrine administration in anaphylaxis
* **Antihistamines** (such as diphenhydramine) intramuscularly or intravenously at 1–2 mg/kg (up to 50 mg). * **Albuterol** for bronchospasm * **Corticosteroids** (such as hydrocortisone prevent recurrent or protracted anaphylaxis
128
# 15. Complications during and after local anesthesia. Types of prevention Conditions of nerve trauma
- Anaesthesia - Hypesthesia - Paraesthesia - Dysesthesia
129
Classifications of nerve injury
- Neurapraxia - Axonotmesis - Neurotmesis -
130
Neurapraxia
- Small contact w/ nerve - Favourable prognosis - Complete recovery→rapid
131
Axonotmesis
- Injury **without anatomic severance of endoneurium** - **Slower recovery** than neurapraxia**(paraesthesia 6-8 weeks after injury)** - Risk of remaining sensory disturbance ## Footnote -The endoneurium is a delicate layer of connective tissue surrounding each myelinated nerve fiber - innermost layer of the nerve structure - crucial role in supporting nerve fibers by allowing presence of tissue fluid and providing space for capillaries to supply oxygen and nutrients
132
# 18. Retention of the teeth. Etiology, pathogenesis, clinical features Etiology of tooth retention
* **Rickets** * **Devitalized deciduous teeth=>** delay root resorption preventing normal eruption of permanent teeth * **Dystopia** (incorrect positioning) or **partial anodontia** (lack of a germ of the respective permanent tooth)=> * Deciduous tooth remains in the alveolar process longer than usual. * **Genetic factors**
133
# 18. Retention of the teeth. Etiology, pathogenesis, clinical features Differential diagnoses for tooth retention
* **Delayed eruption** due to nutritional deficiencies or systemic conditions like rickets. * Presence of **supernumerary teeth** which might prevent the eruption of permanent teeth
134
# 18. Retention of the teeth. Etiology, pathogenesis, clinical features Treatment options for retained teeth
* **Operative** **Treatment**: **Extraction** if the retained tooth causes complications=> * such as **cysts** or **infections**. * **Surgical**-**Orthodontic** **Treatment**: (e.g., canines), * Bone above the tooth is removed and the tooth is gradually moved to proper position
135
# 18. Retention of the teeth. Etiology, pathogenesis, clinical features Complications that can arise from retained teeth
* **Infections** and **cyst formation** around the retained tooth. * Formation of **dental abscesses.** * **Displacement or crowding** of adjacent teeth. * **Resorption of roots** of adjacent teeth. * Potential impact on development of the **dental arch and occlusion problems**
136
# 19. Acute periodontitis. Etiology, classification, clinical features Periodontitis defintion
* Inflammatory process in **periodontal** **space** * Affects **alveolar** **bone**, **soft** **tissues** and **lymphatics**
137
# 19. Acute periodontitis. Etiology, classification, clinical features Periodontitis can be classified according to:
* Aetiology * Type of inflammation * Location * Clinical course
138
# 19. Acute periodontitis. Etiology, classification, clinical features Periodontitis classifications according to aetiology
* Infectious * Trauma * Chronic * Chemotaxic * Allergic
139
# 19. Acute periodontitis. Etiology, classification, clinical features Periodontitis classification according to location
* Periapical * Total
140
# 19. Acute periodontitis. Etiology, classification, clinical features Periodontitis classification according to type of inflammation
1. **Exudative** * Serous * Purulent 2. **Proliferative** * Granulomatous
141
# 19. Acute periodontitis. Etiology, classification, clinical features Periodontitis classification according to Clinical course
* Sharp * Chronic * Excacerbated
142
# 19. Acute periodontitis. Etiology, classification, clinical features Acute periodontitis classifications
* Periodontitis **periapicalis** acuta- **serosa** et **purulenta** * Periodontitis **marginalis** acuta- **Serosa** et **purulenta** * Periodontitis **totalis** **acuta**
143
# 19. Acute periodontitis. Etiology, classification, clinical features The clinical course of periodontitis depends on:
* Aetiology * Location and type of process * Microbial contamination * Virulence of microorganisms * Local and general immune status * Age * Contomitant diseases
144
# 19. Acute periodontitis. Etiology, classification, clinical features Acute serous periodontitis clinical presentation
* Pain similar to pulpitis * Pain on percussion * May or may not be able to localise
145
# 19. Acute periodontitis. Etiology, classification, clinical features Treatment of Acute serous periodontitis
* Endodontic treatment
146
# 19. Acute periodontitis. Etiology, classification, clinical features Phases of Acute Purulent periodontitis
* Periodontal * Endosteal * Subperiosteal * Submucosal
147
# 19. Acute periodontitis. Etiology, classification, clinical features Periodontal phase of Acute Purulent periodontitis characteristics
* Serous exudate-> Purulent * Spreading bone resorption * Strong constant pain intensifying on percussion ## Footnote * Mixed virulent microflora, Complement activation * Infiltration of neutrophils and macrophages
148
# 19. Acute periodontitis. Etiology, classification, clinical features Periodontal phase of Acute Purulent periodontitis general symptoms
* Slightly enlarged and painful lymph nodes * General malaise
149
# 19. Acute periodontitis. Etiology, classification, clinical features Treatment of Periodontal phase of Acute Purulent periodontitis
* Endodontic treatment * Extraction * Antibiotics
150
# 19. Acute periodontitis. Etiology, classification, clinical features Endosteal phase of Acute Purulent periodontitis characteristics
* Process **continues** expansion into bone * **Constant** throbbing pain=> * **Unbearable** on percussion * Regional lymph nodes **enlarged** and **painful**
151
# 19. Acute periodontitis. Etiology, classification, clinical features Endosteal phase of Acute Purulent periodontitis general condition
Flu like symptoms ## Footnote Most are minor symtoms
152
# 19. Acute periodontitis. Etiology, classification, clinical features Treatment of Endosteal phase of Acute Purulent periodontitis
* Endodontic treatment * Extraction * Medication ## Footnote Medication: Anti-inflammatory, antibiotic(Clindamycin), analgesic, Antipyretic
153
# 19. Acute periodontitis. Etiology, classification, clinical features Periosteal/subperiosteal phase of Acute Purulent periodontitis characteristics
* **Increased** **invasion** of bone and purulence * **Spontaneous** very strong pain, mucosa hyperemic and edematous * **Mobility** ## Footnote MOST PAINFUL STAGE
154
# 19. Acute periodontitis. Etiology, classification, clinical features Periosteal/subperiosteal phase of Acute Purulent periodontitis general condition
* Regional lymph nodes enlarged
155
# 19. Acute periodontitis. Etiology, classification, clinical features Periosteal/subperiosteal phase of Acute Purulent periodontitis treatment
* Draining of abcess * Endo * Medication- Analgin, Ibuprofen(400mg), Amoxicillin(1000mg x2), metranidazole ## Footnote Analgin, aka=> metamizole, is a painkiller and fever reducer used to treat various types of pain, including headaches, toothaches, and muscle pain
156
# 19. Acute periodontitis. Etiology, classification, clinical features Submucosal abcess Acute Purulent periodontitis characteristics
* Purulent collection **below** **periosteum** forms abcess * **Decrease** in pain * **Hyperemia** and severe **edema**-spread => **Abcesses** and **phlegmons** ## Footnote Edema spreads to: lips, cheeks, nasolabial folds, eyelids, sublingual, submental and submandibular space
157
# 19. Acute periodontitis. Etiology, classification, clinical features Submucosal abcess Acute Purulent periodontitis general condition
Flu like symptoms
158
# 19. Acute periodontitis. Etiology, classification, clinical features Submucosal abcess Acute Purulent periodontitis paraclinical studies
* Radiographic changes difficult to detect * Leukocytosis * Accelerated ESR * C- reactive protein
159
# 20. Chronic periodontitis. Etiology, classification, clinical features Chronis periodontitis classifications
* Periodontitis periapicalis **chronica** **granulomatosa** **diffuse** (**sin**/**cum** **fistulae**) * Periodontitis periapicalis chronica **granulomatosa** **localisata** * Periodontitis periapicalis chronica **fibrosa** * Periodontitis **chronica** **exacerba**
160
# 20. Chronic periodontitis. Etiology, classification, clinical features Characteristics of Chronic periodontitis
* Can occur w/ **low virulence mo** and **good immune status** * **Long course**-months/years * **Proliferation**->Blood vessels+tissues * **Fibrosis** of connective tissue
161
# 20. Chronic periodontitis. Etiology, classification, clinical features Periodontitis periapicalis chronica granulomatosa (sin/cum fistula) characteristics | Chronic granulating periapical periodontitis
* **Chronic purulent proliferative** process in bone * Bone **resorption** * **No** subjective complaints/pain * **Fistula** that may be located away from causative tooth * **Acute exacerbations** may occur- **painful, edema** and **hyperaemia**
162
# 20. Chronic periodontitis. Etiology, classification, clinical features Treatment of Periodontitis periapicalis chronica granulomatosa (sin/cum fistula) | Chronic granulating periapical periodontitis
* Endo * Tooth extraction * Resection of root tip * Hemisection * Anti-inflammatory treatment-osteotrophic drugs ##Footnote -Osteotrophic drugs=>modify bone metabolism by inhibiting bone resorption or stimulating bone formation=> -Bisphosphonates(inhibit bone breakdown) -RANKL inhibitors(Denosumab) -Parathyroid hormone analogues(bone formation stimulators)
163
# 20. Chronic periodontitis. Etiology, classification, clinical features Periodontitis periapicalis chronica granulomatosa localisata characteristics ## Footnote Chronic periapical granulomatous localisaed periodontitis
* **Necrosis** and **bone destruction** replaced by **granulation tissue=>** * Granulation tissue formation followed by **fibrosis** w/ proper treatment and optimal response=> * Becomes **granuloma** w/ **inadequate** treatment or poor response
164
# 20. Chronic periodontitis. Etiology, classification, clinical features Granulation tissue cells
* Well vascularised and rich in cells * Fibroblasts * Endothelial cells * Plasma cells * Mast cells
165
# 20. Chronic periodontitis. Etiology, classification, clinical features Granuloma characteristics
* **Chronic inflammatory response**=> Granulation tissue rich in **cells** and **blood vessels** * **Connective tissue capsule=>**limits penetration of infection
166
# 20. Chronic periodontitis. Etiology, classification, clinical features Types of Granuloma according to their histology
* **Common** Granuloma/granuloma simplex * **Epithelialising** granuloma * **Cystic** granuloma/Granuloma cycsticum
167
# 20. Chronic periodontitis. Etiology, classification, clinical features Treatment of granuloma
* Extraction * Endo * Surgical removal of granuloma * Hemisection of roots * Less common-reimplantation and autotransplantation of root
168
# 20. Chronic periodontitis. Etiology, classification, clinical features Periodontitis periapicalis chronica fibrosa characteristics
* **Following** **endo** treatment * Granulation tissue **replaced** w/ fibrous tissue * **Reduction** in cells and vessels- w/exception of **fibroblasts** * Fibrous tissue **replaced** w/ **bone** after some months ## Footnote Healing phase of acute and chronic periodontitis
169
# 20. Chronic periodontitis. Etiology, classification, clinical features Treatment of chronic periodontitis
* **Extraction**-Followed by **removal /curettage** of pathologically altered tissue/granuloma * **Endo-rare** * **Surgical** methods
170
# 20. Chronic periodontitis. Etiology, classification, clinical features Surgical methods of treatment of Chronic Periodontitis
* Apical osteotomy * Hemisection * Amputation * Reimplantation * Autotransplantation * Coronory radicular seperation
171
# 21. Periostitis of the jaws and facial bones. Etiology, pathogenesis Different classifications of periostitis of the jaws and facial bones
* Classification according to=> * **Degree** of Pathogenic Bacteria Involvement * **Nature of Exudative Discharge** * **Severity** of the Process * **Form** of the Disease * **Inflammatory extent**
172
# 21. Periostitis of the jaws and facial bones. Etiology, pathogenesis Etiology of periostitis
* **Inflammatory** Periostitis * **Toxic** Periostitis=>infectious agents enter through bloodstream, related to systemic diseases * **Traumatic** Periostitis=>infection entering due to injury * **Specific** Periostitis=>diseases like actinomycosis and tuberculosis * **Allergic** and **Rheumatic** Periostitis
173
# 21. Periostitis of the jaws and facial bones. Etiology, pathogenesis Pathogenesis of periostitis
* **Purulent foci** from previous diseases empty through **tooth canals, fistulas, or gingival pockets=>** * **Outflow blocked=>**purulent exudate spreads from periodontal tissues to the **periosteal plate** * Exudate accumulates between the **jawbone and periosteum=>** * Inflammatory process
174
# 21. Periostitis of the jaws and facial bones. Etiology, pathogenesis Treatment approaches for chronic periostitis
* **Removal** of the causative tooth * **Physiotherapy** procedures * **Laser therapy** w/ infrared and helium-neon rays * **Surgical removal of ossified sites** if other treatments are ineffective
175
# 21. Periostitis of the jaws and facial bones. Etiology, pathogenesis Acute periostitis general treatments
* **Endodontic therapy=>** * Allow **exudate** (fluid) to flow out from affected area * **Surgery**=>To **drain** the abscess=> * **Periostotomy** * **Conservative Treatment=>**Antibiotics * Causative tooth **extracted**
176
# 22. Odontogenic cysts of the jaws. Classification, etiology, pathog Types of odontogenic cysts
- Radicular - Eruption - Residual - Lateral periodontal cyst - Dentigerous - Odontogenic keratocyst - Gingival cyst
177
# 22. Odontogenic cysts of the jaws. Classification, etiology, pathog Radicular cyst
- **Most common** jaw cyst - Develop from **periapical granuloma** from remnants of pulp→chronic inflammation stimulates **cell rests of malassez**→Epithelial proliferation→phase of development and growth - **Fluid filled**(expand in jaw by osmotic pressure) - Cytokines cause local resorption of bone ## Footnote - Firm swelling at apex of tooth
178
# 22. Odontogenic cysts of the jaws. Classification, etiology, pathog Treatment methods for Radicular cysts
- Root filling - Extraction - Enucleation for large cysts - Curetting cyst lining - Apicectomy ## Footnote **Enucleation**=>complete surgical removal of a cystic lesion together w/ its epithelial lining **Marsupialisation** is a surgical procedure where cyst opened and lining sutured to oral mucosa creating permanent opening=> continuous drainage and decompression=>cyst shrinks gradually and fills w/ bone over time.
179
# 22. Odontogenic cysts of the jaws. Classification, etiology, pathog Residual cyst
- From **residual periapical infection** - Cyst fragments from **extraction of non vital tooth** - Similar features to radicular cysts
180
# 22. Odontogenic cysts of the jaws. Classification, etiology, pathog Residual cyst treatment
Enucleation or **Marsupialisation** ## Footnote **Enucleation**=>complete surgical removal of a cystic lesion together w/ its epithelial lining **Marsupialisation** is a surgical procedure where cyst opened and lining sutured to oral mucosa creating permanent opening=> continuous drainage and decompression=>cyst shrinks gradually and fills w/ bone over time.
181
# 22. Odontogenic cysts of the jaws. Classification, etiology, pathog Lateral periodontal cysts
- Arise from **cell rests within PDL** - Adjacent teeth vital - Asymptomatic ## Footnote - **Between roots** of teeth - Mandibular canine and premolar area
182
# 22. Odontogenic cysts of the jaws. Classification, etiology, pathog Lateral periodontal cysts treatment
- Enucleation - Extraction somtimes ## Footnote **Enucleation**=>complete surgical removal of a cystic lesion together w/ its epithelial lining
183
# 22. Odontogenic cysts of the jaws. Classification, etiology, pathog Dentigerous cysts
- **Asymptomatic** swelling - Expansion of **dental follicle**=>may affect eruption and displace teeth - Attached to crown at **CEJ** * Mandibular third molar and maxillary canine
184
# 22. Odontogenic cysts of the jaws. Classification, etiology, pathog Dentigerous cyst treatment
- Definitive surgery - Enucleation - Treatment of cavity - carnoys solution(kills residual cells in bony spaces) - Removal of overlying mucosa(removal of overlying dental lamina rests) ## Footnote **Enucleation**=>complete surgical removal of a cystic lesion together w/ its epithelial lining
185
# 22. Odontogenic cysts of the jaws. Classification, etiology, pathog Calcifying epithelial odontogenic cyst
- **Rare** - **Interosseous** or in **gingiva** - **Benign** but can become **aggressive** and **recur**
186
# 22. Odontogenic cysts of the jaws. Classification, etiology, pathog Calcifying epithelial odontogenic cyst treatment
-Enucleation and curettage ## Footnote **Enucleation**=>complete surgical removal of a cystic lesion together w/ its epithelial lining
187
# 23. Nonodontogenic cysts of the jaws. Classification, etiology Types of non-odontogenic cysts
- Globulomaxillary cyst - Median mandibular cyst - Nasopalatine cysts - Stafne/static bone cyst - Aneurysmal bone cyst - Solitary bone cyst
188
# 23. Nonodontogenic cysts of the jaws. Classification, etiology
189
# 24. Cysts of soft tissues in the maxillofacial region. Classification Soft tissue cyst types
* Nasolabial cysts * Sublingual dermoid cysts * Branchial lymphoepithelial cysts * Thyroglossal cysts
190
# 35. Phlegmon of the floor of the mouth. Angina von Ludvic. Topographic Ludwig's Angina and its anatomical locations
* **Severe**, **rapidly** progressing **cellulitis**=> * Involves the **submandibular**, **sublingual**, and **submental** spaces **bilaterally**
191
# 35. Phlegmon of the floor of the mouth. Angina von Ludvic. Topographic Treatment protocol for Ludwig's Angina
* **Surgical** intervention * **Drainage** of the infected spaces=> * Rubber drains=>least three days until clinical symptoms resolve * **Antibiotics** ## Footnote IV Ampicillin–Sulbactam IV Penicillin G + Metronidazole If allergy=>IV Clindamycin
192
# 35. Phlegmon of the floor of the mouth. Angina von Ludvic. Topographic Complications from untreated Ludwig's Angina
* Fatality within **12 to 24 hours=>asphyxia** * **Spread** of infection to other spaces * **Septicemia**/**septic** **shock**
193
# 36. Abscess of hard palate. Abscess and phlegmon of the tongue Anatomical boundaries of hard palate abscess
* Superior Boundary=>Palatal mucosa * Inferior Boundary=> Alveolar bone * Intermediate Boundary=>Palatal bone
194
# 36. Abscess of hard palate. Abscess and phlegmon of the tongue Common etiological factors for hard palate abscess
* Infection from **Maxillary Teeth=>**those with roots pointing in the palatal direction=> * First molar **palatal root** Infection Perforates=>palatal alveolar bone=> * pus accumulation beneath palatal mucoperiosteum * **Lateral incisors** * **First premolars (which have two roots).**
195
# 36. Abscess of hard palate. Abscess and phlegmon of the tongue Clinical features of a hard palate abscess
* **Pus** accumulation=> * **No** **expansion** due to the **strong** **mucoperiosteum** connected to the underlying bone=> * Small, Firm, non-fluctuant swelling
196
# 36. Abscess of hard palate. Abscess and phlegmon of the tongue Clinical features of an abscess of the tongue
* **Painful** swelling=> * **Protrusion** of the tongue * **Dysphagia** (difficulty swallowing) and **odynophagia** (painful swallowing) * **Dysphonia** (difficulty speaking)
197
# 36. Abscess of hard palate. Abscess and phlegmon of the tongue Complications associated with an abscess of the tongue
* Swelling=>Airway compromise * Spread to other regions
198
# 36. Abscess of hard palate. Abscess and phlegmon of the tongue Treatment protocol for a tongue abscess
* Antimicrobial Therapy=>**antibiotics** * Surgical Intervention=>**Incision and drainage** without delay
199
# 37. Necrotizing fasciitis. Etiology, clinical features, diagnosis, Necrotizing fasciitis
* **Rapidly** spreading infection=> * **Necrosis** of **subcutaneous** **tissue**=> * **Severe** tissue damage
200
# 37. Necrotizing fasciitis. Etiology, clinical features, diagnosis, Clinical features of necrotizing fasciitis
* **Severe** **pain**=>**disproportionate** to appearance * Rapidly **spreading** inflammation * **Necrosis** of subcutaneous tissue * **flu-like** symptoms * **Skin changes**=>blisters, bullae, or darkened skin patches * Crepitus ## Footnote Crepitus- (a crackling sensation under the skin) due to gas production by bacteria
201
# 37. Necrotizing fasciitis. Etiology, clinical features, diagnosis, Treatment for necrotizing fasciitis
* **Surgical** **intervention**=>Immediate and aggressive **surgical** **debridement** (removal) of necrotic tissue * **Antibiotic** **therapy**=>Broad-spectrum
202
# 38. Diseases Of The Lymph Nodes And Vessels Classifications of Lymph node diseases
- **Inflammatory**=>**non specific** (acute/chronic)/**specific** - **Other forms of lymphadenitis**→infectious diseases * **Tumour diseases**
203
# 38. Diseases Of The Lymph Nodes And Vessels Lymphadenitis
Secondary inflammatory infection of **lymph** **nodes**← Periostitis, osteomyelitis
204
# 38. Diseases Of The Lymph Nodes And Vessels Lymphangitis
- Secondary inflammatory condition of **lymph** **vessels** - Primary form in case of trauma
205
# 38. Diseases Of The Lymph Nodes And Vessels Infections that may cause **lymphadenitis and lymphangitis**
- Acute or exacerbated periodontitis - Radicular cyst - Alveolitis - Maxillary abscesses and phlegmons - Acute periostitis - Osteomyelitis of the jaw
206
# 38. Diseases Of The Lymph Nodes And Vessels Treatment of lymphadenitis
- Removal or primary cause - Incision in purulent forms→ Drainage - Removing destroyed/damaging nodes - Medication→ Antibiotics/anti-inflammatory
207
Osteomyelitis definition
- Infection in **bone** **marrow** - More common in **mandible** due to **less** **profuse** blood supply and **cortical** **plate** **density** - **Odontogenic** infection cause
208
Clinical presentation of osteomyelitis
- Deep pain - Edema - Associated teeth tender to percussion and may be loose - Regional lymphadenitis - Altered sensation in lower lip(IAN) - Thrombosis of vessels→ Necrosis of bone
209
Types of Osteomyelitis
- Acute - Subacute - Chronic
210
Management of Osteomyelitis
- Culture and sensitivity testing→ Antibiotic therapy - Drainage and debridement - Removal of infection source - Resection and reconstruction of affected bone
211
# 38. Diseases Of The Lymph Nodes And Vessels Sinusitis of odontogenic origin
* **Inflammation** of the paranasal sinuses => * **Dental** infections=> * Due to its proximity to the **upper** **teeth**
212
# 38. Diseases Of The Lymph Nodes And Vessels Clinical features of acute odontogenic sinusitis
* Dull or intense **pressure-like pain**=> * Erythema, swelling of the **cheek** and **anterior** **maxilla** * **Full like symptoms** * **Postnasal drip**, nasal congestion * **Tooth** **ache**=> If periapical cause ## Footnote Post nassal drip-drainage of foul-smelling mucopurulent material into the nasal cavity and nasopharynx
213
# 38. Diseases Of The Lymph Nodes And Vessels Symptoms of chronic odontogenic sinusitis
* **Little** or **no** systemic upset * Persistent **malodor** * **Pus** discharge from oroantral fistula, * **Nasal congestion**=>discharge * **Toothache** during chewing=> * Increased **mobility** of teeth * Some cases may be symptom-free
214
# 38. Diseases Of The Lymph Nodes And Vessels Treatment for acute odontogenic sinusitis
* Antimicrobial Therapy * Analgesics and antihistamines=>Pain Relief and Edema Reduction * Drainage: To reduce pain, prevent progression * Dental Procedures=>Early extraction or endodontic treatment * Nasal Treatment * Sinus Endoscopy ## Footnote -Antimicrobials-penicillin, clindamycin, and metronidazole -Nasal Treatment: Insertion of gauze with ephedrine and lidocaine into the nasal mucosa to relieve congestion and promote pus drainage. -Sinus Endoscopy enlarge and drain channels if necessary
215
# 38. Diseases Of The Lymph Nodes And Vessels Surgical treatments for odontogenic sinusitis
* Caldwell-Luc Procedure * Endoscopic Surgery
216
# 38. Diseases Of The Lymph Nodes And Vessels Caldwell-Luc Procedure
* **Removal of the antral lining** and creation of a **new drainage opening**=> * Allows **inspection** and **removal** of abnormal tissue or foreign bodies * Disadvantage=>Increased recovery time * Blood loss, postoperative pain * Facial swelling, and potential recurrence due to sinus scarring
217
# 38. Diseases Of The Lymph Nodes And Vessels Sinus walls
- Upper wall (facies orbitalis) - Lower wall (facies alveolaris) - Posterior wall (facies dorsalis) - Front wall (facies anterior) - Medial wall (facies nasalis) - Lateral wall (facies lateralis)
218
# 38. Diseases Of The Lymph Nodes And Vessels Membrane of the maxillary sinus
Schneiderian membrane→ covered by pseudo - stratified columnar ciliated epithelium
219
# 38. Diseases Of The Lymph Nodes And Vessels Vascularisation of Maxillary sinus
- Posterior superior alveolar artery - Greater palatine artery - Infraorbital artery - Posterior lateral nasal artery
220
# 38. Diseases Of The Lymph Nodes And Vessels Innervation of maxillary sinus
Posterior, middle and anterior superior alveolar nerves
221
# 44.complications Of Odontogenic Inflammatory Diseases Causes of sepsis in the context of odontogenic inflammatory diseases
* odontogenic infections=> * Toxic condition resulting from the systemic inflammatory response
222
# 44.complications Of Odontogenic Inflammatory Diseases How sepsis diagnosed in adults
* **Infection** and two or more of the following **SIRS (Systemic Inflammatory Response Syndrome)** criteria met=> * Temperature **>38°C or <36°C.** * Heart rate **>90 beats/min**. * Respiratory rate **>20 breaths/min or PaCO2 <32 mmHg** * Leukocyte count **>12,000 cells/µl, <4,000 cells/µl**
223
# 44.complications Of Odontogenic Inflammatory Diseases Mediastinitis and how it arises from maxillofacial infections
* Inflammation of the mediastinum=> * Infections through pretracheal fascia, lateral pharyngeal space, and/or retropharyngeal spaces ## Footnote mediastinum=>the area between the pleural cavities.
224
# 44.complications Of Odontogenic Inflammatory Diseases Clinical features of mediastinitis
* Fever, chills * Shortness of breath, chest pain * Dyspnea, and dysphagia
225
# 51. Mikulich Syndrome. Sjorgen Syndrome Primary Sjögren's syndrome (pSS)
* **Autoimmune** disorder=> * Immune system mistakenly attacking body's moisture-producing glands=> * Dry eyes and mouth ## Footnote -Typically occurs around age 40. -Sex: More common in women. -Rheumatic Disease: Higher risk if the individual has rheumatoid arthritis or lupus.
226
# 51. Mikulich Syndrome. Sjorgen Syndrome Distinguishes secondary Sjögren's syndrome (sSS) from primary Sjögren's syndrome (pSS)
* Secondary Sjögren's syndrome (sSS) occurs w/ **another rheumatic disease=>** * Systemic Lupus Erythematosus (SLE) * Rheumatoid Arthritis * Systemic Sclerosis
227
# 51. Mikulich Syndrome. Sjorgen Syndrome Treatment options for Sjögren's syndrome
* **Medications**=>> Prescription eyedrops like cyclosporine (Restasis) * **Saliva Production**: Drugs such as pilocarpine (Salagen)=> * Increase saliva and tears. * **NSAIDs** =>arthritis * **Antifungal medications** => yeast infections in the mouth * **Surgery**=>Punctal Occlusion=> * Seal tear ducts with collagen or silicone plugs to preserve tears
228
# 51. Mikulich Syndrome. Sjorgen Syndrome Mikulicz Syndrome
* **painless, symmetrical swelling of the major salivary gland**s (parotid, submandibular, and sublingual) and lacrimal glands. * Part of => benign lymphoepithelial lesions (BLL). ## Footnote -Benign lymphoepithelial lesions (BLL)=> focal collections of lymphocytes that gradually form follicles, resembling mucosa-associated lymphoid tissue (MALT). These lesions are typically found in the major salivary and lacrimal glands.
Oral surgery
flashcards
Decks in class (114)
# Cards
Brainscape helps you reach your goals faster, through stronger study habits.
© 2026 Bold Learning Solutions. Terms and Conditions