W Ch 40

Question 1

Strand of material used to control bleeding, stabilize wound edges in proper position, protect wound, and aid in pt comfort

Answer 1

Suture

Question 2

Ideal suture has adequate _____ strength

This strength is the amount of strength the material will ___ _____ ____

Wound gains strength and suture loses strength

Answer 2

Tensile

Retain throughout healing

Question 3

Functions of sutures (6)

Answer 3

Close periodontal wounds and secure grafts

Maintain hemostasis (end bleeding)

Reduce posttx discomfort

Promote primary intention healing

Prevent bone exposure

Protect wound from debris and trauma

Question 4

Characteristics: (science class vs PE)
Biologic
Physical

Answer 4

Bio:
Sterile
Reabsorption
Minimal inflammatory reaction in tissue

Physical:
Tensile strength
Flexible
Plasticity (maintain shape)
Elasticity
Maneuver
Fluent through tissue w min trauma
Length and diameter

Question 5

What material type?

Animal origin- catgut and silk
Vegetal origin- cotton and linen

Vs

Developed to reduce tissue reactions and unpredictable absorption

Answer 5

Natural

Synthetic

Question 6

Natural absorbable: (absorbed in…)

Monofilamentous, derived from purified collagen of sheep/cattle and lasts about 8 days before degrading

Chromatic salts to delay enzyme resorption for 18 days

Answer 6

Plain gut

Chromic gut

Question 7

Synthetic resorbable sutures: (hydrolysis breakdown)

All these types begin with prefix

Answer 7

Poly

(Water makes you P!… Poly)

Question 8

If suture is non absorbable pt returns removal after

Answer 8

1 week

Question 9

Non absorbable

Natural (1)
Synthetic (5)

Answer 9

Silk - can cause inflammation

-Nylon
-All the polys (polyester, polypropylene, polytetrafluoroethylene
-Coated sutures (antibacterial agents)

Question 10

Number of strands :
-Typical of gut, nylon, PYFE and other synthetic sutures

-Typical of silk, nylon, polyglycolic, polyester, and other synthetics

Answer 10

Monofilament

Multifilament

Question 11

Most suture types used for perio flaps and closure?

What is used for extraction socket, bone grafting, free gingival grafting?

What is preferred for implant flap closure? If swelling and pain anticipated?

Answer 11

Gut, absorbable

Absorbable

Non absorbable

Question 12

Allows suture material and needle to act as one unit

Answer 12

Swayed end (eyeless)

Question 13

What is weakest part of body of swaged needle?

Answer 13

Swaged end

Question 14

Extends from tip to widest part of needle

Answer 14

Point

Question 15

2 opposing cutting edges for difficult to penetrate tissue like skin
Sharpest

Answer 15

Reverse

Question 16

3rd cutting edge on concave curve of needle

Answer 16

Conventional

Question 17

Most frequently used knot in dentistry

Easiest and most reliable

Answer 17

Square knot

Question 18

3 to 4 mm suture tail is left to assist in locating for removal

True or false

Answer 18

False 2-3mm tail

Question 19

Each stitch brought over a loop of preceding one

Forms series of loops on one side of incisor and stitches over incision

Used after alveolectomy (removing alveolar bone)

Answer 19

Blanket (Continuous)

Question 20

Stripes of interrupted sutures

One knot per incision

Answer 20

Interrupted

Question 21

Series of stitches tied at one or both ends

Can include sling, suspension , and blanket sutures

Answer 21

Continuous uninterrupted

Question 22

EnCIRCLES tooth for suspension and retention of a flap

Answer 22

Circumferential

Question 23

Flaps are both the lingual and facial sides

Joined by passing suture through each interdental area

Coverage accomplished by coapting papillae (edges not touching)

Answer 23

Interdental

Question 24

Flap is on one side facial or lingual and sutures pass through interdental papilla, around tooth, and into adjacent papilla

Suture adjusted two flap can be positioned for correct healing

Answer 24

Sling or Suspension

Question 25

Suture removal. How long after surgery? No longer than? Why?

Answer 25

7 days after surgery No longer than 14 days to prevent tissue infection

Question 26

Who requires a consult with cardiologist?

Answer 26

Pts with valvular heart disease

Question 27

Record! deviations in color, size, shape, adaption of flap or coaptation of healing

Question 28

If a suture is placed without a dressing what should the cotton tip be dipped in to aid in debris removal?

Answer 28

0.12% chlorhexidine mouth rinse or 3% peroxide

Question 29

Steps to suture removal

Answer 29

1. Check notes, locate sutures 2. Caution when removing dressing and tearing suture 3. When exposed remove debris by irrigation by water or chlorhexidine on cotton tip 4. Grasp end of suture above knot with pliers in non dominant hand and gently draw up, golf with slight tension (finger rest for control) 5. Scissors in dominant hand and insert blade just under knot 6. Gently pull suture out opposite of where it was cut7. Place on gauze 8. Count total removed 9*irrigate with water or antiseptic10 post removal instructions written and verbal 11.obeserve tissue and note any adverse reactions or bleeding

Question 30

Periodontal dressings are based on personal preference and judgment of clinician True or false

Answer 30

True

Question 31

Dressing needs to have a _____ surface to resist accumulation of biofilm Should adhere to self, teeth, tissues

Answer 31

Smooth

Question 32

Types of dressings (5)

Answer 32

Zinc oxide with Eugenol Chemical cured Visible light cured Collagen dressing Alternative material for periodontal dressing.

Question 33

Ex- Kirkland periodontal pack Advantages: Firm and heavy-support for tissues and flap Slow setting Produced in quantity and stored (frozen) in work sized pieces Disadvantages: Shape unpleasant taste Irritating, hypersensitive Rough hard and brittle. Encourages Biolfim retention

Answer 33

Zinc Oxide with Eugenol Dressing

Question 34

Ex- PerioCare- metal oxides and CoePak-zinc oxides (2 paste systems) Advantages: Pliable easy to place with light pressure Resists biofilm and debris Easy often comes off in 1 piece

Answer 34

Chemical Cured Dressing

Question 35

Advantages: Color is like gingiva compared to others, preferred for anteriors Easy removal, often in 1 piece

Answer 35

Visible Light Cure Dressing (VLC) Same light cure for composites and sealants

Question 36

Absorbable Decreased inflammation and reduces discomfort Special use in perio surgery (grand site on palate) Bullet shape for deep biopsy sites Can be placed on clean moist or bleeding wounds

Answer 36

Collagen Dressing

Question 37

Anti inflammatory and antioxidant properties Reduces edema Topical application Ex curcumin (turmeric) gel Not the norm, seasoning used often in diff culture

Answer 37

Alternative Material for Periodontal Dressing

Question 38

A well placed dressing locks _____ _____ and cannot be displaced

Answer 38

Mechanically Interdentally

Question 39

Epithelium begins to cover a wound in _____ days Complete healing _____ days

Answer 39

5-6 7-14

Question 40

If needed is dressing replaced in entirety or patched?

Answer 40

In entirety

Question 41

Smooth instrument can be inserted under the border and gentle pressure applied. This instrument material can be?

Answer 41

Plastic

Question 42

Pt can return to normal oral care after how many days? With what and how often should they rinse their mouth?

Answer 42

3-4 0.12% chlorhexidine twice daily during healing period

Question 43

Follow up visit should be rescheduled?

Answer 43

1-2 weeks

Question 44

Can the pt take aspirin post surgery?

Answer 44

NO. anticoagulant