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81 Cards in this Set
- Front
- Back
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Definition: loculated fluid in or under the epithelium of skin or mucosa; a large blister
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bulla
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Definition: dried or clotted serum protein on the surface of skin or mujcosa
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crusts
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Definition: superficial ulcer
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erosion
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definition: circumscribed area of color change without elevation (like a freckle)
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macule
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definition: large palpable mass, elevated above the epithelial surface
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nodule
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definition: flat elevated lesion, the confluence of papules
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plaque
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definition: cloudy or white vesicle, the color of which results from the presence of PMNS (pus)
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pustule
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definition: macroscopic accumulation of keratin
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scale
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definition: loss of epithelium
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ulcer
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definition: small loculation of fluid in or under the epithelium; a small blister
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vesicle
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What is the term for a palpable pulsation of a lesion; and an audible pulsation
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thrill; bruit
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What are indications for biopsy?
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lesion for 2 weeks without a reason, inflammatory lesion that does not respond to treatment in 10-14 days, persistent changes in surface tissues, and persistent tumescence (swollen)
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What are the indications for a excisional biopsy?
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lesion is less than 1 cm in diameter; small vascular and pigmented lesions; any lesion that can be removed without mutilating the pt
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How much healthy tissue should you get in biopsy?
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2-3 mm if lesion looks benign, 5 mm if it looks bad
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What do you have to be aware of when giving local anesthesia for biopsy?
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give it atleast 1 cm away from tissue because the hydrostatic pressure can alter the appearance under a microscope
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What is the ratio of the length of biopsy to the width?
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2:1
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How should a soft tissue biopsy be handled?
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place in 4% formalin in 20x the volume of the specimen
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What are some disadvantages of enucleation?
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may jeopardize adjacent teeth or impacted teeth that need to be retained; may lead to jaw fracture
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How long does bone fill take in enucleation?
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6-12 months
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In enucleation, is the crest of the ridge included in forming your osseus window?
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no, it should be spared it at all possible
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What is the process in marsupialization?
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exposure of the cyst to the oral cavity, sinus, or nasal cavity to give access to the cyst and allow shrinkage and may be all that is necessary or performed before enucleation
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What are disadvantages of marsupialiazation?
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not obtaining histopathalogical diagnosis of ENTIRE lesion; pt inconvenience
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If a watertight closure cannot be obtained, what should be done?
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pack the area with iodiform gauze
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what are the indications for enucleation with curretage
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OKC or recurrence of any cyst that was thoroughly removed
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how much bone is removed with curretage
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1-2 mm with a large round or acrylic bur
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What are some factors influencing the choice of surgical procedures
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aggressiveness, location, maxilla vs mandible, proximity to adjacent structures, size, intrasseous vs extraosseous, duration, reconstructive efforts
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What are some tumors/cysts that indicate marginal/partial resection
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ameloblastomas, CEOC (pindborg tumors), myxomas, squamous odontogenic tumors, ameloblastic odontoma
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How far away from lesion should your margin be on resection?
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1 cm of bone beyond the radiographic margins
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What is T1, T2 and T3 staging
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T1- 2 cm or less
T2>2cm, <4cm T3 >4cm |
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What N0 - N3 staging
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N0- no nodal involvement, N1- homolateral involvement, N2- contra or bilateral nodal involvement, N3- fixed nodal involvement and mets suspected
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What is M0 and M1 staging
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M0 no mets M1- evidence of mets beyond cervical nodes
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What is characterized as stage 1 TNM
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only T1
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What is characterized as stage 2 TNM
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only T2
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What is characterized as stage 3 TNM
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T1, 2, or 3 with only N1
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What is characterized as stage 4 TNM
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T1, 2, or 3 with only N2 or N3 or any T and N with M1
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What is the 5 yr survival of Stage 4
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10-15%
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Who is involved in the treatment of the cancer pt
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surgeons, radiotherapists, chemotherapist, general dentists, prosthodontists, nutritionists, speech pathologist, psychiatrist, social worker
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If the crown and root are both fractured, the tooth should be extracted immediately to reduce trauma. T/F
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False. allow healing to prevent undue loss of bone
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What dental trauma has the worst prognosis after avulsion?
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intrusion
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How long should an intruded tooth be splinted
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2-3 months, endo may be necessary with closed apex
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How long should an extruded tooth be splinted
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1-3 weeks, endo often necessary
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lateral displacement of the tooth only is treated differently than displacement with the alveolar plate how?
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when the alveolar plate is displaced as well, reduce tooth and splint rigidly for 6-8 week and observe
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When should endo begin on a fully formed tooth whose apex has been moved
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2 weeks; fill with barium sulfate and change every 3 months
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How long should an alveolar fracture be splinted
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4-6 weeks
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How do you suture a laceration?
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inside tissues first, then outside
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What are the most commonly impacted maxillary teeth after 3rd molars
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canines
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what are the most commonly impacted mandibular teeth after 3rd molars
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premolars
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What is the second most common angulation of 3rd molars in the maxilla
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distoangular
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what is the second most common angulation of 3rd molars in the mandible
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vertical
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what is the most common angulation of 3rd molars in the mandible
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mesioangular
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what is the 3rd most common angulation of 3rd molars in the maxilla
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mesioangular
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what would a Pell and gregory class I A molar look like
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entire tooth in front of the anterior ramus and fully erupted into the occlusal plane
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what would a Pell and Gregory class II B molar look like
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about half the tooth in front of the ramus and partially erupted or almost in occlusion
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what would a Pell and Gregory class III C molar look like
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tooth completely behind the ramus and unerupted/completely out of occlusion
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what factors make impaction surgery less difficult?
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mesioangular position, Class IA, roots incompletely formed and fused, wide PDL, large follicle, elastic bone, space from second molar and IA canal, only soft tissue impaction (many of these are in the young pt)
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what factors make impaction surgery more difficult?
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distoangular, Class 3C, long thin divergent roots, narrow PDL, thin follicle, dense bone, contact with second molar and/or IA canal, complete bone impaction
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If you use a release on your flap in an impaction surgery where should it be placed?
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at least 1 tooth anterior to surgical site
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what handpiece requirements do you want for OS
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high speed, high torque, rear exhaust
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Where do you remove bone in impaction surgery
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Mandible- occlusal and buccal down to CEJ; Maxilla- usually buccal only and with hand instruments
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When sectioning a tooth from buccal to lingual you go all the way through?
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no. go 3/4 and break rest with elevator
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What instruments are commonly used in mandibular impaction surgery?
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301/34S, cryers and crane pick
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What instruments are commonly used in maxillary impaction surgery?
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301/34S, Potts, Milllers
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What could occur if epithelial remnants are not removed in extracting 3rds
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can transform cyst or SSC
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If a mandibular molar is horizontally angled and its roots curve toward each other, which root do you remove first after sectioning?
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the lower one because you have to follow the curvature
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What can you do if you can't extract a tooth after sectioning?
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section more or make your hole bigger
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What factors can influence bone resorption?
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nutrition, bone disease (osteoporosis), endocrine disorders, systemic conditions affecting bone metabolism, dentures, overzealous alveoplasty
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Which is first, bony procedures or soft tissue?
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bony, then soft tissue
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What materials could be used for a sinus lift?
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autogenous, freeze dried demineralized bone, bio-Oss natural bovine cancellous bone mineral, bone putty, and platelet rich plasma
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Where is the incision made in the Clark vestibuloplasty
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It is made on the ridge and placed at the depth of the vestibule, periosteum left attached
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Where is the incision made in the Kazanjian vestibuloplasty
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on the lip and placed at the depth of the vestibule
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Where is the incision made on a transpositional vestibuloplasty
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on the lip and placed in vestibule, however, periosteum is removed and placed over the lip to replace that tissue.
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What is the submucous vestibuloplasty
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blunt dissection of the vestibule
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What is battles sign
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palsy of CN #6 (abducens and lateral rectus of the eye) so their eye movement is restricted , usually unilateral
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where is the most common site of orbital fractures
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the floor
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what is the most common cause of facial fractures
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motor vehicle accidents
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what percentage of mandibular fxs are multiple
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50%
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what is the most common area of the mandible to fracture? the second?
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condyle; body
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What is different between favorable and unfavorable fractures
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favorable is when muscle holds pieces together, and unfavorable is when they dont
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How long are mandibular fractures splinted
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6-8 weeks, only 2-3 for condyles
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what are advantages of rigid fixation of mand fractures
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faster healing, less time in IMF
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what are disadvantages of rigid fixation of mand fractures
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more technique sensitive, greater exposure, more time in OR, more periosteal stripping
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