Reading...
Play button
Play button
Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
45 Cards in this Set
- Front
- Back
|
Retractors
|
Mirror
Hanehan retractor - One sided Seldin retractor - type of double sided hanehan Minnesota retractor |
|
|
Pharyngeal drape
|
4x4 or 3x3 gauce that acts as catcher's mitt mostly on palate & contacts tongue
|
|
|
Straight elevator uses & forces
|
Mobilize & remove tooth or root
Wedge Rotation Lever action |
|
|
Ideal axis of rotation using forceps
|
Apical third to mid root
|
|
|
Maxillary vs mandibular foreceps
|
Maxillary is straighter & mandibular is more bent
|
|
|
Maxillary foreceps 4
|
Upper universals for all single rooted maxillary teeth
#1 maxillary anterior forceps are better used for maxillary incisors & canines Molar bayonet forceps come in left and right set Root tip forceps with narrow beak that are used to remove broken maxillary molar roots & narrow premolars & lower incisors |
|
|
Mandibular forceps 3
|
Lower universal forceps used for single rooted mandibular teeth
Ash forceps for single rooted mandibular teeth. Must be careful b/c of great force. Cowhorn forceps for sqeeze, pump, figure of 8 on mandibular molars |
|
|
Rotation
|
Round root
Used on maxillary central incisor & possibly maxillary lateral after it is mobile. Lateral is primarily buccal & lingual due to distal curvature |
|
|
Rotation & buccal lingual luxation
|
Oval root
Maxillary canines Mandibular canines Mandibular premolars |
|
|
Buccal & Lingual luxation
|
Mandibular incisors - Thin oval
Maxillary first premolar Bifurcated Maxillary molars Mandibular molars |
|
|
Rongeur uses & function
|
Alveoplasty
Trim Soft tissue when appropriate Side cutting End cutting Side & end cutting (Blumenthal) |
|
|
Bone file use & function
|
Alveoplasty
Finger rest & pull stroke |
|
|
Alveoplasty considerations
|
Consider possible implant placement
Eliminate buccal-occlusal sharp edges & points Eliminate undercuts & irregularities for removable |
|
|
Suture materials
|
Nonresorbable
Silk Nylon Resorbable Gut - 5 days Chromic gut - 10-12 days Polyglycolic acid - up to 4 weeks Monifilament vs polyfilament (Braided) |
|
|
Suture needles types
|
Cutting - Triangle points to concave side
Reverse cutting triangle points to convex side Tapered - Round |
|
|
Extraction sequence 7+5+5+6+6
|
Medical history
Vital signs Examination Informed consent Local Anesthesia Test for local Pharyngeal drape Scalpel +/- Periosteal Elevator Dental elevator +/- Forcep Extraction How is patient Examine tooth Examine Socket Palpate alveolus Maybe compress socket for recontouring or hemostasis but not for implant or ortho cases. Alveoloplasty or gingival plasty if indicated Debride socket +/- Irrigate socket Suture if needed Wet gauze & wipe oral cavity Suction mouth Place gauze & tell pt to bite Post op instructions Prescriptions if needed Check hemostasis & change gauze Schedule post op visit Accurate chart entry |
|
|
Post op instructions
|
Medications
Hemostasis Rest/Recovery Ice pack Post anesthesia Nourishment Oral hygiene Danger signs Followup |
|
|
Indications for surgical extractions 9
|
Grossly decayed tooth or root
Large restorations Fractured tooth or root Multi-rooted tooth otherwise requiring excessive force Protect vital structures Severe hook Wide root divergence Hypercementosis Ankylosis |
|
|
Special considerations for surgical extractions
|
Flap design
Bone removal +/- Tooth sectioning +/- |
|
|
Principles of flap design & flap types
|
- Balance size for visibility & post op swelling & discomfort
- Base broader than free end to maintain blood supply - Vertical releasing incisions over bone, at line angle, & never cross canine eminence Envelope flap either through sulcular or envelope incision on edentulous alveolar crest. 1 vertical releasing incision for 3 corner flap or two vertical releasing incisions for 4 corner flap. Semilunar incision to avoid attached gingiva Trapezoidal incison at mucogingival junction Y flap on palate & pedicle flap |
|
|
Sectioning trifurcation
|
First split palatal root
Then split MB & DB roots |
|
|
Prenatal factors for impacted teeth 4
|
Hereditary
Malnutrition Syphilis TB |
|
|
Postpartum factors for impacted teeth 5
|
Rickets
TB Exanthematous diseases Diseases of jaws & tissues Endocrine disorders |
|
|
Impacted teeth associations 5
|
Cleidocranial dysostosis
Oxycephaly Progeria Achondroplasia Cleft palate |
|
|
Frequency of impaction 7
|
Mand 3rd
Max 3rd Max canine Mandibular bicuspid, canine Maxillary bicuspid Maxillary central Maxillary lateral |
|
|
Mandibular impaction axial relationship to second molar classification
|
I - Vertical 38
II - Mesioangular 43 III - Horizontal 3 IV - Distoangular 6 V - Buccoangular VI - Linguoangular VII - Inverted VIII - Unusual |
|
|
Maxillary impaction classification
|
Mesioangular impaction 12%
Vertical impaction 63% Distoangular impaction 25% |
|
|
Indications for 3rd molar removal 13
|
Infection - Pericoronitis, Deep space
Periodontal disease Caries Resorption of adjacent teeth Internal resorption Odontogenic cysts & tumors Pain of undetermined origin Jaw fracture Prosthodontic considerations Orthodontic considerations Unopposed tooth Prophylactic Pre-radiation |
|
|
Contraindications for 3rd molar removal 7
|
Middle of 3rd decade without pathology
Medically contraindicated Risk of damage to adjacent structures Needed for restoration Healthy & in function Needed for fracture stability Pt rejects treatment |
|
|
3rd molar removal complications
|
Anesthesia/Paresthesia
Damage to adjacent tooth Tissue trauma Fracture of mandible Fracture of tuberosity Oral-antral communication Displacement of tooth or root into sinus, infratemporal fossa, & submandibular area Infection Swelling Discomfort Bleeding Trismus Ecchymosis Hematoma Alveolar osteitis: Dry socket |
|
|
Post op medications
|
Analgesics
Antibiotics Corticosteroids |
|
|
Antibiotic Prophy guidelines 4 & 5
|
Prosthetic heart valves
Previous bacterial endocarditis Congenital heart malformation - Unrepaired cyanotic heart disease -Completely repaired CHD with prosthetic material during 1st 6 months - Repaired congenital heart disease with residual defects at site of prosthetic patch or device that inhibits endotheliation. Cardiac transplantation recipients with cardiac valvular disease Dental procedures that are likely to result in bacteremia - Extractions - PD - Intraligamentary injections - Cleanings when bleeding is likely - Endo beyond apex |
|
|
Oral dosages of antibiotic prophy
|
Given 30-60min before procedure
Good for up to 6 hrs Amoxicillin 2g Cephalexin 2g Clindamycin 600mg Azithromycin 500mg |
|
|
HTN categories
|
Mild-Moderate
Systolic <200 Diastolic <110 Severe Systolic >200 Diastolic >110 |
|
|
Fractures & treatment
|
If crown-root fracture goes more than 2mm sub-alveolar then extract
If root fracture at gingival third |
|
|
Concussion
|
Injury without loosening or displacement but sensitivity to percussion
|
|
|
Subluxation
|
Abnormal loosening but without displacement
|
|
|
Primary bleedings & treatment
|
Primary - Uncontrolled during surgery & up to 5 minutes after surgery.
Soft tissue capillary bleeding - suture & pack with gauze under pressure. Electrocautery but never in extraction sockets Bone arterial bleeding - Crush bone into site of bleeding & pack socket with gauze under pressure. Use hemostatic agents Arterial bleeding - ligation of artery, pressure, electrocautery. |
|
|
Secondary bleeding & treatment
|
Secondary - post extraction bleeding occuring hours after surgery. Due to immature clot formation, inadequate pressure or bleeding disorder.
Administer local with vasoconstrictor, remove old suture & clot. Pack with collaplug & resuture |
|
|
Hematoma & treatment
|
Due to effusion of blood into tissues resulting in tumor. Can be from posterior superior alveolar injection or extractions & alveoplasty.
Treat with ice packs for first 24 hrs followed by heat. Can aspirate if close to surface. *Same treatment for ecchymosis |
|
|
Maxillary tuberosity fracture
|
Generally occurs with maxillary third & lone standing second molars with pneumatized sinus
|
|
|
Dry socket mechanism, symptoms, treatment
|
Fibrinolysis of the clot
Etiology: Bacterial, spirochete organism is responsible for fibrinolysis Post extraction pain on 3rd to 4th day due to loss of clot and exposure of nerve endings Fetor-oris Pain radiating to ear Maintain wound hygiene by irrigating socket Apply analgesic & antiseptic dressings Oral analgesics Do not curett |
|
|
Small oral-sinus communication & Large openings, treatments
|
Small openings will generally heal uneventfully. Do not place gauze or packing in the extraction site.
Treat large openings with antibiotics, irrigations, buccal, palata, or tongue tissue flap. Gold foil closure, bone graft closure, & buccal fat pad graft. |
|
|
Dry socket mechanism, symptoms, treatment
|
Fibrinolysis of the clot
Etiology: Bacterial, spirochete organism is responsible for fibrinolysis Post extraction pain on 3rd to 4th day due to loss of clot and exposure of nerve endings Fetor-oris Pain radiating to ear Maintain wound hygiene by irrigating socket Apply analgesic & antiseptic dressings Oral analgesics Do not curett |
|
|
Small oral-sinus communication & Large openings, treatments
|
Small openings will generally heal uneventfully. Do not place gauze or packing in the extraction site.
Treat large openings with antibiotics, irrigations, buccal, palata, or tongue tissue flap. Gold foil closure, bone graft closure, & buccal fat pad graft. |
