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26 Cards in this Set
- Front
- Back
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Problems associated with Cleft Palate
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Speaking
Suckling Scarring Growing |
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Cleft Epidemiology
M:F Cleft lip & palate |
1:2,000, 2:1 M:F
1:800 Cleft & palate 2:1 M:F cleft lip |
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Etiology
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Failure of frontonasal process and maxillary process to fuse
Fusion: when they come together properly Mergence: When they join together |
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Types of Clefts
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Incomplete--doesn't go to nose
Complete Unilateral--goes to nose Complete cleft of lip and palate unilateral Submucosal--fusion is successful, and mergence isn't |
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Procedure to close lip
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Mallard Procedure
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Areas where minor salivary glands DON'T exist
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Anterior hard palate
Attached Gingiva Dorsal surface of anterior 1/3 of the tongue |
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Major Salivary Glands
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Parotid--largest, serrous. Stendon's Duct
Submandibular--mixed mucous and serrous. Wharton's duct Sublingual--Mucous secreting. Bartholin's duct |
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Salivary gland imaging
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Panorex
Occlusal "buccal soft tissue' Sialography C-T MRI |
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Symptoms: Pain, especially when beginning a meal.
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Sialolithiasis.
M>W, 30-50 year olds common Submandibular 85% Parotid 10% Sublingual 5% Minor Rare |
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Most often occurs in association with minor salivary glands.
Extravasation of mucous and formation of mucocoele or pseudocyst In association with sublingual gland-->ranula |
Mucous Retention Phenomenon
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Infections of Salivary Glands
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Associated with obstructions-->submandibular gland most common
If parotid, seen in association with debilitated pt. Antibiotics, I&D, supportive therapy If viral (parotid mumps) bilateral parotid swelling, fever, chills, headaches |
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Vascular infarct of minor salivary glands
Hard palate, large ragged ulcers, can be painful Appears similar to mucoepidermoid carcinoma or ssc histologically and clinically-->may require referral to rule out Heals in 6-10 weeks |
Necrotizing Sialometaplasia
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Multisystem disease found primarily in females. Primary (sicca) involves eyes and mouth. Secondary symptoms of rheurmatoid arthritis and other connective tissue disorders.
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Sjogren's Syndrome.
Occurs as lymphocytic replacement of glandular tissue. Often diagnosed via minor salivary gland biopsy. |
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Indications for bone grafting
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Trauma
Alveolar cleft Orthognathic Surgery Implants Pre-prosthetic surgery Oral, facial, and craniofacial reconstructive surgery |
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Autogenous bone grafting sites
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Mandibular symphysis, ramus
Iliac Crest Tibia Rib Split Calvarium |
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Forms of autogenous bone grafts
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Cancellous
Cortical Cortico-cancellous |
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Cancellous bone grafts (autogenous)
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Osteoconductive (scaffold) and faster revascularization
Greatest concentration of osteogenic cells Small quantity of growth factors (osteoinductive) (-) Little initial structural support, but rapidly gained as bone grows |
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Cortical Bone Grafts
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Less biologically active than cancellous (longer time for revascularization)
Provides more structural support (good for long span defects) |
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Graft Healing Mechanisms
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Hematoma--cytokines and growth factors
Inflammation--develop fibrovascular tissue Vascular Ingrowth--Extends haversian canals Focal osteoclastic resorption of graft Intramembranous or endochondral growth at graft surfaces |
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Autogenous Graft Disadvantages
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Limited availability
Postop pain at operative site Postop hematoma Infection at op site Potential injury to superior gluteal artery (hip) Gait disturbance (hip) Injury to lateral femoral cutaneous nerve (hip) |
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Allografts are:
A) osteoinductive B) osteogenic |
Osteoinductive--when the graft is freeze dried, cell viability and protein antigenicity is destroyed leaving only the matrix
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Bone Graft Substitutes
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Calcium phosphate
Calcium sulfate Collagen based matrices Demineralized bone matrix Hydroxyapatite Tricalcium phoshpate Osteoinductive proteins |
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Indicatioins for Biopsy
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Lesion persisting >2 weeks with no etiologic basis
Inflammatory lesion >10-14 days Persistent hyperkeratosis changes Persistent swelling beneath healthy tissue Lesion interfering with local function Bone lesion not specifically id in radiograph Lesions with characteristics of malignancy |
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Excisional Biopsy
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total excision of a small lesion (<1 cm)
Removal of entire lesion Perimeter of normal tissue surrounding lesion removed as well |
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Indication for Aspiration Biopsy
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Lesions thought to contain fluid, or intraosseous lesion before surgical exploration
Fluctuant mass in soft tissues Radiolucency in the bone of the jaw to rule out vascular lesion which could cause life threatening hemorrhage |
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Intraosseous and Hard Tissue Biopsy
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intra-osseous lesion that fails to respond to routine treatment of the dentition
Intraosseous lesion that appears unrelated to the dentition |
