Oral Surgery Second Semester Midterm

Front 1

When making an incision use __ grip and __ stroke

Back 1

pen grip
Firm continuous stroke

Front 2

#__ blade is curved and is the work horse of OS

Back 2

#12

Front 3

__ is the easiets and most commonly used flap

Back 3

Envelope

Front 4

FLAP DESIGN
1. Apex should __ than base
2. Lenght __ width
3. __ should be included in base
4. Base should/should not be __

Back 4

1. Never be wider
2.L no more than 2x width
3. Axial blood supply
4. Should not kink, twist, strech base

Front 5

__ is exposure of underlying bone-can be avoided by __ and ___

Back 5

Dehiscence
Closing w/o tension and gently handeling flaps edges

Front 6

Flap should be cut at __ angles

Back 6

oblique

Front 7

Inscision should be made w/ blade __ to tissue-why?

Back 7

Perpendicular-easier to close, less risk or necrosis, better cosmetic scar

Front 8

Incision should be placed over __ and in __ gingiva (usually around teeth) but sometimes in __ tissue when releasing

Back 8

Healthy bone
Attached gingiva
Sometimes unattached

Front 9

Flaps should be smaller or larger

Back 9

larger

Front 10

T/F Properly repaired long incisions heals slower than a short one

Back 10

False-heal at same rate

Front 11

Oblique releasing incision is placed where?

Back 11

1 tooth anterior to area of bone removal

Front 12

When handeling tissue: Avoid __ __ and __

Back 12

Extremes of temp
Aggressive retraction
Inadvertent injury to lips

Front 13

Only allow __ fluids to contact tissue

Back 13

Physiologic

Front 14

Advantages of proper hemostasis:

Back 14

Preserve pt's O2 carrying capacity
Decreased operating time
Avoid hematoma

Front 15

Steps in Pre-Operative Hemostasis

Back 15

History
Lab investigation
Case sleection

Front 16

Intra-operative hemostaisis:
Local infiltration at least __ min b4 surgery
__ wound if bleeding
Apply __ min of pressure for sm. vessle or __ min for lg

Back 16

7 minutes
Dab
20-30 sec
5-10 min

Front 17

Best way to control bleeding __

Back 17

Pressure

Front 18

__ may be soaked in trombin but __ cannot be but is bacteriocidal

Back 18

Gelfoam
Surgicel

Front 19

__=bovine collagen
__-mechancially stops bleeding by tamponade but can't be used where osseous integration is necessary
__-inactivates conversion of plaminogen to plasmin and is administered orally/IV

Back 19

Avitene
Bone Wax
Tranexamic acid

Front 20

Post-op hemostasis

Back 20

Head of bed elevated >30, avoid exercise, no spitting, avoid alcohol, apply heat for 1st 24 hrs

Front 21

Examples of URT flora
Ex. of Max/face flora
Nonmax/face flora

Back 21

URT: G+ cocci, H. influenzae, Staph. aureus
Max/Face: Staph, corynebact
Nonmax/face: E.coli, Klebsiella, Proteus, B. frag

Front 22

Heps:
__ spreads by fecal contamination
__ and __ by contact w/ any secretion __ by fecal contamination and blood routes

Back 22

A
B and D
C

Front 23

Hep B resists __

Back 23

Phenols, alcochols, ammonium compounds

Front 24

Don't treat pt's w/ HIV if CD4 is below

Back 24

200

Front 25

TB is resistant to __ and suceptable to __ sterilization

Back 25

Chemical
Heat, ethylene oxide gas, irradiation

Front 26

Autoclave is faster but may cause rust; __ is temp for __ minutes

Back 26

24 min at 121 degree

Front 27

__ are the spores tested for to monitor sterilization

Back 27

Bacillus stearothermophilus

Front 28

BLADES
#__ is strait and pointed
#__ is borad and curved
#__ is the workhorse and is curved and pointed

Back 28

#11
#10
#12

Front 29

#__ handel is the most commonly used

Back 29

#3

Front 30

Instruments used for elevating mucoperiosteum

Back 30

#1 or 9 Woodsen
#2 or 4 Molt

Front 31

Instruments for retracting Soft tissue

Back 31

Weider (sweetheart) Seldin, Minn., Austin

Front 32

Grasping soft tissue

Back 32

Adson, Gerald pickup, College pleir (locking cotton plier), Russin tissue , forceps Allis clamp

Front 33

Removing bone
__-combo of end and side cutting
__ and __ used for uni belvel ostetome
__-removes bone in pull stroke-not efficient for removing a lot of bone-irrigate afterwards
__-medium speed/high torque

Back 33

Blumenthal rongeurs
Chisels and mallet
Bone file
Brassler

Front 34

Sever PDL
__-small, easily broken/bent

Back 34

Periotome

Front 35

Removing soft tissue
__-removal of PA ST after extraction, systecomy

Back 35

PA curette

Front 36

2 types of suction

Back 36

Frazer tip and yankauer

Front 37

Describe the needle holder grasp for suturing

Back 37

Thumb and ring finger engage handle-index finger stabilize shank

Front 38

__ tyes of needes are used in OS for suturing

Back 38

Reverse cutting needles

Front 39

Cutting ST

Back 39

Iris scissors
Metzenbaum scissors

Front 40

Adding __ to the cryer potts or miller elevators will give you more force

Back 40

"T" or crossbar handle

Front 41

The __ side of the elevator is the working side and should be toward tooth

Back 41

concave

Front 42

The __ elevators are used to remove bone and roots, as are __ but after placemnt of purchase point using handpiece or bur

Back 42

Cryer
Crane Pick

Front 43

__ used to remove fracture root tips

Back 43

Root tip pick

Front 44

Forcep grasp for max teeth: __
Mand teeth=__

Back 44

Max: palm under handle
Mand: thumb around and under handle for grtr force

Front 45

__ grasp is in verticle direction, palm over top, thumb to side but can generate a lot of force so be careful

Back 45

English Forcep grasp

Front 46

__ is the maxillary "Universal" forceps, __ is where you should grasp

Back 46

#150
Grasps below CEJ

Front 47

__ forceps-beaks are more parallel, beaks don't tough w/ handles t/g unlide the regular verison; used for __ extractions

Back 47

#150 A-Max PM's

Front 48

#__ is used for max anterior teeth

Back 48

#1

Front 49

# __ has a paired left and righ for max molars and grasps at CEJ

Back 49

#53 L/R

Front 50

#__has paired left and right, beaks fid max molar roots

Back 50

#88 L/R

Front 51

#__ is the max 3rd molar forecps

Back 51

#210 S

Front 52

#__ is the bayonet-maxillary root forceps

Back 52

#65

Front 53

#__ and __ foreps are mandibular "Universial" with the A having more parallel beaks

Back 53

#151 and #151A

Front 54

In 150S and 151S-what does the S indicate?

Back 54

It is for primary teeth

Front 55

#__ is the mandibular molar forceps w/ beaks into furcs which is like the #__ aka cowhorn

Back 55

#17
#23

Front 56

#__ is for mand 3rds

Back 56

#222

Front 57

Indications for Special Technique include:

Back 57

Infection, pathology, trismus, trauma

Front 58

__ injection was develope to improve sucess rate and is a "true" nerve bock

Back 58

Gow-Gates

Front 59

Target area for gow gates=__
Name the 3 land marks:__
How long does mouth have to be open

Back 59

Neck of condyle below insertion of pterygoid
ML cusp of Max 2nd molar, intertragic notch, corner of mouth
1-2 minues

Front 60

Name 2 compliations of Gow-Gates

Back 60

Hematoma, trismus

Front 61

__ is the alternitive for mand block when opening is limited; T/F the sucess rate is high

Back 61

Aknosi
True

Front 62

T/F When doing and Akanosi you should hit a bony stop

Back 62

False-if you do may cause trauma

Front 63

Target area for akanosi=__
Landmarks=__

Back 63

Soft tissue medial to ramus-above foramen, below condyle
LM= mucogingival junciton of max 2nd or 3rd molar, max tuberosity

Front 64

Area of insertion for akinosi and technique

Back 64

Soft tissue overlying medial ramus-adjacent to tuberosity
Penetrate 25 mm, parallel to max occlusal plane in a posteriolateral direction

Front 65

Complications of Akinsoi

Back 65

Hematoma-lgr risk then with GG
Facial nerve paralysis
Trismus (rare)

Front 66

Name Category B anesthetics for pregnancy

Back 66

Lido, prilo, etido (LEP)

Front 67

Name Category C drugs for pregnancy (Better Avoid)

Back 67

Articaine, Bupivicaine, Mepivicane (BAM)

Front 68

__ works best for anesthetizing inflammed or abscessed tissue due to __
what is the max dose

Back 68

2 car in juvenile

Front 69

Max dose:
Epi in heathly
Epi in cardiac
Levonor in healthy
Levonor in cardiac

Back 69

Epi-healthy 200 mcg
Epi cardiac 40 mcg
Lec-healthy 10000mcg
Lev-cardiac 200 mcg

Front 70

Name some thing you should evaluate (regarding teeth) before you extract

Back 70

TMJ dysfuntion, mobility of tooth, condiiton of crown, relationship of assoc. vital sutures, configuration of roots, surrounding bone

Front 71

Extraction in max. left quadrant-turn pts head toward __

Back 71

operator

Front 72

Mand extractions: pt should be __ and occlusal plane should be __

Back 72

More upright
Parallel to floor

Front 73

Ant. mand teeth: pt should look __

Back 73

straight ahead

Front 74

Mand posterior teeth: pt head turned __, use __ grasp, for mand right post teeth stand __

Back 74

toward operator, overhand grasp
Stand slighly behind pt

Front 75

Purchase point is designed to pick tooth out but _ is a risk

Back 75

excessive force=pressure necrosis

Front 76

__-placed apically and expand bone and force tooth occlusally-do this by walking #__ all the way around to get good bone expansion

Back 76

Wedge
#301

Front 77

__ are example of wheel and axle machine-engage root and remove it

Back 77

Cryer, potts, miller

Front 78

3 ways to begin extraction

Back 78

Elevaton, Wedge, wheel-and axle

Front 79

When using bite block the small is usually fine but use large when?

Back 79

Edentulous

Front 80

Names some reasions you want to detach gingival attachments

Back 80

Ensure anesthesia, allows more apical position of elevator, dec. tearing of tissue, dec. risk of trauma to papilla

Front 81

Luxation accomplishes 2 things:

Back 81

Bone expansion, Sever PDL

Front 82

Where do you want to place forecps and why?

Back 82

As far apical as posslbe, weges and causes bone expansion, decreases incidence of root fracture

Front 83

__ bone is the thinnes and most likely to expand there for most of your movment should be in __ direction

Back 83

Buccal bone
move more bucally

Front 84

Which root is most likely to fracture and which root is the hardtest to remove

Back 84

Root you are moving towards-so if you are moving buccal you will fracture the buccal
Paletal is most difficult

Front 85

__ is the best forcep to use on max canine b/c has a broader beak and engages more root surface; if buccal plate fractures remove it with tooth or leave it attached to periosteum

Back 85

#150

Front 86

Common cause of post op bleeding=__

Back 86

Granulation tissue-this is my you need to remove granulation tissue-longer bleeding time=prolonged healing

Front 87

Name some systemic factors that may contribute to impacted teeth

Back 87

Cleidocranial Dysplasia, endocrine deficiencies, Febrile Illness, Downs, radiotherapy

Front 88

List the MC impated teeth in decending order

Back 88

Man/Max 3rds, Max canine, Mand PM's, Man 2nd molar

Front 89

Dev. of mand 3rd molars: tooth germ visible at __ yrs, mineralization complete by __, root half fomed by __ and completed by __

Back 89

9 yrs
14 yrs
16 yrs
18 yrs

Front 90

If 3rd are going to erutp 95% will have done it by age __

Back 90

24

Front 91

Name some causes of impaction of 3rds

Back 91

Differential growth b/t M and D roots, not enough room in arch, lateral positioning of tooth buds, retarted maturation of 3rs

Front 92

Teeth are considered impaced when...

Back 92

Tooth has failed to erupt into mouth w/i its expected time and can no longer be expected to do so

Front 93

When doing a flap: release incision on __ (reverse hockey stick incision); never extend incision beyond __;

Back 93

Ext. oblique ridge
DL angle of the 2nd molar

Front 94

__ incision is used for apical access in PA surgery-avoid crssing bony prominences

Back 94

Semilunar incision

Front 95

T/F when retrieving a broken root you can grasp buccal bone with forcepts to remove tooth or remove some buccal bone

Back 95

True-but not a good idea in ortho cases-use periotome instead

Front 96

When doing the open extraction technique list the finishing steps

Back 96

Smooth bone, irrigate and suture w/ 3-0 gut suture

Front 97

How would remove surgically a max molar

Back 97

Flap, remove buccal bone, section buccal roots from crow, remove crown w/ paletal and remove other 2 roots

Front 98

When removing bone-remove from __ __ and __if necessary

Back 98

occlusal, buccal, careful from the distal

Front 99

T/F you should be very conservative with removing bone

Back 99

False-five yourself room to work

Front 100

When exposing a tooth-bone should be removed to __

Back 100

CEJ of crown

Front 101

__ burs are good to remove bone; bone can be chipped away from buccal in max/mand

Back 101

#702 or 703 fissure burn or #8 round bur

max w/ a #9 or straight elevator

Front 102

T/F You should section all the way through the tooth to the lingual plate

Back 102

False-leave a plate and break through it

Front 103

Mesolingual impaction-what do you do? Parital impaction?

Back 103

Section off distal half from buccal groove to CEJ and luxate rest w/ 301
Make a trough/ditch then proceed as above

Front 104

Horizonal impactions-needs more/less bone reomved than mesioangular impactions,section crown and deliver w/ __ elevators; make purchase pt and luxate in __ direction

Back 104

More
East-west elevators
anterior

Front 105

Pain peaks __hrs post-op and only persistis __ days

Back 105

6-12 hrs
2-3 days

Front 106

When should first dose of analgesic be taken after surgery

Back 106

B4 anesthetic wears off

Front 107

List some centrally acting analgesics

Back 107

Codeine, hydrocodone oxycodone

Front 108

Tylenol #1 contains __ amt of tylenol and __ amt of codeine

Back 108

300 mg tylenol
7.5 mg codeine
#4=60 mg codeine, just remember 7.5 is baseline and it is doubled for every step up

Front 109

What is max dose in a day of:
Tylenol
Asprin
Ibuprofen
Naproxen

Back 109

Tylenol 4 g
Aspirin 4g
Ibuprofen 3.2 g
Naproxen 15 g

Front 110

List drugs used for mild pain

Back 110

Tylenol, aspirin, ibuprofen

Front 111

Lisdt drugs for moderate pain

Back 111

Naproxen, Ibuprogen, Tylenol/Aspirin w/ codeine, Propooxyphene

Front 112

List drugs for severe pain

Back 112

Oxycodone, hydrocodone, combunox

Front 113

Oxycodone, hydrocodone come in what mg dosages?

Back 113

5, 7.5 or 10 and both can be combines w/ ASA or tylenol, Hyrocodone can aslo be combined w/ ibuprophen

Front 114

T/F Pain killers given b/4 pain is felt is more effective than after feel pain

Back 114

True-reduces "pain memory" in the nervous system

Front 115

Name the long acting anesthetic that should be given pre-operatively and sometimes post-operatively

Back 115

.5% Marcaine w/ Epi 1:200,000

Front 116

Describe a post-op diet

Back 116

High volume, high calorie liquid diet for 1st 24 hours, longer for multiple extractions

Front 117

__ is the inflammation of masticatory muscles and happens as a result of injury usually from needles; what is the tmt of choice

Back 117

Trismus-warm compress and analgesics

Front 118

Brusing is more common in __; onset __ days, lasts __ days

Back 118

Older ppl
2-4 days
7-10 days

Front 119

What are the hygiene instruction after surgery (including rinsing)

Back 119

Do not rinse for 1st day, brush/floss as usualy, careful near site, rinse with warm salt water beginning 2nd day the more the better