Assessment of Supporting Tissues and Treatments

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Questions and Answers

What is a contraindication for cyst enucleation in the apical third?

  • Risk of jaw fracture (correct)
  • Patient's age
  • Presence of infection
  • Size of the cyst

Which of the following is an indication for marsupialization followed by enucleation?

  • Patient prefers minimally invasive procedures
  • Desire to examine the lesion histologically (correct)
  • Size of the cyst is large
  • Presence of multiple cysts

Milk is considered a good alternative medium for avulsed teeth because it is:

  • Easier to obtain than saline
  • Free of bacteria (correct)
  • Better for remineralization
  • Higher in nutrients than saline

What is the maximum time frame for achieving a good prognosis when replanting an avulsed tooth?

<p>30 minutes (C)</p> Signup and view all the answers

What treatment method is typically used for lateral displacement of a tooth?

<p>Repositioning and splinting (A)</p> Signup and view all the answers

Which factor can make odontectomy more difficult?

<p>Presence of a follicular sac (B)</p> Signup and view all the answers

In treatment planning for preprosthetic surgery, which evaluation should NOT be included?

<p>Auscultation (D)</p> Signup and view all the answers

When removing a vertically impacted tooth, the tooth is typically sectioned into:

<p>Mesial and distal sections (C)</p> Signup and view all the answers

What is the main advantage of marsupialization?

<p>It is a simple procedure (C)</p> Signup and view all the answers

What is the goal of reducing overlying bone during the removal of an impacted tooth?

<p>To expose the crown (B)</p> Signup and view all the answers

What is a potential cause of dentoalveolar injuries?

<p>Direct trauma to the teeth (B)</p> Signup and view all the answers

Which of the following is NOT a contraindication for impacted tooth removal?

<p>Patient on ASA 2 category (B)</p> Signup and view all the answers

Which condition indicates involvement of the muscles of deglutition?

<p>Dysphagia (B)</p> Signup and view all the answers

Dentigerous cyst is categorized as which type of cyst?

<p>Odontogenic cyst (C)</p> Signup and view all the answers

What is a characteristic of a lesion that raises suspicion of malignancy?

<p>Surrounding tissue is firm to touch (B)</p> Signup and view all the answers

What is the volume of the maxillary sinus?

<p>15cc (C)</p> Signup and view all the answers

What should be considered during health history assessments when lesions are discovered?

<p>It is a routine procedure in dental treatment (C)</p> Signup and view all the answers

Which procedure is performed when multiple areas of ulceration are found within the mouth?

<p>Differential diagnosis (D)</p> Signup and view all the answers

What is indicated by a rapidly developing sense of pressure in the sinus area?

<p>Acute maxillary sinusitis (B)</p> Signup and view all the answers

After sectioning the crown from the roots during horizontal impaction removal, the roots are delivered by what means?

<p>Cryer elevators (C)</p> Signup and view all the answers

Which area should be evaluated by the clinician in mesioangular impaction?

<p>Ascending ramus (B), Distobuccal bone (D)</p> Signup and view all the answers

Which incision design is ideal for reflecting flaps during impacted tooth removal?

<p>Envelop incision (D)</p> Signup and view all the answers

Which type of epithelium lines the maxillary sinus?

<p>Pseudostratified ciliated columnar epithelium (B)</p> Signup and view all the answers

What is the main focus of early treatment for maxillary sinusitis?

<p>Relief of breathing (D)</p> Signup and view all the answers

In assessing maxillary sinus health, which view is utilized?

<p>Water's view (B)</p> Signup and view all the answers

In dentoalveolar injuries, which group is most affected?

<p>Children aged 0-5 years (C)</p> Signup and view all the answers

What is a favorable fracture line of the mandible?

<p>Opposite the masseter muscle (C)</p> Signup and view all the answers

What may lead to serious pulpal and periodontal problems in the treatment of intruded teeth?

<p>Surgical repositioning and splinting (A)</p> Signup and view all the answers

What is the preferred treatment for crown fractures involving exposed pulp?

<p>Root canal treatment (C)</p> Signup and view all the answers

Which procedure is associated with the use of alloplastic material in preprosthetic procedures?

<p>Alveolar ridge recontouring (D)</p> Signup and view all the answers

Chronic maxillary sinusitis is characterized by which of the following?

<p>Episodes respond to treatment yet return (A)</p> Signup and view all the answers

In distoangular impaction, bone reduction is primarily directed towards which area?

<p>Ascending ramus (B)</p> Signup and view all the answers

What type of impacted third molar is characterized by being completely embedded in bone with a distally oriented crown?

<p>Class 3 distoangular (C)</p> Signup and view all the answers

Which of the following conditions is considered a contraindication for odontectomy due to compromised medical status?

<p>Acquired coagulopathy (C)</p> Signup and view all the answers

In the assessment of patients with dentoalveolar injuries, which factor is deemed most important?

<p>Maintenance of patent airway (C)</p> Signup and view all the answers

Which sign indicates malignment when examining the base of an ulcer?

<p>Black necrotic tissue (C)</p> Signup and view all the answers

Which type of injury is primarily responsible for dentoalveolar injuries in adults?

<p>Physical assault (D)</p> Signup and view all the answers

When examining a bluish swelling that blanches on pressure, what does it typically indicate?

<p>Vascular lesion (A)</p> Signup and view all the answers

During the surgical procedure for decompression, what should be ensured regarding the continuity of the cyst?

<p>The continuity with the oral cavity should be maintained (D)</p> Signup and view all the answers

What is the correct term for an injury to the tooth supporting structures often referred to as sensitivity?

<p>Concussion (C)</p> Signup and view all the answers

Flashcards

Supporting tissue assessment after alveoloplasty

The assessment of the supporting tissue involves evaluating the soft tissue scar after alveoloplasty, which is a surgical procedure to reshape the bone surrounding an extracted tooth.

Early maxillary sinusitis treatment

Early treatment of maxillary sinusitis focuses on relieving breathing difficulties. This involves using nasal decongestants, saline nasal irrigation, and sometimes antibiotics.

Most common dentoalveolar injury cause

Falls are the most common cause of dentoalveolar injuries, especially in children aged 0-5 years.

Intrusion complication

Intrusion, when a tooth is pushed deeper into its socket, can lead to serious complications like pulp and periodontal damage. This is due to the pressure and potential damage to the nerves and surrounding tissues.

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Tooth concussion treatment

Concussion treatment for a tooth often involves relieving the tooth from occlusion (the biting surface). This helps reduce the pressure on the tooth and allows it to recover.

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What is lateral displacement?

Lateral displacement is when a tooth is moved sideways, often into an empty space where another tooth has been lost. It's one of the types of dental displacement caused by trauma.

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What is intrusion?

Intrusion involves a tooth being pushed into its socket, often accompanied by a compression fracture of the socket. This is a serious type of dental trauma.

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Describe chronic maxillary sinusitis

Chronic maxillary sinusitis refers to recurrent or persistent sinus infections that don't respond fully to treatment and often exhibit persistent symptoms.

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Marsupialization

A simple procedure that involves creating an opening in the affected area to allow drainage and healing.

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Aspiration Biopsy

A type of biopsy that involves removing a small sample of tissue with a needle. It is used for lesions containing fluids.

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Incisional Biopsy

A type of biopsy that involves surgically removing a larger portion of the lesion. It is used for smaller, more localized lesions.

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Firm Lesion Consistency

A hard, firm consistency of a lesion can suggest the possibility of malignancy.

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Soft Lesion Consistency

A soft, squishy consistency of a lesion can suggest a benign growth like a lipoma.

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Reduction of Overlying Bone in Impacted Tooth Removal

The goal is to expose the crown of the impacted tooth by removing the overlying bone, allowing for extraction.

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Dentigerous Cyst

A dental cyst that develops around the crown of a tooth.

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Recentouring Alveolar Ridges

The ideal contour for supporting a prosthesis, achieved by reshaping the alveolar ridge after tooth removal.

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Large cyst size and enucleation

Enucleation may be a contraindication if the cyst is too large, as this could increase the risk of jaw fracture.

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Best treatment for extruded teeth

Splinting is the best treatment for extruded teeth, helping to stabilize and support the tooth in its correct position.

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Lateral displacement of teeth

Splinting and repositioning can address lateral displacement of teeth, guiding the tooth back to its proper alignment.

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Why is milk good for avulsed teeth?

Milk is an ideal medium for avulsed teeth because it is free of bacteria, minimizing contamination and promoting tooth survival.

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Reducing alveolar fracture

Alveolar fracture reduction can be achieved by applying digital pressure, gently repositioning the bone fragments into their correct alignment.

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Replanting time for avulsed teeth

Replanting an avulsed tooth within 30 minutes drastically increases the chances of successful reattachment and tooth survival.

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Securing alveolar ridges

Continuous suture is the method used to secure properly contoured alveolar ridges, holding the tissue together and promoting healing.

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Mucoperiosteal elevator

A mucoperiosteal elevator is a tool used during surgery to lift and separate the mucoperiosteal flap, exposing the underlying bone.

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Class 3 distoangular impacted molar

A classification of impacted third molars where the crown is completely embedded in bone and tilted distally.

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Concussion

An injury to the tooth supporting structures, also known as sensitivity.

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Decompression

A condition where the continuity between the cyst and the oral cavity is maintained after removing the cystic contents.

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Vascular lesion

A bluish swelling that turns white when pressed, suggesting a problem with blood vessels.

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Follicular sac removal

A surgical procedure where the follicular sac is removed, determining the amount of bone to be removed.

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Intrusion

A condition where a tooth is pushed deeper into its socket, often causing damage to the surrounding structures.

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Class 1 position of an impacted tooth

A condition where the impacted tooth is situated above the cervical line of the second molar with sufficient anteroposterior space.

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Differential diagnosis

The procedure done when multiple areas of ulceration are found within the mouth, involving a systematic evaluation to determine the cause and nature of each lesion.

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Dentoalveolar injuries in adults

Physical assault is the main cause of dentoalveolar injuries in adults.

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Battle sign

A sign of a fracture in the skull, specifically at the mastoid bone. It may be characterized by bleeding behind the ear.

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Le Fort 1

A fracture of the maxillary bone that affects the midface, involving the maxilla and the surrounding structures. It is also known as a "floating jaw" due to the instability of the affected bones.

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Favorable fracture of the mandible

A type of fracture of the mandible (jawbone) in which the fracture line is opposite the masseter muscle, considered a favorable fracture as it doesn't usually affect the muscle's function.

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Dysphagia

A clinical sign where swallowing is difficult or painful, indicating an issue with the muscles involved in swallowing, the floor of the mouth, or parapharyngeal areas.

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Nodule

A large, palpable mass that is elevated above the surface of the skin or mucous membrane.

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Crust

A dried or clotted serum protein found on the surface of the skin or mucosa.

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Scale

A thin, flaky layer of dead skin cells, which can result from the accumulation of keratin.

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Study Notes

Assessment of Supporting Tissues

  • Clinicians should evaluate the supporting tissue of the primary bearing area.

Early Treatment of Maxillary Sinusitis

  • Aims to relieve breathing.

Dentoalveolar Injuries

  • Children aged 0-5 are most affected.
  • Falls are a common etiology.

Intrusion Treatment

  • May lead to serious pulpal and periodontal problems.
  • Surgical repositioning and splinting with orthodontic forces might be required.

Treatment for Concussion

  • Relieve tooth occlusion.

Crown Fractures with Exposed Pulp

  • Apicoectomy is not a treatment option.

Tooth Displacement

  • Lateral and other types of displacements, often associated with socket fractures.

Marsupialization

  • This procedure simplifies cavity issues. It's a straightforward approach.

Biopsy Indications

  • Lesions with fluids are a reason for aspiration biopsy.
  • Small lesions and extensive lesions can trigger incisional biopsies.

Mesioangular Impaction

  • The ascending ramus of the bone has the most reduction.

Labial Frenoplasty

  • Done with wide vestibular base and a "v" incision.

Maxillary Sinusitis Treatments

  • Nasal spray with a vasoconstricting agent may be used.

Chronic Maxillary Sinusitis

  • Recurring episodes, resistant to treatment.

Preprosthetic Procedures

  • Reshaping alveolar ridges is a key function here. This involves removing bony undercuts. Often uses alloplastic material.

Impacted Tooth Removal

  • This involves bone reduction directed towards the ascending ramus.
  • Exposing the crown.

Contraindications to Impacted Tooth Removal

  • ASA 2 category patients.
  • Odontogenic cysts.

Lesion Characteristics

  • Lipoma: soft consistency
  • Suspicious lesions: firm surrounding tissue.

Dental Treatment Procedures

  • Computed tomography (CT) is useful to see dentoalveolar fractures (axial cuts).
  • Splinting is a common treatment for extrusion.
  • Milk is a good alternative for tooth repositioning.
  • Tooth replanting needs to happen quickly, within 30 minutes.
  • Using a continuous suture to secure properly contoured alveolar ridges.
  • Mucoperiosteal elevators facilitate flap elevation.
  • Best tissue contour is a goal of ridge repositioning.
  • Cryer elevators are employed during horizontal impaction removal.
  • Class 3 position B is indicated for flap reflection in impacting teeth.
  • Envelop incision is a common flap design.
  • Marsupialization, followed by enucleation, is an option for cyst management.
  • Histological examination is an aspect of successful marsupialization.
  • Intracystic pressure is maintained in enucleation.
  • Thorough evaluation of supporting bone is key in preprosthetic surgery.
  • Denture support involves adequate form and tissue coverage.
  • Vertical impaction is sectioned into mesial and distal sections.

Odontectomy Factors

  • Incomplete root formation makes odontectomy easier.
  • Absence of a follicle makes odontectomy harder.
  • Follicle size predicts bone removal amount.
  • Class 1 position B is impacted second molar positions.
  • Class 3 impacted third molars have a distally oriented crown, completely embedded in the bone.
  • Concussion is injury to the tooth supporting structure.
  • Battle sign is bleeding from mastoid bone area.
  • Patient airway management is crucial.
  • Adults may experience physical assaults leading to injuries.
  • Studies suggest reduced injuries with increasing age.
  • Injuries can also come from direct injury or bicycle accidents.

Impacted Tooth Removal Considerations

  • Flexibility of bone is reduced for the elderly (patients over 35).
  • Thin periodontal ligament space needs to be considered for root morphology.
  • Coagulopathy and other compromised status are contraindications.
  • Temporomandibular Joint disorder needs to be sought when the pain is related.
  • An indication for odontectomy may exist to avoid adjacent tooth damage and the option for future repair.

Cystic Lesion Management

  • Decompression procedures maintain oral cavity continuity after cyst drainage.
  • Use of a concave surface of curette when separating cyst from bone is essential.
  • Vascular lesions can be indicated by a bluish swelling that is also responsive to pressure.
  • Malignancies may show up as a fungating ulcer.
  • Multiple oral ulcers might require a differential diagnosis.

Oral Examination and Procedures

  • Dysphagia occurs when the muscles needed for swallowing are affected/damaged.
  • Acute maxillary sinusitis presents as pressure, pain, fullness.
  • Maxillary sinusitis examination involves palpation.
  • Maxillary sinus capacity is 15 cc.
  • Maxillary sinus is lined with pseudostratified ciliated columnar epithelium.
  • Midface fractures (le fort 1) involve significant fracture and involve maxilla.
  • Neurologic status evaluation is key in trauma assessment.
  • Examination of the paranasal sinuses is vital to assessment findings in trauma.
  • Fistula closure is a consideration in oral and maxillofacial cases.
  • Occlusal trauma can cause oral and maxillofacial injuries.
  • Instruments used in oral surgeries, like blades are commonly 15.
  • Needle gauges of 18 are common for aspirating fluids in cystic lesions.

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