INBDE Bootcamp - Oral Surgery Essentials

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Questions and Answers

What describes the direct histologic connection between bone and implant?

Primary stability

Biochemical stability

Osseointegration (correct)

Secondary stability

Which type of bone offers the best primary stability for dental implants?

Type IV

Type I (correct)

Type III

Type II

What is the most common type of mandibular fracture?

Condyle fracture (correct)

Angle fracture

Symphysis fracture

Comminuted fracture

Which surgical procedure is designed to move a retrusive maxilla forward?

Le Fort I osteotomy Signup and view all the answers

Which TMJ treatment option involves an instrument being inserted into the superior joint space?

Arthroscopy Signup and view all the answers

What type of fracture is defined as one that is open to the oral cavity?

Compound fracture Signup and view all the answers

What is the main purpose of distraction osteogenesis?

To provide gradual bone deposition Signup and view all the answers

What is the first step in managing medical emergencies like asthma or airway obstruction?

Stop treatment Signup and view all the answers

What is the first step in treating a patient showing signs of difficulty breathing with hands around their neck?

Position the patient properly Signup and view all the answers

What is a key sign of a severe allergic reaction?

Difficulty breathing Signup and view all the answers

What treatment option is specifically used for a hypoglycemic patient who is unconscious?

IV dextrose Signup and view all the answers

What is the proper first step for a patient with chest pain due to ischemia of heart tissue?

Position the patient upright Signup and view all the answers

Which treatment is indicated for a patient with signs of hyperventilation?

Guide the patient to breathe through one nostril Signup and view all the answers

What is a common sign of a stroke?

Facial droop Signup and view all the answers

What should be done to prevent complications from intravascular injections of local anesthetic with epinephrine?

Aspire during injection Signup and view all the answers

What is the primary treatment for a patient experiencing a seizure?

Remove objects from the mouth Signup and view all the answers

Which sign is commonly associated with difficulty breathing due to bronchiole constriction?

Wheezing Signup and view all the answers

What is an essential factor in preventing severe allergic reactions?

Accurate health history Signup and view all the answers

What is the first line treatment for chest pain due to ischemia?

Morphine Signup and view all the answers

Which treatment is indicated for a patient with hyperglycemia?

EMS activation Signup and view all the answers

In cases of vasovagal syncope, which sign typically appears?

Pale skin Signup and view all the answers

Which emergency management step is crucial for a patient exhibiting signs of hyperventilation?

Sit upright and breathe through pursed lips Signup and view all the answers

What characterizes angina as opposed to myocardial infarction?

Chest pain due to ischemia Signup and view all the answers

What is a common symptom of hypoglycemia?

Pale and sweaty skin Signup and view all the answers

What characterizes primary stability in dental implants?

The biomechanical stability of the implant when first placed Signup and view all the answers

What type of fracture has the worst prognosis for implants?

Type IV Signup and view all the answers

What step follows the latency phase in distraction osteogenesis?

Distraction phase Signup and view all the answers

Which of the following is a common complication of a bisagittal split osteotomy (BSSO)?

Nerve damage Signup and view all the answers

Le Fort II fractures are characterized by which of the following?

Involvement of orbits and nasal bones Signup and view all the answers

What technique allows for bone deposition through gradual traction after an osteotomy?

Distraction osteogenesis Signup and view all the answers

Which of the following describes a closed fracture regarding its relation to the oral cavity?

Does not break the skin Signup and view all the answers

What is a typical nonsurgical treatment option for TMJ disorders?

Counseling Signup and view all the answers

Study Notes

INBDE Bootcamp - High-Yield Oral Surgery

Dental Implants:
- Primary stability: Initial biomechanical stability of the implant, achieved when first placed.
- Secondary stability: Osseointegration of the implant into the bone, representing long-term healing.
- Osseointegration: Direct histologic connection between the bone and implant.
- Bone quality types (dense to least dense):
  - Type I: Anterior mandible (best primary stability)
  - Type II: Posterior mandible (best osseointegration)
  - Type III: Anterior maxilla
  - Type IV: Posterior maxilla (worst prognosis for implants)

Traumatic Injuries & Orthognathic Surgery

Midface fractures:
- Le Fort I: Horizontal across the maxilla
- Le Fort II: Pyramidal across midface, involving orbits and nasal bones.
- Le Fort III: Complete craniofacial disjunction, involving the zygomatic arch.
Mandibular fractures (most common to least common):
- Condyle
- Angle
- Symphysis
- Types of fractures:
  - Simple: Closed to the oral cavity
  - Compound: Open to the oral cavity (breaks skin)
  - Greenstick: Partial thickness fracture
  - Comminuted: Fractured in multiple pieces
Orthognathic Surgical Procedures:
- Le Fort I osteotomy: For retrusive maxilla or vertical maxillary excess (moves upper jaw forward or upward) Corrects Le Fort I fracture.
- BSSO (Bisagittal split osteotomy): For retrusive or protrusive mandible (moves mandible back or forward). Common complication is inferior alveolar nerve (IAN) damage.
- Distraction osteogenesis: Gradual traction for bone deposition (osteotomy phase → latency phase → distraction phase)

TMJ (Temporomandibular Joint) Disorders

Nonsurgical Treatments: Counseling, medical therapy (NSAIDs, steroids, analgesics, muscle relaxants), physical therapy, occlusal splint.
Surgical Treatments:
- Arthrocentesis: Flush out superior joint space
- Arthroscopy: Instrument superior joint space
- Arthroplasty: Disc repositioning surgery
- Discectomy: Disc repair or removal
- Condylotomy: Vertical ramus osteotomy
- Total joint replacement

Medical Emergencies (General Steps: SPORT)

Stop treatment
Position the patient properly
Oxygen
Reassure the patient
Take vitals
Airway obstruction: Clear throat, check for breathing, chin tilt, back blows, Heimlich maneuver. Prevention is key - e.g. throat pack.
Anaphylactic shock: Albuterol, epinephrine, antihistamine, oxygen, EMS. Prevention is key - accurate health history.
Asthma: Albuterol inhaler, avoid triggers.
Angina: Oxygen, nitroglycerin (NTG), aspirin. (Wait 5 minutes between NTG doses, then give aspirin and EMS). Position the patient Upright.
Myocardial Infarction (Heart Attack): MONA (morphine, oxygen, nitroglycerin, aspirin), EMS. Position patient upright.
Epinephrine Overdose: Beta-blockers.
Hyperventilation: Sit upright, decrease O2 intake by breathing through one nostril or pursed lips; relaxation techniques. (Supplemental oxygen is contraindicated)
Diabetic Complications:
- Hypoglycemia: Conscious: glucose tab, juice; Unconscious: IV dextrose, IM glucagon, EMS.
- Hyperglycemia: Activate EMS.
Seizure: Remove objects from mouth, do not restrain, benzodiazepine (grand mal: Dilantin, phenytoin; status epilepticus: Valium, diazepam).
Stroke: Administer O2, EMS.
Syncope (Fainting):
- Vasovagal syncope: Anxiety related.
- Orthostatic hypotension: Blood pressure decreases upon standing.
- Treatment Position: supine or left lateral decubitus (pregnant).

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Description

Test your knowledge on high-yield concepts in oral surgery, including dental implants, traumatic injuries, and orthognathic surgery. This quiz covers primary stability, osseointegration, and various types of fractures. Perfect for those preparing for the INBDE exam.