INBDE Bootcamp: Oral Surgery Essentials

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Questions and Answers

What characterizes primary stability of an implant?

Biomechanical stability at placement (correct)

Osseointegration of the implant into the bone

Long-term healing process

Histologic connection with surrounding tissue

Which type of bone is associated with the best primary stability for implants?

Type I: Anterior mandible (correct)

Type IV: Posterior maxilla

Type III: Anterior maxilla

Type II: Posterior mandible

What is the primary treatment approach for a Le Fort II fracture?

Pyramidal disjunction involving nasal bones (correct)

Horizontal movement of the maxilla

Complete craniofacial reconstruction

Vertical correction of the maxilla

Which type of fracture is characterized as open to the oral cavity?

Compound fracture Signup and view all the answers

What is the main purpose of distraction osteogenesis?

Gradual bone deposition through traction Signup and view all the answers

Which complication is most commonly associated with a bisagittal split osteotomy (BSSO)?

Nerve damage (IAN) Signup and view all the answers

Which nonsurgical treatment is commonly used for TMJ disorders?

Physical therapy Signup and view all the answers

Which step is NOT part of the general emergency protocol known as SPORT?

Provide immediate anesthesia Signup and view all the answers

What is the first intervention when a patient is experiencing difficulty breathing with their hands around their neck?

Clear throat of foreign objects Signup and view all the answers

Which medication is NOT part of the treatment for a severe allergic reaction?

Insulin Signup and view all the answers

What does the acronym MONA stand for in the context of myocardial infarction treatment?

Morphine, oxygen, nitroglycerin, aspirin Signup and view all the answers

In which condition is supplemental oxygen contraindicated due to the risk of further complications?

Hyperventilation Signup and view all the answers

During a seizure, what should NOT be done to the patient?

Hold the patient down Signup and view all the answers

What is a common sign of hypoglycemia?

Irritability Signup and view all the answers

What is the indication for administering beta blockers?

Increased blood pressure due to local anesthetic Signup and view all the answers

Which symptom characterizes both asthma attacks and anaphylaxis?

Wheezing Signup and view all the answers

Study Notes

INBDE Bootcamp: High-Yield Oral Surgery

Dental Implants:
- Primary stability: Biomechanical stability of the implant immediately after placement.
- Secondary stability: Osseointegration—long-term healing and bone growth around the implant.
- Osseointegration: direct bone-implant connection.
- Implant Types (most dense to least):
  - Type I: Anterior mandible (best primary stability).
  - Type II: Posterior mandible (best osseointegration).
  - Type III: Anterior maxilla.
  - Type IV: Posterior maxilla (worst prognosis).

Trauma & Surgery

Midface Fractures:
- Le Fort I: Horizontal across maxilla, only maxillary bone involved.
- Le Fort II: Pyramidal across midface, involves orbits and nasal bones.
- Le Fort III: Complete craniofacial disjunction, involves zygomatic arch.
Mandibular Fractures (most common to least):
- Condyle > Angle > Symphysis
- Fracture types:
  - Simple: Closed to the oral cavity.
  - Compound: Open to the oral cavity (breaks skin).
  - Greenstick: Partial thickness fracture.
  - Comminuted: Fractured in multiple pieces.
Orthognathic Surgery Procedures (examples): - Le Fort I osteotomy: For retrusive maxilla (vertical maxillary excess). - Bisagittal split osteotomy (BSSO): For retrusive or protrusive mandible. - Distraction osteogenesis: Appliance for gradual bone repositioning.
Key Complications to remember: IAN nerve damage (in BSSO)

Temporomandibular Joint (TMJ) Disorders

Nonsurgical Treatment:
- Counseling.
- Medical therapy (NSAIDs, steroids, analgesics, muscle relaxants).
- Physical therapy.
- Occlusal splint.
Surgical Treatment:
- Arthrocentesis: Flushes superior joint space.
- Arthroscopy: Instruments in superior joint space.
- Arthroplasty: Disc repositioning surgery.
- Discectomy: Disc repair or removal.
- Condylotomy: Vertical ramus osteotomy.
- Total joint replacement.

Medical Emergencies (SPORT)

General Steps (SPORT):
- Stop treatment.
- Position the patient (appropriate position).
- Oxygen.
- Reassure the patient.
- Take vitals.
Airway Obstruction:
- Signs/Symptoms: Difficulty breathing, hands around neck.
- Treatment: Clear throat of foreign objects, check for breathing, chin tilt, back blows, Heimlich maneuver.
Anaphylactic Shock:
- Signs/Symptoms: Rash, difficulty breathing, low BP, nausea, vomiting.
- Treatment: Albuterol, epinephrine, antihistamine, oxygen, EMS.
Asthma:
- Signs/Symptoms: Wheezing.
- Treatment: Albuterol inhaler.
Angina:
- Signs/Symptoms: Chest pain due to ischemia of heart tissue.
- Treatment: Oxygen, nitroglycerin (NTG), aspirin (wait 5 minutes between doses of nitroglycerin).
Myocardial Infarction:
- Signs/Symptoms: Chest pain, difficulty breathing, nausea/vomiting, pain (jaw, neck, arm).
- Treatment: MONA (morphine, oxygen, nitroglycerin, aspirin), EMS.
Epinephrine Overdose:
- Signs/Symptoms: Increased BP and HR.
- Treatment: Beta blockers.
Hyperventilation:
- Signs/Symptoms: Dizziness, weakness, lightheadedness.
- Treatment: Sit upright, decrease O2 intake.
Diabetic Complications:
- Hypoglycemia:
  - Signs/Symptoms: Sweating, pale, irritable, hungry, sleepy.
  - Treatment (conscious): Glucose tab, juice.
  - Treatment (unconscious): IV dextrose, IM glucagon, EMS.
- Hyperglycemia:
  - Signs/Symptoms: Dry mouth, thirsty, headache, blurred vision, weak.
  - Treatment: Activate EMS.
Seizure:
- Signs/Symptoms: Uncontrollable jerking, staring, temporary loss of consciousness.
- Treatment: Remove objects from mouth, do not restrain, benzodiazepine (e.g., valium, diazepam). -Specific seizure types: -Grand mal: Dilantin, phenytoin (anticonvulsant). -Status epilepticus: Valium, diazepam (anticonvulsant).
Stroke:
- Signs/Symptoms: Facial droop, arm drift, slurring speech.
- Treatment: Administer O2, EMS.
Syncope (Fainting):
- Signs/Symptoms: Reduced HR and BP, loss of consciousness.
- Treatment: Supine or left lateral decubitus (pregnant) position.

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Description

This quiz covers high-yield concepts in oral surgery, including dental implants and midface fractures. Test your knowledge on primary and secondary stability, osseointegration types, and fracture classifications to prepare for the INBDE. Perfect for dental students and professionals aiming for excellence in oral surgery.