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Questions and Answers
What is the purpose of adhering to Langer's lines when making incisions?
What is the purpose of adhering to Langer's lines when making incisions?
Why is it important to check for fluctuance before performing incision and drainage?
Why is it important to check for fluctuance before performing incision and drainage?
How can one induce fluctuance if it is not initially present?
How can one induce fluctuance if it is not initially present?
What type of suture is recommended for closing incisions after drainage?
What type of suture is recommended for closing incisions after drainage?
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Why should incisions not be made in the most fluctuant area of an abscess?
Why should incisions not be made in the most fluctuant area of an abscess?
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What condition is indicated by a patient experiencing dyspnea and dysphagia?
What condition is indicated by a patient experiencing dyspnea and dysphagia?
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Which patient group is NOT considered immunocompromised?
Which patient group is NOT considered immunocompromised?
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What is indicated by an elevated body temperature higher than 40 degrees?
What is indicated by an elevated body temperature higher than 40 degrees?
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When is it necessary to go to the operating room?
When is it necessary to go to the operating room?
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Which of the following is NOT a criterion for referral to a specialist or ER?
Which of the following is NOT a criterion for referral to a specialist or ER?
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What does the presence of multiple space involvement suggest?
What does the presence of multiple space involvement suggest?
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What is the primary reason for surgically removing the source of infection?
What is the primary reason for surgically removing the source of infection?
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Which symptom indicates a potentially serious condition requiring urgent attention?
Which symptom indicates a potentially serious condition requiring urgent attention?
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What is the correct initial method for preparing the area before making a stab incision?
What is the correct initial method for preparing the area before making a stab incision?
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When swabbing the area with alcohol, which technique is recommended?
When swabbing the area with alcohol, which technique is recommended?
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Which type of antibiotics should be preferred according to the given guidelines?
Which type of antibiotics should be preferred according to the given guidelines?
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What is the proper action to reduce pain when using a blade for incision?
What is the proper action to reduce pain when using a blade for incision?
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What consideration should be prioritized when selecting antibiotics for a patient?
What consideration should be prioritized when selecting antibiotics for a patient?
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What should be done if the lesion's border is diffused and no pus is present for drainage?
What should be done if the lesion's border is diffused and no pus is present for drainage?
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What is the appropriate gauge for aspiration if a small lumen needle is necessary?
What is the appropriate gauge for aspiration if a small lumen needle is necessary?
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What is a common characteristic of an abscess?
What is a common characteristic of an abscess?
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Where should the point of incision for draining an abscess be located?
Where should the point of incision for draining an abscess be located?
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What is an important technique to use when evacuating pus from within an abscess?
What is an important technique to use when evacuating pus from within an abscess?
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When should antibiotics not be necessary in the treatment of a cystic lesion?
When should antibiotics not be necessary in the treatment of a cystic lesion?
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Which gauge needle may result in a false negative during aspiration?
Which gauge needle may result in a false negative during aspiration?
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What is the primary purpose of performing drainage in a dental abscess case?
What is the primary purpose of performing drainage in a dental abscess case?
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What is a potential complication if an abscess drains through the tooth area?
What is a potential complication if an abscess drains through the tooth area?
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Which procedure should be performed if a tooth requires removal due to an abscess?
Which procedure should be performed if a tooth requires removal due to an abscess?
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When is the culture and sensitivity test considered essential in the management of dental abscesses?
When is the culture and sensitivity test considered essential in the management of dental abscesses?
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What is the ideal position of the blade when performing incision and drainage for an abscess?
What is the ideal position of the blade when performing incision and drainage for an abscess?
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What additional treatment is necessary in cases of severe spreading infection or systemic toxicity?
What additional treatment is necessary in cases of severe spreading infection or systemic toxicity?
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Which statement best describes the role of apicoectomy in the treatment of acute abscesses?
Which statement best describes the role of apicoectomy in the treatment of acute abscesses?
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What is a common consequence of not allowing for adequate drainage in an abscess?
What is a common consequence of not allowing for adequate drainage in an abscess?
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In managing acute dental abscesses, when is incision and drainage most effective?
In managing acute dental abscesses, when is incision and drainage most effective?
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What is the primary purpose of marsupialization in the treatment of cysts?
What is the primary purpose of marsupialization in the treatment of cysts?
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What should be applied to the site after performing marsupialization?
What should be applied to the site after performing marsupialization?
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When should the dressing after marsupialization be changed?
When should the dressing after marsupialization be changed?
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Which statement correctly describes the use of the acrylic plug after marsupialization?
Which statement correctly describes the use of the acrylic plug after marsupialization?
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Why is marsupialization often performed before enucleation?
Why is marsupialization often performed before enucleation?
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Study Notes
Oral Surgery 2 (Midterms)
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Post-Operative Surgical Complications:
- Fat Pad Prolapse: Incision extends beyond the MGJ, allowing fat from the cheeks to protrude.
- Fractured Maxillary Tuberosity: Excessive force on forceps can detach part of the maxilla. If the detached portion is not attached to the rest of the maxilla, it should be removed.
- Soft Tissue Injuries: Tearing of mucosal flaps, puncture wounds, or stretch/abrasion injuries are possible.
- Surgical Emphysema: Excessive air or water during surgery can enter soft tissue spaces. Use preventative measures like 45 degree handpiece, milk the flap, or give antibiotics.
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Soft Tissue Injury Prevention:
- Pay close attention to soft tissues during procedures, especially angular cheilitis (common in 3rd molar surgeries).
- Use appropriate instruments while retracting soft tissue.
- Appropriate sized flaps prevent tearing.
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Tooth Extraction Complications:
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Root Fracture/Displacement:
- Excessive force can lead to root fracture during tooth extraction.
- Root displacement is also possible.
- Buccal delivery helps prevent these complications.
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Root Fracture/Displacement:
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Oro-Antral Communications:
- Oro-Antral Perforation/Fistula: Communication between oral cavity and maxillary sinus.
- If <2 mm: primary closure, secure clot, and decongestants.
- If >2 mm: primary closure, watertight closure, reduce bone for better coaptation, decongestants, and antibiotics.
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Injuries to Adjacent Teeth During Extraction:
- Advise the patient about possible fracture of restorations or luxation of adjacent teeth to prevent these issues.
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Maxillary Sinus Disorders and Management:
- Maxillary Sinus (Antrum of Highmore): Air-filled cavities in the maxilla, with tubular sacs in embryos and pyramidal shape in adults. Its volume is typically 15-20 ml.
- Innervation: Maxillary sinus innervation is similar to teeth, so pain might be misidentified.
- Communication: Ensure proper maxilla pneumatization, especially with 3rd molar surgeries.
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Orofacial Infections:
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Odontogenic Infections:
- Common bacteria include aerobic, anaerobic, and mixed.
- The course can be acute, subacute, or chronic.
- Acute: involves pain, borders (diffuse or specific), large size, red color, and increasing edema.
- Chronic: involves pain, borders (localized), small size, shiny center, and decreasing edema.
- Cellulitis: Most severe of chronic infections and can be from aerobic and anaerobic bacteria.
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Odontogenic Infections:
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Chronic Oro-Antral Fistula Management:
- Flush out content of max sinus using sterile normal saline (NSS) through perforation using 20 cc syringe and thin tube.
- Administer antibiotics that address bacterial infections.
- Know the different bacteria involved.
- Closure of oro-antral fistula involves care of the perforation site.
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Odontogenic Infections:
- Cause: From bacterial infection of the tooth, or its surrounding tissue.
- Clinical Course: Acute, Sub-Acute, Chronic.
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Periodontitis:
- Gingival (diffused or localized)
- Periodontitis (no bone loss)
- Periodontitis (horizontal bone loss with pocket)
- Periodontitis (vertical bone loss with pocket)
- Mobility and suppuration
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Surgical Management of Cellulitis:
- Mild: Remove cause, and administer antistreptococcal antibiotics.
- Severe: Remove cause, incision and drainage, and administer antistreptococcal antibiotics.
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Acute Periapical Abscess:
- Affected cortical area, apical only.
- Curettage is a common technique for removal of pathogens.
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Probing Fistula/Cutaneous Fistula:
- Fistula has diffuse edges and a high probability of being the location of an abscess.
- Can be diagnosed by palpation.
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Drainage of Abscess:
- Low/high attachment of buccinator muscle affects drainage location (buccal space vs vestibule).
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Factors Determining Route of Pus Drainage:
- Bone thickness overlying infection
- Level of site of bony perforation
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Primary/Secondary/Tertiary Spaces:
- Pterygopalatine space, infratemporal space, canine space
- Superficial/Deep/Submental/Submandibular spaces.
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Pseudo Ludwig's Angina/True Ludwig's Angina:
- Pseudo: Extra-oral swelling w/o floor of mouth infection.
- True: Infection/swelling of the floor of the mouth.
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Osteomyelitis: Bone inflammation extending from the marrow to the periosteum, potentially due to loss of blood supply from tissue/nerve compression.
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Saucerization: Surgical creation of a depression/opening in an infected area that allows pus to drain.
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Decortication: Removal of infected cortical plate of bone around a tooth or infection site.
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Cysts: A fluid-filled sac in the jaw. These are classified based on their formation (odontogenic, non-odontogenic) as well as features. Specific categories include radicular cysts, dentigerous cysts, and others.
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Cyst management/treatment: Enucleation, saucerization, and marsupialization.
- Enucleation: Removing the entire cyst.
- Saucerization: Creating a saucer-like opening in the cyst to allow for drainage.
- Marsupialization: Creating a flap on the cyst to expose it to the mouth and facilitate drainage.
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Complications of Dental Abscesses:
- Cavernous sinus thrombosis
- Ludwig's angina
- Necrosis
- Necrosis and cell death.
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Description
Test your knowledge on post-operative surgical complications in Oral Surgery. This quiz covers critical issues like fat pad prolapse, fractured maxillary tuberosity, and soft tissue injury prevention. Prepare for your midterms with a focus on complications and their management.
