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Flashcards in Oral Surgery Deck (28)
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1
Q

Osteoradionecrosis has the highest incident rate within the first ___ years of radiotherapy. What is the % rate?

A
  • first 3 years

- 70%

2
Q

which jaw has the higher risk of ORN? give 2 reasons why

A

mandible
less vascular
denser bone

3
Q

what are the 5 conservative Tx for ORN?

A
antiseptic MW
antibiotic 
hyperbaric oxygen therapy
ultrasonic therapy 
sequestrectomy
4
Q

what is the Marx’s classification? (3)

A

severity of ORN
has 3 stages
based on response to hyperbaric oxygen therapy

5
Q

what is the newest classification for ORN severity? (3)

A

Notani (in 2002)
has 3 stages
based on radiographic and clinical findings

6
Q

What bacteria causes actinomycosis ?

A

Actinomyce isrealii

7
Q

What antibiotic is effective against actinomycosis? (2)

A

Penicillin

Doxycycline (if penicillin allergy)

8
Q

according to NICE guidelines, what conditions constitutes an urgent referral for oral cancer? (7)

A

unexplained ____ lesion for >3 weeks

  • red and white patch
  • ulceration or mass
  • tooth mobility
  • horseness
  • lump in neck
  • pain in head/neck associated with otalgia (ear ache)
  • persistent swelling of parotid or submandibular gland
9
Q

what are the post XLA socket healing stages? (3)

A

0-3 weeks - inflammation
3-4 weeks - proliferation
6-8 weeks - remodelling

10
Q

flap design rules (7)

A

Maximise blood supply
o broad base
o oblique/curved relieving incisions
o avoid prolonged retraction

  • Avoid overtense sutures
  • Avoid damage to nerves
  • Support margins on bone
  • Larger rather than smaller (one unit anterior and one unit posteriorly)
11
Q

what is

  • Lignocaine
  • Septocaine
  • Scandonest
  • Citanest
A

2% lidocaine
septocaine - 4% articaine

scandonest 2% mepivicaine

citanest - 2.5% prilocaine

12
Q

flap designs

- types (6)

A
  • trapezoid
  • triangular
  • envelope
  • Y-shaped (for palatal exotoses)
  • semilunar (Caldwell-Luc)
  • pedicle
13
Q

suture material

  • types (2)
  • examples (4)
A

resorbable
- collagen, vicryl

non-resorbable
- silk, nylon, prolene, titanium

14
Q

what flap is made to manage OAC?

A

pedicle flap

  • buccal advacement
  • palatal rotational flap
15
Q

signs of roots of 8s close to IDC? (6)

A

IDC canal

  • diversion
  • darkening
  • narrowing
  • loss of lamina dura
  • Deflection of root of lower 8s as they approach IDC
  • Interruption of juxta apical area
16
Q

bone grafts

- types (3)

A
  • autogenous (self)
  • xenograft (dif species)
  • allograft (same species)
17
Q

where are autogenous grafts taken from? (4)

A

ramus
chin (symphysis)
tuberosity
hip

18
Q

histology shows __, what is the diagnosis?

  • outer basal cell layer is comprised of elongated palisaded cells with reversed nuclear polarity
  • towards basement membrane, overall appearance looks like piano keys
  • above basal cell layer, is a zone of very loosely packed stellate cells with large spaces between them
A

ameloblastoma

elongated cells resemble pre-ameloblast
loose cells resemble stellate reticulum

19
Q

what is the Tx for ameloblastoma?

A

excision with 1cm margin of normal bone

20
Q

what is TNM? (3)

A

assessing cancer stage

TNM

  • Tumour size
  • Lymph node involvement
  • Metastasis
21
Q

How is T in TNM graded? (4)

A
(in max diameter)
T1 - <2cm 
T2 - 2-4cm 
T3 - >4cm
T4 - extends to involve other structures (ie mandible or skin)
22
Q

how is cancer prognosis assessed? (2)

A
  • stage (TNM)

- grade (histology)

23
Q

How is N in TNM graded? (5)

A

N0 - no lymph node involvement

(in single ipsilateral node ___ max diameter)
N1 - <3cm
N2a - 3-6cm

N2b - multiple ipsilateral node, not more than 6cm

N2c - bilateral or contralateral node <6cm

N3 - >6cm

24
Q

How is M in TNM graded? (2)

A

M0 - none

M1 - distant metastasis

25
Q

what constitutes stage 4 in cancer assessment? (4)

A

T4
N2, N3
M1

26
Q

what histological features indicate oral dysplasia? (5)

A
  • cellular atypia (pleomorphism)
  • lost of stratification of epithelial layer
  • basal cell hyperplasia (“tear drop” rete ridges)
  • hyperkeratosis
  • acanthosis
27
Q

what are the branches of the facial nerve? (5)

A

TZBMC

  • temporal
  • zygomatic
  • buccal
  • marginal mandibular
  • cervical
28
Q

facial nerve innervates? (2)

A
  • muscles of facial expression (motor)

- anterior 2/3 of tongue (taste) via chorda tympani