OS- Mental Dental| 120 QUESTIONS |
100% CORRECT ANSWERS
Indications for Extraction Correct Answer: Caries
Endo
Perio
Ortho
Cracked teeth
Impacted teeth
Supernumerary
Pathology
Questionable teeth should be extracted before radiation therapy
Contraindications for Extraction Correct Answer: Brittle (unstable) diabetes
End stage
Unstableangina
Leukemia and lymphoma
Hemophilia or platelet disorder
Head and neck radiation—give hyperbaricoxygen helps before (and after)
extraction preventing Osteoradionecrosis
IV bisphosphonates—try to RCT or restore
Pericoronitis—treat infection first
Impacted Teeth
-most to least Correct Answer: • Fail to erupt into the dental arch within the
expected time
• Mandibular third molars > maxillary third molars > maxillary canines
• Primary reason is inadequate arch length
Congenitally Missing Teeth
-most to least Correct Answer: • Fail to form
• Third molars > maxillary lateral incisors > mandibular second premolars
,Nature of Overlying Tissue- impaction types Correct Answer: For any impacted
teeth
Soft tissue impaction= height of contour is above bone level and gingiva is
completely or partially covering tooth, easiest
Hard tissue impaction- Partial bony impaction= height of contour is below bone
level
- Full bony impaction= tooth is entirely encased in bone, most difficult
Winter's Classification Correct Answer: • ONLY For impacted third molars
• Based on position of long axis of the 3rd molar in relation to the long axis of the
2nd molar
• For lower molars:
- Mesioangular= easiest (mesio for easio)
- Distoangular= most difficult (D for difficult)
Pell and Gregory Classification Correct Answer: For impacted lower third molars
only-
ABC= depth, 123= how far back into ramus
Class A= same plane as other molars
Class B= halfway down other molars
Class C= below cervical line of 2nd molar, most difficult
Class I= crown anterior to ramus
Class II= half crown within ramus
Class III= entire crown within ramus, most difficult
Subperiosteal Abscess Correct Answer: • Possible whenever a mucoperiosteal
flap is elevated for surgical extraction
• Irrigate thoroughly to remove fractured tooth or bone spicules below the soft
tissue
-usually occurs when a small piece of necrotic bone is left under a flap
Oro-Antral Communication (OAC):
What is it?
Most common spot?
Treatmetn (2mm, 2-6mm, >6mm) Correct Answer: Sinus exposure
Most common with maxillary first molars
Prevent with good pre-op radiograph and avoid excessive apical pressure
, Tx: if <2mm do nothing, 2-6mm 4As (antibiotics, antihistamines, anelgesics, afarin
nasal spray) and figure-eight suture, >6mm flap surgery
-can lead to sinusitis, infection of the sinus cavity, oral-anthral fistula
Alveolar Osteitis Correct Answer: "Dry socket"
When blood clot dislodges or dissolves before wound heals following an
extraction
-why its important to currette and clean the socket to stimulate bleeding
-in high risk cases place gel foam
• Does not require antibiotics
• Tx: irrigation, put in dry socket paste (contains eugenol) and local pain control
Nerve Injury:
Most common with?
Tx?
When to refer for micro surg eval? Correct Answer: • Most common with lower
third molars & IAN
• Tx: medrol dosepak
• Patients with numbness or parestesia (pins and needles) lasting more than 4
weeks should be referred for microneurosurgical evaluation
Tooth Displacement risks:
Mx 1st and 2nd
Mx 3rd
Md 3rd Correct Answer: IMPORTANT
Maxillary first/second molar -> maxillary sinus
Maxillary third molar -> infratemporal fossa
Mandibular third molar -> submandibular space
Tooth lost into the oropharynx, send to ER for chest and abdominal x-rays
Suction Tips types Correct Answer: • Yankauer suction= soft tissue• Frazier
suction= hard and soft tissue
Towel Clip Correct Answer: • Holds drapes placed around patient
• Locking handle with finger and thumb rings
• Careful not to pinch patient
100% CORRECT ANSWERS
Indications for Extraction Correct Answer: Caries
Endo
Perio
Ortho
Cracked teeth
Impacted teeth
Supernumerary
Pathology
Questionable teeth should be extracted before radiation therapy
Contraindications for Extraction Correct Answer: Brittle (unstable) diabetes
End stage
Unstableangina
Leukemia and lymphoma
Hemophilia or platelet disorder
Head and neck radiation—give hyperbaricoxygen helps before (and after)
extraction preventing Osteoradionecrosis
IV bisphosphonates—try to RCT or restore
Pericoronitis—treat infection first
Impacted Teeth
-most to least Correct Answer: • Fail to erupt into the dental arch within the
expected time
• Mandibular third molars > maxillary third molars > maxillary canines
• Primary reason is inadequate arch length
Congenitally Missing Teeth
-most to least Correct Answer: • Fail to form
• Third molars > maxillary lateral incisors > mandibular second premolars
,Nature of Overlying Tissue- impaction types Correct Answer: For any impacted
teeth
Soft tissue impaction= height of contour is above bone level and gingiva is
completely or partially covering tooth, easiest
Hard tissue impaction- Partial bony impaction= height of contour is below bone
level
- Full bony impaction= tooth is entirely encased in bone, most difficult
Winter's Classification Correct Answer: • ONLY For impacted third molars
• Based on position of long axis of the 3rd molar in relation to the long axis of the
2nd molar
• For lower molars:
- Mesioangular= easiest (mesio for easio)
- Distoangular= most difficult (D for difficult)
Pell and Gregory Classification Correct Answer: For impacted lower third molars
only-
ABC= depth, 123= how far back into ramus
Class A= same plane as other molars
Class B= halfway down other molars
Class C= below cervical line of 2nd molar, most difficult
Class I= crown anterior to ramus
Class II= half crown within ramus
Class III= entire crown within ramus, most difficult
Subperiosteal Abscess Correct Answer: • Possible whenever a mucoperiosteal
flap is elevated for surgical extraction
• Irrigate thoroughly to remove fractured tooth or bone spicules below the soft
tissue
-usually occurs when a small piece of necrotic bone is left under a flap
Oro-Antral Communication (OAC):
What is it?
Most common spot?
Treatmetn (2mm, 2-6mm, >6mm) Correct Answer: Sinus exposure
Most common with maxillary first molars
Prevent with good pre-op radiograph and avoid excessive apical pressure
, Tx: if <2mm do nothing, 2-6mm 4As (antibiotics, antihistamines, anelgesics, afarin
nasal spray) and figure-eight suture, >6mm flap surgery
-can lead to sinusitis, infection of the sinus cavity, oral-anthral fistula
Alveolar Osteitis Correct Answer: "Dry socket"
When blood clot dislodges or dissolves before wound heals following an
extraction
-why its important to currette and clean the socket to stimulate bleeding
-in high risk cases place gel foam
• Does not require antibiotics
• Tx: irrigation, put in dry socket paste (contains eugenol) and local pain control
Nerve Injury:
Most common with?
Tx?
When to refer for micro surg eval? Correct Answer: • Most common with lower
third molars & IAN
• Tx: medrol dosepak
• Patients with numbness or parestesia (pins and needles) lasting more than 4
weeks should be referred for microneurosurgical evaluation
Tooth Displacement risks:
Mx 1st and 2nd
Mx 3rd
Md 3rd Correct Answer: IMPORTANT
Maxillary first/second molar -> maxillary sinus
Maxillary third molar -> infratemporal fossa
Mandibular third molar -> submandibular space
Tooth lost into the oropharynx, send to ER for chest and abdominal x-rays
Suction Tips types Correct Answer: • Yankauer suction= soft tissue• Frazier
suction= hard and soft tissue
Towel Clip Correct Answer: • Holds drapes placed around patient
• Locking handle with finger and thumb rings
• Careful not to pinch patient
