Oral Surgery & Extractions Flashcards

What is the most appropriate consent process for third molar surgery under general anaesthesia?

Answer: Written informed consent with specific risks including nerve injury, infection, dry socket, and anaesthetic risks

Written informed consent is required, with specific discussion of procedure-specific risks including IAN/lingual nerve damage, dry socket, infection, and general anaesthetic risks, following Montgomery v Lanarkshire ruling.

Which radiograph is recommended before lower third molar surgery to assess root-IAN proximity?

Answer: CBCT when periapical shows intimate contact

CBCT is indicated when OPG/periapical radiographs show signs of intimate root-IAN contact (e.g., root narrowing, canal interruption, darkening), providing accurate 3D assessment to plan surgery safely.

What is the most common site for an odontogenic keratocyst (OKC)?

Answer: Posterior mandible, often associated with unerupted third molar

Odontogenic keratocysts most commonly occur in the posterior mandible and are frequently associated with impacted lower third molars, presenting as a well-defined radiolucency.

A patient takes clopidogrel for a cardiac stent placed 4 months ago. What is the safest approach for a simple extraction?

Answer: Proceed with extraction without stopping clopidogrel; use local haemostatic measures

Antiplatelet agents should NOT be stopped within 12 months of stent placement due to risk of stent thrombosis; extractions can be performed safely with local haemostatic measures.

What is the difference between primary and secondary haemorrhage following extraction?

Answer: Primary is immediate at time of surgery; secondary occurs 7–10 days post-op due to infection

Primary haemorrhage occurs at or immediately after the time of surgery; secondary haemorrhage occurs 7–10 days later when infection causes clot breakdown.

Which investigation is most useful when osteonecrosis of the jaw (MRONJ) is suspected on clinical grounds?

Answer: CBCT to assess extent of bone involvement

CBCT provides superior detail of cortical and trabecular bone changes in suspected MRONJ, allowing accurate assessment of disease extent and sequestrum, guiding surgical management.