Viva in Oral Surgery for Dental Students V Ramkumar
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Introduction to Oral Surgery1

  1. What is oral and maxillo facial surgery?
    Oral and maxillo facial surgery is a branch in dentistry that deals with the art of diagnosis and treatment of various diseases, pathological defects involving the Oro facial region.
  2. Define Exodontia or tooth extraction.
    According to Geoffrey L Howe, tooth extraction is the painless removal of the whole tooth or tooth root with minimal trauma to the investing tissues, so that the wound heals uneventfully and no postoperative prosthetic problem is created.
  3. Define scope of oral surgery.
    The scope of oral surgery ranges from dental extraction to major oral and maxillo facial surgery eventually there may be two types of oral surgeons, practicing minor and major oral surgery respectively each acceptable in one owns national and regional situation by virtue of the training or personal relationship with the surgical colleague.
 
CASE HISTORY
  1. The complaint
  2. History of present illness:
  3. Personal history:
    1. School life
    2. Occupation
    3. Recreation
    4. Habituation
    5. 2Environment
    6. Meals
    7. Holidays
    8. Has he lived abroad
    9. Worries
  4. Previous diseases
  5. Family history
 
PAIN
  1. Its character.
  2. The severity.
  3. Date of onset.
  4. Is the pain continuous or have there been remissions?
  5. Is it increasing or decreasing in severity?
  6. Where is the point of maximum intensity?
  7. Area to which pain spreads.
  8. Area to which the pain radiates.
  9. What makes the pain worse?
  10. Are there other symptoms?
 
THE EXAMINATION OF A LUMP
  1. The exact anatomical situation of the Mass.
  2. Are the associated lymph nodes enlarged.
  3. Is the swelling single or multiple?
  4. The shape.
  5. The size.
  6. The surface of the Mass.
  7. The Edge.
  8. The consistency.
  9. Is the lump tender or warm on palpation?
  10. Is the lump attached to the skin?
  11. Care must be taken to ascertain whether the lump arises from deeper structures.
  12. Is fluctuation present?
  13. Are there signs of inflammation present?
  14. 3Transillumination (Positive in cystic hygroma, naso labial cysts).
  15. Is there an impulse on coughing and crying?
  16. Does the lump pulsate?
  17. Any mass may produce pressure effects on.
  18. The colour of the lump.
  19. The general condition of the patient.
 
EXAMINATION OF AN ULCER
  1. The situation of the ulcer.
  2. Is the ulcer single or multiple?
  3. Note the size of the ulcer.
  4. Examine the shape of the ulcer—Ulcers may be round, oval, crescentic, serpiginous, irregular, punched out, etc.
  5. Note the base of the ulcer.
  6. The floor of the ulcer may be covered by:
    1. Granulations. These may be red, pale or fabby that may or may not bleed
    2. The floor may be smooth.
    3. It may be covered with slough, membrane, scab, etc.
    4. The floor may be adherent to soft parts or bone.
    5. The floor may be fungating as seen in some clinical varieties of malignant disease.
  7. The edge of the ulcer may be:
    1. Undermined (as seen in tubercular ulcers)
    2. Punched out (as found in gummatous ulcers)
    3. Rolled out (as characteristically occurs in rodent ulcers)
    4. Rolled, raised and everted (as characterized by malignant ulcers)
  8. The condition of the parts surrounding the ulcers must be examined.
  9. If there is a discharge from the ulcer, its colour and smell should be noted and bacteriological smear taken for culture.
  10. Is the ulcer painful.
  11. The general conditioning the patient must always be considered.