NBDE Examination Practice Question # 106

NBDE Examination.

Practice Question # 106.

Surgical Endodontics

1. Incision and drainage/trephination
2. The objectives are to evacuate exudates, purulence, and toxic irritants. Removal speeds healing and reduces discomfort from irritants and pressure. (The best treatment for swelling from acute apical abscess is to establish drainage, and to clean and shape the canal.)
3. Incision and drainage of soft tissues is indicated:
4. If a pathway is needed in soft tissue with localized fluctuant swelling that can provide necessary drainage.
5. When pain is caused by accumulation of exudates in tissues.
6. When necessary to obtain samples for bacteriologic analysis.
7. Trephination of hard tissues is indicated:
8. If a pathway is needed from hard tissue to obtain necessary drainage.
9. When pain is caused by accumulation of exudates within the alveolar bone.
10. To obtain samples for bacteriologic analysis.

1. Procedure
2. Incision and drainage is a surgical opening created in soft tissue for the purpose of releasing exudates or decompressing an area of swelling.
3. Trephination is the surgical perforation of the alveolar cortical bone to release accumulated tissue exudates.
4. Profound anesthesia is difficult to achieve in the presence of infection due to the acidic pH of abscess and hyperalgesia.
5. The incision should be made firmly through periosteum to bone. Vertical incisions are parallel with major blood vessels and nerves and leave very little scarring.
6. These procedures may include the placement and subsequent timely removal of a drain.
7. Antibiotics may be indicated if there is diffuse swelling (cellulitis), systemic symptoms, or in patients who are immunocompromised.