Give examples of possible peri-operative extraction complications
- difficult access
- abnormal resistance
- fracture of tooth or root
- fracture of alveolar bone
- jaw fracture
- loss of tooth
- soft tissue damage
- damage to nerves or vessels
- damage to adjacent teeth
- dislocation of TMJ
- wrong tooth
- broken instruments
- haemorrhage
What factors may lead to difficult access?
- trismus
- reduced opening of mouth
- crowded teeth
What factors may lead to abnormal resistance?
- thick cortical bone
- shape of roots e.g. hooked roots
- number of roots e.g. 3 rooted molars
- ankylosis
What factors make a tooth more vulnerable to fracture during extraction?
- caries
- alignment
- size
- root morphology e.g. ankylosis
What are the risk factors for OAC following extraction?
- upper molars or premolars extracted
- close relation to sinus on radiograph
- large, bulbous roots
- previous OAC
- recurrent sinusitis
Gives ways to avoid excessive soft tissue damage during extraction
- take time positioning instruments
- correct placement using correct instruments
- controlled pressure
- sufficient but not excessive force
define paraesthesia
a tingling sensation
define dysaesthesia
an unpleasant sensation/pain
define hypoaesthesia
reduced sensation
define hyperaestheisa
increases or heightened sensation
Give reasons why excessive bleeding can occur during an extraction
- local factors e.g. mucoperiosteal tears
- undiagnosed clotting abnormalities
- liver disease
- medication e.g. warfarin
management of maxillary sinus involvement
inform patient
if small or sinus intact
- encourage clot
- suture margins
- antibiotic
- post op instructions
if large or lining torn
- close with buccal advancement flap
- antibiotic and nose blowing instructions
neuropraxia definition
- contusion of nerves
- continuity of epieneural sheath and axons maintained
axonotmesis definition
- continuity of axons disrupted
- epieneural sheath maintained
neurotmesis
- complete loss of nerve continuity
