3. Complications of exodontia

Question 1

What are the risks of exodontia?

Answer 1

Question 2

Surgical complications can be :

Answer 2

Question 3

Immediate intraoperative complications include? (7)

Answer 3

Question 4

Haemorrhage- coagulation process

Answer 4

Primary haemostasis
Secondary haemostasis

Question 5

Haemorrhage- coagulation process
Primary haemostasis - what happens in primary haemostasis?

Answer 5

Question 6

Haemorrhage- coagulation process
Secondary haemostasis - what does it involve?

Answer 6

•Formation of fibrin through the coagulation cascade

•Defects in the coagulation cascade manifest as more serious bleeding than primary haemostasis defects.

Question 7

Secondary haemostasis pathways?

Answer 7

Extrinsic pathway
Intrinsic pathway

Also Common pathway

Question 8

Secondary haemostasis
What does extrinsic pathway involve?

Answer 8

Question 9

Secondary haemostasis
What does intrinsic pathway involve?

Answer 9

Question 10

Secondary haemostasis
What does common pathway involve?

Answer 10

Question 11

Question 12

Bleeding

Answer 12

Question 13

What is haemostasis

Answer 13

Stopping of blood

Question 14

What is a haemostatic measure

Answer 14

Way to stop bleeding

Question 15

Haemorrhage - local heamostatic measures
What are local heamostatic measures?

Answer 15

ADD IN PHOTO OD LSIDE 11

Question 16

What is a coagulopathy?

Answer 16

A condition that affects how your blood clots

Question 17

Haemorrhage
Examples of different coagulopathies?

Answer 17

Soft tissue bleed (vessel/ Inflamed tissue/ periodontal disease)
Bone bleed
Anti-platelet medication (aspirin, clopidogrel)
Warfarin
Bleeding disorders (haemophilia, Von Willebrand disease, thrombocytopenia), liver or kidney disease
Combination warfarin AND bleeding disorder, liver/kidney disease

Question 18

Haemorrhage
How would you manage a patient with Soft tissue bleed (vessel/ Inflamed tissue/ periodontal disease)

Answer 18

Question 19

Haemorrhage
How would you manage a patient with bone bleed?

Answer 19

Question 20

Haemorrhage
How would you manage a patient with Anti-platelet medication (aspirin, clopidogrel) ?

Answer 20

Local haemostatic measures

Question 21

Haemorrhage
How would you manage a patient with warfarin ?
(For tooth extractions/ exodontia )

Answer 21

Question 22

Answer 22

Question 23

Haemorrhage
How would you manage a patient with Bleeding disorders (haemophilia, Von Willebrand disease, thrombocytopenia), liver or kidney disease

Answer 23

Question 24

Haemorrhage
How would you manage a patient with Combination warfarin AND bleeding disorder, liver/kidney disease?

Answer 24

Question 25

Question 26

Soft tissue injury How can it be caused? How can it be prevented?

Answer 26

Question 27

Fracture of tooth/ root Why might a tooth or root fracture? How to manage?

Answer 27

•Normal part of process of tooth extraction •Brittle teeth (previous RCT) •Grossly carious/ heavily restored •Curved apex •Inappropriate use of elevators/forceps

Question 28

Displacement of root in antrum How do we retrieve it?

Answer 28

For understanding - antrum is another way of saying maxillary sinus aka root could go to maxillary sinus Understanding - Oroantral communication - unnatural space that forms between maxillary sinus and oral cavity following extraction of antral teeth

Question 29

Caldwell Luc Procedure

Answer 29

Question 30

Fracture of bone May be caused by? Management?

Answer 30

Question 31

Fracture of maxillary tuberosity Causes? Management - when small fragment attached to tooth ? - when large fragment of bone?

Answer 31

Question 32

Question 33

Oro-antral communication Incidence ? Risk factors? What can develop?

Answer 33

Oroantral fistula for understanding is an epithelialised pathological unnatural communication between oral cavity and maxillary sinus. - develops when Oroantral communication fails to close spontaneously

Question 34

Treatment of oroantral communication

Answer 34

Question 35

Treatment of oroantralcommunication pt 2

Answer 35

Question 36

Surgical closure of Oroantral fistula

Answer 36

Question 37

Look at answers for more diagrams

Answer 37

Question 38

Dislocation of TMJ

Answer 38

Avoid by always supporting the mandible Patient will not be able to close mouth and occlusal derangement. Manipulate mandible manually downwards and backwards to correct +/- IV sedation or GA. Prevention with use of mouth props (Pt may have flat articular eminence)

Question 39

Dislocated jaw/tmj

Answer 39

Question 40

Everything up to now has been Immediate Intraoperative complications

Question 41

Early post-operative What are Early post-operative complications that can occur?

Answer 41

Question 42

Pain and swelling

Answer 42

Question 43

Trismus Occurs when? Causes? Management?

Answer 43

Question 44

what is trismus?

Answer 44

- also known as lockjaw - usu due to tetanic spasms of muscles of mastication

Question 45

Dry socket Common in? Occurs when? Causes? Management

Answer 45

Question 46

what is dry socket (google)

Answer 46

- blood clot fails to develop in tooth socket - blood clot becomes dislodged or disappears - can happen 3-5 days after surgery - empty socket causes an ache or throbbing pain in gum or jaw (like toothache)

Question 47

Dry socket risk factors

Answer 47

Question 48

Delayed haemorrhage Reactionary haemorrhage Occurs when? Delayed haemorrhage occurs when? Management?

Answer 48

Question 49

Prolonged anaesthesia Follows what? Risk increases with? Is it permanent?

Answer 49

Question 50

Late lost operative Late post operative complications include?

Answer 50

Question 51

Bisphosphonates What are Bisphosphonates ? What conditions are Bisphosphonates used for? What can they do?

Answer 51

Question 52