Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

5th Oral Disease - Teeth > Complication 8s XLA > Flashcards

Complication 8s XLA Flashcards

1
Q

What are the minor complications?

A

Pain, swelling, trismus, infection, fracture, bleeding, bruising, TMJ problems, temporary nerve damage, damage other teeth, OA communication

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What can be done to reduce pain?

A

Guaranteed after surgical removal
Pre-op warn and give advice how to minimise/ NSAIDs
Analgesia prior to LA wearing off can be advantageous

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

How common is swelling following XLA?

A

Guaranteed after surgical removal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

How common is infection following XLA?

A

Higher incident in lower 8s socket

Need good OH post-op

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Should ab be used to stop infection following XLA?

A

No - not routine

If pt has co-morbidities may be acceptable

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

How to prevent damage to adjacent teeth?

A

Assess clinically and radiographically pre-op
Warn pt
Have plan to minimise risk and deal w/ complications

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Who is more at risk of fracture of mandible?

A

Elderly pt - esp edentulous w/ atrophic mandible
Pre-existing bone pathology
Large bony defect
If excessive use of force is used

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

How common is it to displace the tooth during XLA?

A

Uncommon

Can happy upper 8s - very rare

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Major complication of XLA lower 8?

A

Trigeminal nerve damage

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What is the incidence of IAN damage?

A

5-7% is temporary

0.5-1% permanent

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is incidence of damage to lingual nerve?

A

3-7% temporary

0.3-0/5% permanent

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Possible causes of IAN damage?

A

XLA 8’s, implantology, other surgery e.g orthographic, trauma, needle stick

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Why is third molar XLA most common cause trigeminal nerve injury?

A

Due to anatomy
Mainly drill injuries
Lingual flaps raised

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is the anatomy of the trigeminal nerve?

A

Mandibular division of trigeminal branches into IAN and lingual branch
IAN runs through mandible exit at foramen near roots 3rd molar
Lingual nerve transverse mesial in soft tissue - height of crest on 3rd molars

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What does IAN split into?

A

Mental and incisive branches

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is the effect of trigeminal nerve injury?

A 
Loss of sensation anterior tongue/ lip/cheek
Paraesthesia - reduced sensation 
Dysasthesia - pain, tingling
Allodynia - painful response stimuli 
Loss of taste
17
Q

What would pt w/ trigeminal injury complain about?

A 
Pain
Dribbling
Don't enjoy kissing
Tongue feels strange
Don't enjoy eating
18
Q

Surgical technique for lingual nerve injury?

A

Lingual flap raised - central and distal nerve stump identified
Damaged nerve excised
Direct reapposition

19
Q

How to minimise lingual nerve injury?

A

Avoid lingual retraction -crush and drill injuries

20
Q

How to measure outcome of management of nerve injuries?

A

Touch - two point discrimination

Subjective assessment

21
Q

How effective is management of nerve injury?

A

Most pt regain some sensation

Pt consider it worthwhile - but won’t be back to normal

22
Q

Should IAN be repaired at time of XLA?

A

Nerve is well supported in canal - primary repair not usually required

23
Q

What is likely to be damaged if the IAN is damaged?

A

Inferior alveolar artery - get arterial bleed

but can damage artery w/o nerve damage

24
Q

What should be avoided when managing IAN damage?

A

Diathermy
Whitehead varnhish
Surgical - potentially neurotoxic (only place top of socket)
Bone wax - stop nerve regeneration

25
Q

How can implanvology lead to IAN nerve damage?

A

From drill or implant
Overdrilling in low resistance bone - slip
Miscalculation position of IAN

26
Q

What safety measure should be calculated in implantology?

A

2-4mm safety zone

27
Q

What else is a high risk area?

A

Mental foramen

28
Q

What factors could be suggestive IAN damage?

A

Sudden give
Electric shock
Arterial bleed

29
Q

How to manage IAN damage following implantology?

A

Inform pt - take radiograph and evaluate
Neruosensory evaluation
Ideally remove implant 24-36 hours

30
Q

Indications for surgical management following IAN injury?

A

Persistant anaesthesia
Dysaestheisa/ pain
Complete anaesthesia

31
Q

How effective is IAN decompression?

A

Improves level of sensation - but no improvement in some pt

Can’t predict who will benefit - only offer to pt with severe symptoms

32
Q

Incidence of nerve damage following needle-stick injury?

A

Low 1 in 20,000 - 850,000

33
Q

How can needle cause injury

A

Direct trauma - bevel fave laterally

34
Q

Can LA cause nerve injury?

A

Direct injection of nerve intraneural can cause damage

35
Q

What can be assessed with a radiograph?

A 
Type impaction
Depth tooth within bone
Crown form
Root number and form
Coronal or root pathology
Relationship Canal/sinus
36
Q

What is ABCDE assessment IAN?

A 
A = radiolucency
B = deviation/ constriction
C = loss cortication
D = deviation of roots
E = narrowing of roots
37
Q

Is CT used?

A

Not routinely indicated

CBCT appropriate high risk cases

5th Oral Disease - Teeth (3 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions