COMPLICATIONS Flashcards
what is the term for limited mouth opening?
trismus
what anatomical feature may overlie an upper 7?
root of the zygoma
what anatomical feature may be found around the apices of the lower 4 or 5?
mental neurovascular bundle
what happens if the mental neurovascular bundle is distrupted?
altered sensation of lower lip
*very unlikely
what is it called when a tooth is left in the palate?
an ectopic tooth
what do you call the direction of an 8 horizontally impacting a 7?
mesioangular
what anatomical feature is found at the apices of the lower 8s sometimes?
inferior alveolar neurovascular canal
what other nerve should be anaesthetised as well as the IAN?
lingual and long buccal
how is LA tested prior to xLA?
probing around tooth with sharp probe
what area does the zygoma insert in to?
maxillary buttress
what has happened if you want to give a mental nerve block but only the lower lip is numb?
you haven’t anaesthetised the terminal branch
what pathway is used for LA systemic toxicity?
CYP450 1A2/ 3A4
what drugs are strong inhibitors of CYP1A2? and may slow metabolism?
verapamil - Ca channel blockers
what are inducers of CYP1A2 and have the potential for quicker metabolism?
broccoli
insulin
omeprazole
what drugs may retard metabolism of lidocaine?
SSRI’s
Clopidogrel
warfarin
caffeine
what interaction exists between St Johns wort and lidocaine?
St Johns Wort may speed up the metabolism of lidocaine
what are early signs of CNS LA systemic toxicity?
muscle twitching
agitation - auditory change
tinnitus
metallic taste
what are late signs of CNS LA systemic toxicity?
depression
perioral tingling
drowsiness
unconsciousness
resp arrest
how may LA systemic toxicity affect the CVS?
reduced excitability of myocardium
vasodilation
CVS collapse
may be secondary to hypoxaemia
list the types of displacement
infratemporal fossa - removal of U8 when tooth is partially erupted, root curves distally
subperiosteal - when small bit of root is left and tried to removed if there is an area of thinned/ fenestrated bone
lingual tissues - roots are fenestrating area of thin bone, attempt to retrieve root after fracture
Inferior alveolar canal
Maxillary antrum - canines and first premolars
OAC issues?
perforation of max sinus
required repair
find the root that has been displaced
may need ENT referral
