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BDS3 Oral surgery > Complications > Flashcards

Complications Flashcards

1
Q

Immediate complications?

A
  • FailureofLA
  • Failuretomovethetooth
  • Fractureofthetoothorrootbeingremoved * Fractureofalveolus
  • OroAntralCommunication(OAC)
  • Displacementofatoothorrootintotissues * Lossoftoothorroot
  • Damagetosurroundingtissues&teeth
  • Thermalinjury/chemicalinjury
  • Haemorrhage
  • TMJinjury
  • Fractureofthemandible
  • DamagetotheTrigeminalnerve
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2
Q

What do you call communications with the maxillary sinus?

A

oro antral communication

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3
Q

Artery in the lip?

A

Superior labial artery

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4
Q

Delayed complications?

A
  • Excessive pain, swelling, trismus * Haemorrhage
  • Dry socket
  • Oro Antral Fistula (OAF)
  • Osteomyelitis / osteonecrosis * Failure of the socket to heal * Nerve damage
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5
Q

Oro antral fistula?

A
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6
Q

Why can’t we extract the 8?

A

partially erupted, impacted on distal of the 7, chunky root

Surgical procedure

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7
Q

Management depends on what?

A
  • Amount fractured: apex or whole root
    – Medical history of patient
    – Presence of infection
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8
Q

Can you remove the crown and leave the root?

A

no, blood clot cannot form on top of it

Can leave small apical area of root

Can only leave a small root - 4mm can be left

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9
Q

If there is a periapical area, what can happen to the root?

A

alveolar bone has resorbed - can flick the apical root out

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10
Q

Problem with tuberosity?

A

attached to molar

Can break

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11
Q

If you fracture the tuberosty, what can occur?

A

oro antral fistula

Into middle meatus - difficult to clean antrum if blood gets there

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12
Q

When can the tuberosity fracture?

A

Usually Lone standing upper molar
- bone becomes denser due to increased function

Hypercementosis

Bulbous roots

Splayed roots

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13
Q

What to do if lone standing ,auxiliary molar needs extracted - dense bone indicated on X-ray?

A

elective surgical procedure

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14
Q

Fractured bone?

A

fractured tuberosity

Fractured alveolus

Fractures mandible

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15
Q

TMJ injuries presents how?

A

dislocation presents as a malocclusion/trismus

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16
Q

TMJ painful?

A

no

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17
Q

What happens in TMJ dislocation?

A

Condylar head slides forward on to the articular emminence and beyond

Gel lid fossa to in front of the articular eminence

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18
Q

Do you check TMJ after extraction?

A

yes

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19
Q

How to put put TMJ back?

A

Pt keep calm

Wrap gauze around things

Push down on mandibular molars

Wrap bandage around head

20
Q

Sedatives?

A

benzodiazalines

= diazepam

= midazolam

21
Q

OAC?

A

oro-antral communication

22
Q

What is an oro-antral communication?

A

pathological communication between the maxillary antrum and the oral cavity

23
Q

What happens if OACs don’t heal?

A

they become an oro-antral fistula

24
Q

Other causes of OAC?

A

osteomyelitis/osteonecrosis, maxillary fracture, sinus tumour, osteoradionecrosis, endodontics, dental implant placement

25
Q

A vs B

A

A = oro-antral communication

B = epithelialised and now a oro-antral fistula

26
Q

Type of X-ray?

A

Occipito- mental X-ray

Taken to look at mid-face

27
Q

Arrow pointing to what?

A

fluid - pus / blood

Fluid in right antrum

Oro-antral fistula

28
Q

Called what?

A

buccal advancement flap

Used for oro-antral communication

Ring up oral surgery department

Regent sinusitis

29
Q

Where can displaced roots be?

A

– Inhaled
– Swallowed
– Antrum
– Buccal/Palatal mucosa
– Floor of nose
– Infratemporal fossa
– Lingual pouch

30
Q

Who would you give antibiotics?

A

swelling
Lymphopayhy
Systemic signs - fever

31
Q

Main oro-facial infection?

A

pericoronistis

Periapical abscess

Periodontal abscess

32
Q

Less common oro-facial infections?

A
  • Infected cysts
  • Acute ulcerative gingivitis
  • Cancrum oris
  • Necrotising fasciitis
  • Osteomyelitis
  • Non-specific lymphadenitis
  • Fungal infections (immunocompromised patients)
33
Q

Lidwigs angina?

A
  • Bilateral sublingual, submandibular and submental space infections
  • Raised swollen tongue

= Pyrexia, dysphagia, dysarthria, dyspnoea
* Potentially life threatening
* Treatbydrainage,I.Vantibiotics
* Mayneedtracheostomyforairway
management

34
Q

What to do if pt shows signs of Ludwig’s angina?

A

sent to hospital

35
Q

Symptoms of Ludwig’s angina?

A

Bilateral sublingual, submandibular and submental, space infections

Raised swollen tongue

Prexia, dysphagia, dysarthria, dyspnoea

36
Q

Signs that a lt can’t swallow?

A

Drooling

37
Q

Treatment for Ludwig’s angina?

A

Treatbydrainage,I.Vantibiotics
* May need tracheostomy for airway management

  • Drain pus & remove source
  • Extraction or pulpectomy
  • Antibiotics empirically then MC&S
  • Pen V & Metronidazole
  • Analgesia
  • In severe cases:
  • Hospital admission, IV antibiotics, GA drainage, blood tests
38
Q

Pus aspiration, what to watch out for?

A

facial nerve

Marginal mandibular shown here - drooping of corner of mouth

39
Q

Cause of Ludwig’s angina?

A

oral infection

Poor oh

40
Q

What is occuring here?

A

Cavernous sinus infection
Can travel to brain
Increased pressure in brain

Meningitis
Cerebral abscesses

41
Q

How to know if a swelling is more serious?

A

hard - pus

42
Q

Severely immune-compromised pts?

A

transplant pts

Cancer pts - chemo/radiotherapy

HIV

43
Q

Where to make impression to remove submandibular infection?

A

w finer space under jaw

44
Q

Raise complications of infection?

A
  • Airway obstruction
  • Pus aspiration into lungs
  • Spread;
    – septicaemia
    – orbital cellulitis
    – Septic cavernous sinus thrombosis
    – encephalitis, meningitis
  • Acute necrotising fasciitis
  • Mediastinal spread
  • Death
45
Q
A

BDS3 Oral surgery (5 decks)

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