Complications during tooth extraction Flashcards
Perioperative complications
- Crown fracture of adjacent tooth
- Soft tissue injury
- Fracture of alveolar process/maxillary tuberosity/Mandible
- Broken instrument in tissues
- Displacement of root tip into soft tissues
- Displacement of impacted tooth or root into maxillary sinus
- Dislocation of TMJ
- Subcutaneous or submucosal emphysema
- Haemorrhage
- Oroantral communication
- Nerve injury
Causes of fracture of crown or luxation of adjacent tooth
Excessive force and adjacent tooth used as fulcrum
Causes of soft tissue injury during extraction
-Improper instrument use(slippage)
Causes of fracture of alveolar process
- Improper extraction technique
- Ankylosis of tooth in alveolar process
Treatment of fracture of alveolar process
- Small→ broken parts of alveolar process removed w/forceps
- Sharp bone edges smoothed
- Saline irrigation and suturing
- Broken parts still attached to soft tissues may remain after stabilisation and suturing
Causes of fracture of maxillary tuberosity
- Maxillary sinus pneumatising into alveolar process
- Ankylosis of maxillary molars(resistance to movement great)
- Decreased resistance of bone in area
Treatment of fracture of maxillary tuberosity
- Repositioning of fractured segment and suturing when fractured segment not reflected from periosteum
- Tooth removed, bone smoothing and suturing when segment reflected→ Broad spectrum antibiotics and nasal decongestants
Causes of mandible fracture
- Excessive force with elevator
- Inadequate pathway for impacted tooth removal
- Ankylosed tooth
- Atrophic mandible
Treatment of mandibular fracture
- Removal of tooth first
- Stabilisation→ intermaxillary fixation or rigid internal fixation
- Broad spectrum antibiotics
Causes of broken instrument in tissue
- Excessive force during luxation
- Anaesthesia needle may break
Treatment of broken instrument in tissue
- Radiographic localisation
- Broken pieces surgically removed during same appointment
Causes of TMJ dislocation
- Shallow mandibular fossa or temporal bone
- Low anterior articular tubercle
- Round head of condylar process
Unilateral dislocation of TMJ results in
Mandible deviation to healthy side
Bilateral dislocation of TMJ results in
-Mandible sliding forward in prognathic position
Methods to avoid TMJ dislocation
- Firmly support mandible during extraction
- Avoidance of excessive mouth opening