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Bds 3 - RMAOH ORAL SURGERY > Complications Of Exodontia > Flashcards

Complications Of Exodontia Flashcards

1
Q

What are the risks of exodontia?

A
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2
Q

What are the 3 categories for surgical complications?
Surgical complications can be :

A
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3
Q

Immediate intraoperative complications include?
(7)

A
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4
Q

Haemorrhage- coagulation process

A

Primary haemostasis
Secondary haemostasis

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5
Q

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

A
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6
Q

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

A

•Formation of fibrin through the coagulation cascade

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

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7
Q

Secondary haemostasis pathways?

A

Extrinsic pathway
Intrinsic pathway
Common pathway

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8
Q

Secondary haemostasis
What does extrinsic pathway involve?

A
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9
Q

Secondary haemostasis
What does intrinsic pathway involve?

A
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10
Q

Secondary haemostasis
What does common pathway involve?

A
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11
Q
A
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12
Q

Bleeding
When should haemostasis usually occur
If prolonged bleeding occurs in normal patient what can be done

A
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13
Q

What is haemostasis

A

Stopping of blood

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14
Q

What is a haemostatic measure

A

Way to stop bleeding

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15
Q

Haemorrhage - local heamostatic measures
What are local heamostatic measures?

A
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16
Q

What is a coagulopathy?

A

A condition that affects how your blood clots

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17
Q

Haemorrhage
Examples of different coagulopathies?
(6)

A

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

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18
Q

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

A

Ligate, suture or bipolar in pic

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19
Q

Haemorrhage
How would you manage a patient with bone bleed?

A
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20
Q

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

A

Local haemostatic measures

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21
Q

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

A
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22
Q

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

A
23
Q

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

A
24
Q
A
25
Q

Soft tissue injury
How can it be caused? (2)
How can it be prevented? (2)

A
26
Q

Fracture of tooth/ root
Why might a tooth or root fracture occur? (4)
How to manage?

A

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

27
Q

Displacement of root in antrum
How do we retrieve it?

A

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

28
Q

Caldwell Luc Procedure

A
29
Q

Fracture of bone
May be caused by? (5)
Management?

A

Fracture of Buccal / lingual cortical plate + alveolus is what is being referred to by fracture of bone
Replacing - as in puttting it back

30
Q

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

A
31
Q
A
32
Q

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

A

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

33
Q

Treatment of oroantral communication
What is antral regime

A
34
Q

Treatment of oroantralcommunication pt 2
How do we treat OAFs?
OAF - essentially when OAC doesn’t close + epithelised now

A

Concurrently = at the same time
Line 3 means refer to ENT if sinusitis persists where they can do FESS

35
Q

Surgical closure of Oroantral fistula

A
36
Q

Look at answers for more diagrams

A
37
Q

Dislocation of TMJ
How can this be avoided?

What happens to the patient?

Management?

Prevention?

A

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)

38
Q

Dislocated jaw/tmj

A
39
Q

Everything up to now has been Immediate Intraoperative complications

A
40
Q

Early post-operative
What are Early post-operative complications that can occur? (10)

A
41
Q

Pain and swelling

What is most post op pain?
What causes swelling?
What is given for the pain and what are contraindications for that?

A

Contraindications for NSAIDS: asthmatics, kidney disease

42
Q

Trismus
Occurs when?
Causes?
Management if it doesn’t resolve?

A
43
Q

Dry socket
Common in?
Occurs when?
Causes?
Management

A
44
Q

Dry socket risk factors
(6)

A
45
Q

Delayed haemorrhage
Reactionary haemorrhage Occurs when?
What is reactionary haemorrhage in response to?
Delayed haemorrhage occurs when?
What is delayed haemorrhage in response to?
Management?

A
46
Q

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

A
47
Q

Late lost operative
Late post operative complications include?

A
48
Q

Bisphosphonates
What are Bisphosphonates ?
What conditions are Bisphosphonates used for? (3)
What can they do in regards to extraction?

A
49
Q

BISPHOSPHONATES - extra from oral surgery consultant clinic year 4
What is a major risk factor for patients who take Bisphosphonates ?

A

MRONJ - medically related osteonecrosis of the jaw
Clinical sign of MRONJ - exposed bone and delayed healing

50
Q

Bisphosponates
What are the 2 risk categories for bisphosphonates and developing MRONJ?
Explain what makes a patient high risk? (3)

A

1- High and low risk

2-
HIGH RISK:
1. IV bisphosponates as opposed to oral
2. Taking bisphosphonates more than 5 years
3. bisphosphonates taken for cancer

bisphosphonates stay in system for every so MRONJ risk is present even if patient no longer on bisphosphonates

51
Q

Bisphosphonates
Low risk management

A
52
Q

Bisphosphonates
High risk management

A
53
Q

Examples of Bisphosphonates

A

Alendronic acid

Bds 3 - RMAOH ORAL SURGERY (9 decks)

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