Extraction Complications 1 Flashcards
what can cause difficult access into a mouth
trismus, reduced aperture of the mouth, crowded/ mispositioned teeth
what can cause abnormal resistance during xla
thick cortical bone
shape/ form of roots
hypercementosis
ankylosis
what aspects of root morphology can cause tooth/ root fractures
fused
convergent or divergent roots
extra roots
hypercementosis
ankylosis
what plate of the alveolar bone usually fractures
buccal plate
what teeth are usually associated with fracture of the alveolar bone
canines or molars
what are the steps to take if an alveolar fracture occurs
inform patient, post op radiograph, refer, ensure analgesia, stabilise, antibiotics
what are risk factors for OAFs or OACs
extractions of upper molars and premolars
close relationship of roots to sinus on radiograph
large bulbous roots
older patient
previous OAC
recurrent sinusitis
what are the risk factors of a tuberosity fracture
single standing molar
unknown unerupted molar wisdom tooth
pathological gemination
extracting in wrong order
inadequate alveolar support
what is hypercementosis
excess build up of normal cementum on the root
what is ankylosis
tooth is directly bonded to surrounding bone - no PDL
what increases the chances of a tooth fracturing
caries
alignment
size
when does fracture of the alveolar bone usually happen
when you take the tooth out too quickly
when is the biggest predisposition to fracture of the mandible
an impacted lower 8 or a large cyst
an edentulous mandible
how do you try to prevent fracturing of the mandible
by supporting the mandible with your non-dominant hand
what type of radiograph should you get for a suspected fractured mandible
OPT
what are signs of a fractured mandible
hearing a crack
feeling the mandible is in 2 parts
teeth do not meet in occlusion and they used to
what are the three ways an OAC can occur
the roots of the tooth were sitting in the sinus
when going in to get a fractured third root with and elevator you can push the root into the sinus
fractured tuberosity
what is an OAC
oro-antral communication - hole between the sinus and the mouth
what is an OAF
when the hole between the sinus and the mouth has been left for a while and has become epithelialised and you have a tract that leads from the sinus to the mouth
what are signs of creating OAC
if there is a chunk of bone at the roots of the tooth
if pre-op radiograph shows the roots are close to the sinus
bubbling of air at the socket
what is the test for confirming presence of an OAC
ask patient to pinch nostrils and blow out with closed nostrils - if there is an OAC it forces the air out into the mouth via the sinus
how would you manage an OAC
inform patient
if small OAC - encourage clot and suture margins and prescribe antibiotics
if large OAC - close with buccal advancement flap and prescribe antibiotics
how do you try to prevent tuberosity fractures
finger and thumb supporting the alveolar bone
what direction should you work in when removing teeth
remove the furthest back teeth first and work forward
how is a fractured tuberosity managed
large part of bone - put back in place and use fingers and forceps to hold back in place then use and orthodontic splint
