Extraction Complications Flashcards
Define an OAC
Communication between oral cavity + maxillary sinus
Define an OAF
Epithelial lined tract between oral cavity + maxillary sinus (chronic - as a result of untx OAC)
OAC predisposing factors
Size of tooth
Proximity of roots to sinus
OAC symptoms
Fluid through nose when drinking
Salty discharge
Change in voice
Sinusitis like pain
Difficulty using straw/singing/smoking/wind instruments
Signs of OAC during XLa
Bubbling of blood at trifurcation of roots
Shimmer of sinus
Blunt probe
Echoing of suction
Tx for OAC
If small <2mm + sinus intact
- Encourage clot, suture margins, POIG + abx
If >2mm + sinus lining torn
- BAF, suture margins, POIG, + abx
Chronic OAF tx
LA, incise tract, BAF, suture margins, POIG + abx
OAC/F post-op instruction
No nose blowing/smoking/wind instruments/straw
Steam inhalations
Painkillers
Abx - Pen V
Root in sinus clinical diagnosis
Confirm with X-ray
Tx for root in sinus
CBCT - to plan for removal
Refer - Caldwell Luc + BAF
Can be left if wedged between sinus lining + bone
Predisposing factors for fractured maxillary tuberosity (3)
Lone standing molar
Extractions in wrong order
Inadequate alveolar bone support
Clinical diagnosis of fractured maxillary tuberosity (4)
Tear in palate
Crack noise
Movement noted visually or with fingers
Mobility in more than 1 tooth
Tx of fractured maxillary tuberosity
Reduce + fixation - ortho wire
Ensure out of occlusion, then extirpate 8wks later
Clinical diagnosis of fractured roots
Check apices/socket + radiographically
Tx of fractured roots
<2mm - KUO, may resorb
>2mm - XLA
Advise may come to surface
Predisposing factors to jaw fracture
Elderly, atrophic mandible, cancer pts, cysts
Tx of jaw fracture
Xray + refer for GA (dont eat/drink)
Stabilise w ortho wire
