Extraction Complications 2

Question 1

what sort of operative complications can occur to nerves (types of damage)?

Answer 1

• crush injuries
• cutting/shredding injuries
• transection
• damage from surgery/damage from LA

Question 2

what is neurapraxia?

Answer 2

contusion (bruise) of nerve
(the most mild nerve injury)

Question 3

what is axonotmesis?

Answer 3

axon and their myelin sheath damaged BUT endo, epi and perineurium are ok

Question 4

What is neurotmesis?

Answer 4

complete loss of nerve/nerve transected
(most severe nerve injury)

Question 5

what are the definitions of:
- anaesthesia
- paraesthesia
- dysaesthesia
- hypoaesthesia
- hyperaesthesia

Answer 5

AESTHESIA = NORMAL SENSATIONS

• numbness
• tingling
• unpleasant sensation/pain
• reduced sensation
• increased sensation

Question 6

what are the types of damage to vessels that can occur in surgery?

Answer 6

• veins (bleeding)
• arteries (spurting/haemorrhage)
• arterioles (spurting/pulsating bleed)
• vessels in muscle
• vessels in bone

Question 7

what is the relationship between liver disease and bleeding?

Answer 7

clotting factors made in the liver using vitamin K

Question 8

what is the difference between an antiplatelet vs an anticoagulant?

Answer 8

antiplatelet - prevents platelets from clumping together (clopidogrel)

anticoagulant - prevents synthesis of clotting factors from the liver (warfarin, aspirin)

Question 9

how do you control a soft tissue haemorrhage?

Answer 9

• pressure, biting on gauze
• put LA over it (contains vasoconstrictor)
• Diathermy (burns vessel ends)
• ligature/haemostatic forceps

Question 10

how do you control bone tissue hamorrages?

Answer 10

• pressure (swabs)
• LA on a swap or inject into socket
• haemostatic agents
• bone wax
• pack

Question 11

what should you do in a tmj dislocation?

Answer 11

relocate immediately (provide analgesia and advice on supported yawning immediately after)

if unable to relocate, try LA into masseter intraorally. If doesnt work -> immediate referral

Question 12

how can teeth be damaged during oral surgery?

Answer 12

• hitting teeth with forceps
• crack/fracture/moving teeth with elevators (by accident)
• restorations/crown/bridges may catch on adjacent teeth and cause damage

Question 13

how can extraction of a PERMANENT TOOTH GERM occur?

Answer 13

very rare

• when removing DECIDUOUS molars damage can be caused to the developing permanent tooth below it

Question 14

what are some examples of broken instruments in oral surgery?

Answer 14

• tips of elevators & luxators (thin/fragile)
• tips of burs

[use radiograph to identify where, then try retrieve]