Extraction Complications 2 Flashcards
what do you do when you think you have lost the tooth
stop
look for it
suction
radiograph
how do you prevent soft tissue damage
pay attention
correct placement using correct instruments
take time positioning instruments
application point
controlled pressure
sufficient but not excessive force
how can nerves become damaged
crush injuries
cutting/shredding injuries
transection
damage from surgery or LA
what is neuropraxia
contusion of nerve/continuity of epineural sheath and axons maintained
what is axonotmesis
continuity of axons but not epineural sheath disrupted
what is neurotmesis
complete loss of nerve continuity/nerve transected
what can damage to nerves result in
anaesthesia
paraesthesia
dysaesthesia
hypoaesthesia
hyperaesthesia
what vessels is it possible to damage
veins
arteries
arterioles
vessels in muscle
vessels in bone
what would damage to veins give
lots of bleeding
what would damage to arteries give
spurting/haemorrhage
what would damage to arterioles give
spurting/pulsating bleed
what causes bleeds
local factors - tears/fractures
undiagnosed clotting abnormalities
liver disease
medication
how do you stop a bleed from soft tissue
pressure with gauze
sutures
LA with adrenaline
diathermy
ligatures/haemostatic forceps for larger vessels
how would you stop a bleed from bone
pressure
LA on a swab or injected into socket
haemostatic agents
blunt instrument
bone wax
pack
what do you do if the TMJ dislocated
relocate immediately
if unable try LA into masseter intra-orally
if still unable then immediate referral
how can damage to adjacent teeth/restorations occur
hit opposing teeth with forceps
crack/fracture/move teeth with elevators
how do you manage damage to adjacent teeth
temporary restoration
arrange definitive restoration
what do you do if you break your instrument during operation
radiograph it and retrieve it
refer if cant retrieve it
how do you prevent taking the wrong tooth out
concentrate
check notes/radiographs
safety checks
count teeth
verify with someone else if still unsure
what do you do if you take the wrong tooth out
contact defence union
