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BDS3 Oral Surgery > Extraction Complications 3 > Flashcards

Extraction Complications 3 Flashcards

1
Q

what is ecchymosis

A

bruising

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2
Q

what is the most common complication of an extraction

A

pain

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3
Q

what causes a higher chance of post operative pain

A

laceration/ tearing of soft tissues
leaving bone exposed
incomplete extraction of tooth

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4
Q

why does swelling occur post operative

A

it is oedematous so it is soft - not firm and is made worse by surgical technique

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5
Q

what patients are more at risk of bruising

A

those on antiplatelet or anticoagulant medication

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6
Q

what is trismus

A

jaw stiffness - inability to fully open the mouth

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7
Q

what are causes of trismus

A

related to surgery - oedema and muscular spasm
related to giving LA - IDB goes through medial pterygoid
haematoma - medial pterygoid clot that organises and fibroses
damage to TMJ

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8
Q

what is a joint effusion

A

swelling with the capsule of a joint

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9
Q

how do you manage trismus

A

monitor
gentle mouth opening exercises
trismus screw - between central incisors and turn to increase the space

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10
Q

what is warfarin

A

a vitamin K antagonist

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11
Q

how do you treat a patient taking warfarin

A

do not stop the warfarin
check INR within 24 hours before surgery (under 4)

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12
Q

how should you treat a patient who is taking aspirin alone

A

treat without interrupting medication

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13
Q

how should you treat a patient taking clopidogrel/ dipyridamole

A

treat without interrupting medication and space treatment out

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14
Q

how should you treat patients taking DOACs

A

you need to assess if patient is low or high bleeding risks (depends on number of extractions)
try treat early in the day
miss or delay morning dose
continue with their medication 4 hours after haemostasis achieved

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15
Q

what is immediate post-op period bleeding

A

reactionary/ rebound bleeding
occurs within 48 hours
LA wears off and blood vessels expand

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16
Q

what is secondary bleeding

A

often due to infection
commonly 3-7 days post op

17
Q

what are haemostatic agent examples

A

adrenaline containing LA
oxidised regenerated cellulose - surgicel

18
Q

what is surgicel

A

an oxidised regenerated cellulose to pack socket and encourage clotting

19
Q

why do you need to be careful with oxidised regenerated cellulose

A

they are acidic and can potentially damage IAN

20
Q

what are examples of systemic haemostatic aids

A

vitamin K
tranexamic acid

21
Q

how does systemic vitamin K work to aid haemostasis

A

necessary for formation of clotting factors

22
Q

how do anti-fibrinolytics like tranexamic acid work to aid haemostasis

A

prevents clot breakdown and stabilises clot

23
Q

how can tranexamic acid be given

A

tablets
mouthwash

24
Q

what is an exuberant clot

A

clot grows above the surface of the adjacent teeth - this can be traumatised when the patient occludes the teeth
treatment - debride

25
Q

what are post operative instructions

A

do not rinse mouth for several hours
avoid trauma
avoid hot food
avoid excess physical exercise and alcohol

26
Q

how long can it take for nerve damage to improve

A

18 months

27
Q

what are the three types of sensory change

A

anaesthesia
paraesthesia
dysaesthesia

28
Q

what are the two sensation changes a patient might experience

A

hypoaesthesia
hyperaestheisa

29
Q

what is alveolar osteitis

A

dry socket
can see areas of exposed bone where clot has disappeared

30
Q

what is the feature of alveolar osteitis

A

intense pain
starts 3-4 post extraction
inflammation affecting the lamina dura
bad taste/ odour

31
Q

what are predisposing factors to dry socket

A

molars more common
smoking
OCP
patient has had previous dry socket

32
Q

how is dry socket managed

A

supportive - systemic analgesia
LA
irrigate socket with warm saline
curette/ debridement
antiseptic pack - alvogyl
no antibiotics as no active infection

33
Q

what is alvogyl

A

a fibrous brown past which helps to heal a socket

34
Q

what is sequestrum

A

usually bits of read bone that haven’t been removed
it prevents healing

35
Q

how does an infected socket present

A

pus discharge
check for remaining tooth/ bony sequestra
consider antibiotics and take radiographs

BDS3 Oral Surgery (7 decks)

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