Extractions Complications 2

Question 1

What are examples of some peri-operative complications that can occur during tooth extraction?

Answer 1

• soft tissue damage
• damage to nerves
• fracture of tooth/root
• fracture of alveolar bone
• damage to adjacent teeth
• wrong tooth
• dislocation of TMJ

Question 2

What is neurapraxia?

Answer 2

Contusion of nerve/continuity of epineural sheath and axons maintained

Question 3

What is axonotmesis?

Answer 3

Continuity of axons but not epinerual sheath disrupted

Question 4

What is neurotmesis?

Answer 4

Complete loss of nerve continuity/nerve transected

Question 5

What are examples of damage to nerves that may occur during tooth extraction?

Answer 5

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

Question 6

What is anaesthesia?

Answer 6

numbness

Question 7

What is paraesthesia?

Answer 7

tingling

Question 8

What is Dysaesthesia?

Answer 8

unpleasant sensation/pain

Question 9

What is Hypoaesthesia?

Answer 9

reduced sensation

Question 10

What is hyperaesthesia?

Answer 10

increased/heightened sensation

Question 11

What are causes for haemorrhage after tooth extractions?

Answer 11

• local fatcors (mucoperiosteal tears or fractures of alveolar plate/socket wall)
• clotting abnormalities (haemophilia)
• liver disease
• medications (warfarin/apixaban/clopidogrel/aspirin)

Question 12

If there is haemorrhage from soft tissue during/after an extraction, what methods can be used to stop bleeding?

Answer 12

• pressure (bite on damp gauze)
• sutures
• LA with adrenaline
• diathermy (cauterise/burn vessels)
• ligatures/haemostatic forceps for larger vessels

Question 13

If there is haemorrhage from bone during/after an extraction, what methods can be used to stop bleeding?

Answer 13

• pressure (via swab)
• LA on a swab or injected into socket
• haemostatic agents
• bone wax
• pack

Question 14

What should be done if TMJ dislocation occurs during oral sugery?

Answer 14

• relocated immediately (analgesia & advice on supported yawning)
• if unable to relocated try LA into masseter intra-orally
• if still unable to relocated = immediate referral

Question 15

How can soft tissue damage during oral surgery be minimised?

Answer 15

• correct placement using correct instrument
• controlled pressure
• always support instrument/tissues with non-dominant hand

Question 16

How can damage to adjacent teeth/restorations during oral surgery be managed?

Answer 16

• tell patient
• temporary dressing/restoration
• arrange definitive restoration

Question 17

what negative side effect can occur when deciduous molars are extracted?

Answer 17

extraction of permanent tooth germ

Question 18

how can extraction of the wrong tooth be avoided?

Answer 18

• check clinically against notes/radiograph
• count teeth
• verify with someone else
• pen the tooth