Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

BDS3 Oral surgery > Peri-operative extraction complications > Flashcards

Peri-operative extraction complications Flashcards

1
Q

What are the peri-operative complications

A
  • difficulty of access
  • abnormal resistance
  • fracture of tooth/root
  • fracture of alveolar plate
  • fracture of tuberosity
  • jaw fracture
  • involvement of maxillary antrum
  • loss of tooth
  • soft tissue damage
  • damage to nerves/ vessels
  • haemorrhage
  • dislocation of TMJ
  • damage to adjacent teeth/restorations
  • extraction of permanent tooth germ
  • broken instruments
  • wrong tooth
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What can give difficulty of access and vision

A
  • trismus
  • reduced aperture of mouth
  • crowded/malpositioned teeth
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What can give abnormal resistance

A
  • thick cortical bone
  • shape/form of roots
  • number of roots
  • hypercementosis
  • ankylosis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What can fracture

A
  • tooth
    • crown
    • root
  • alveolus/tuberosity
  • jaw
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

why might a tooth fracture

A
  • caries
  • alignment
  • size
  • root
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Why might a root fracture

A
  • fused
  • convergent or divergent
  • ‘extra’ roots
  • morphology
  • hypercementosis
  • ankylosis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Why might the alveolar bone fracture

A
  • usually buccal plate
  • usually canines or molars
  • molars
    • periosteal attachment
    • suture
    • dissect free
  • canines
    • stabilise
    • free mucoperiosteum
    • smooth edges
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

why might the jaw fracture

A
  • usually mandible
  • often impacted wisdom tooth, large cyst or atrophic mandible
  • radiographs are essential
  • application of force
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

how to manage a jaw fracture

A
  • inform patient
  • post-op radiograph
  • refer
  • ensure analgesia
  • stabilise
  • if delay, antibiotic
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

what are the different ways you can have involvement of the maxillary antrum

A
  • Immediate complication is an Oro-antral communication (OAC). If epithelium lined, it’s an oro-antral fistula (OAF)
  • loss of root into antrum
  • fractured tuberosity
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

How to diagnose oro-antral communication

A
  • size of tooth
  • radiographic position of roots in relation to antrum
  • bone at trifurcation of roots
  • bubbling of blood
  • nose hollding test (careful as can create OAC)
  • direct vision
  • good light and suction
  • blunt probe
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

management of oro-antral communication

A
  • inform patient
  • if small or sinus intact:
    • encourage clot
    • suture margins
    • antibiotic
    • post-op instructions
  • if large or lining torn:
    • close with buccal advancement flap
    • antibiotics and nose blowing instructions
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

How do you do a buccal advancement flap to cover an OAC/OAF

A
  • take buccal bit of tissue and advance it over the hole
  • need to release the underlying periostium because the gum is not elastic
  • if its chronic you need to cut the fistula out or it won’t close over properly
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

what do you do if you think there is a root in the antrum

A
  • confirm radiographically by OPT, occllusal or peiapical
  • decision on retrival
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What do you do if suspect root in antrum

A
  • flap design
  • open fenestration with care
  • suction - efficient and narrow bore
  • small curettes
  • irrigation or ribbon gauze
  • close as for oro-antral communication
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

why might the maxillary tuberosity fracture

A
  • single standing molar
  • unknown unerupted molar wisdom tooth
  • pathological gemination
  • extracting in wrong order (Take out from the back forward (8,7,6) other wise you are undermining the bone as you go along and you will leave yourself with a last standing molar)
  • inadequate alveolar support
17
Q

how might you diagnose a tuberosity fracture

A
  • noise
  • movement noted both visually or with supporting fingers
  • more than 1 tooth movement
  • tear on palate
18
Q

management of fractured tuberosity

A
  • dissect out and close wound
  • or reduce and stabilise
  • fixation with ortho wire, arch bar, splints
  • leave in place for at least 8 weeks
19
Q

what do you do if you lose a tooth

A
  • find it
  • stop what you are doing
  • suction
  • radiograph
20
Q

what damage to nerves can you get

A
  • crush injuries
  • cutting/shredding injuries
  • transection
  • damage from surgery or damage from LA
  • may not know at the time
21
Q

Scientific names for the different types of nerve damage

A
  • Neurapraxia
  • Axonotmesis
  • Neurotmesis
  • Anaesthesia
  • Paraesthesia
  • Dysaesthesia
  • Hypoaesthesia
  • Hyperaesthesia
22
Q

what is neurapraxia

A

contusion of nerve/continuity of epineural sheath and axons maintained

It consists of loss of conduction without associated changes in axonal structure

23
Q

what is axonotmesis

A

continuity of axons but not epineural sheath disrupted

The axons and their myelin sheath are damaged, but the endoneurium, perineurium and epineurium remain intact

24
Q

what is neurotmesis

A

complete loss of nerve continuity/nerve transected

25
Q

what is anaesthesia

A

numbness

26
Q

what is paraesthesia

A

tingling

27
Q

what is dysaesthesia

A

unpleasant sensation/pain

28
Q

what is hypoaesthesia

A

reduced sensation

29
Q

what is hyperaesthesia

A

increased sensation

30
Q

what damage to vessels can you get

A
  • veins (lots of bleeding)
  • arteries (pulsating bleed, lots of bleeding)
  • arterioles (spurting/pulsating bleed)
  • vessels in muscle
  • vessels in bone
31
Q

why might a dental haemorrhage happen

A
  • most bleeds are due to local factors - mucoperiosteal tears or fractures of alveolar plate/socket wall
  • very few bleeds due to undiagnosed clotting abnormalities (haemophilia/ VWD)
  • liver disease (alcohol problems) - clotting factors made in the liver)
  • medication - warfarin/antiplaelet agents e.g. aspirin/ clopidogrel
  • other anticoagulant drugs
32
Q

how to treat soft tissue bleeding

A
  • pressure
  • sutures
  • LA with adrenaline
  • diathermy (cauterise/burn vessels)
  • ligatures/haemostatic forceps for larger vessels
33
Q

how to treat bleeding from the bone

A
  • pressure
  • LA on swab or injected into socket
  • Haemostatic agents - surgicel/kaltostat
  • blunt instrument
  • bone wax
  • pack
34
Q

how to deal with dislocation of TMJ

A
  • relocate immediately (analgesia and advice on supported yawning)
  • if unable to relocate try LA into masseter intraorally
  • if still unable, immediate referal
35
Q

how do you deal with damage to adjacent teeth/restorations

A
  • temporary dressing/restoration
  • arrange definitive restoration
  • if large restoration next to extraction site warn pt of risk
36
Q

how do you avoid extraction of a permanent tooth germ

A

don’t go digging in sockets after taking out a primary tooth (rare)

37
Q

what do you do if there is a broken instrument

A
  • radiograph/retrieve
  • if unable, refer
38
Q

how do you avoid taking out the wrong tooth

A
  • concentrate
  • check clinical situation against notes/radiographs
  • count teeth
  • verify with someone else if still unsure
  • phone the defence union if you do it…
39
Q
A

BDS3 Oral surgery (5 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions