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Oral Surgery > Post Extraction Complications > Flashcards

Post Extraction Complications Flashcards

1
Q

List methods to manage soft tissue bleeding

A

Pressure
LA with adrenaline
Haemostatic agents - surgicel
Sutures
Diathermy

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2
Q

List methods to manage bone bleeding

A

Pressure
LA into socket
Haemostatic agents - Surgicel
Bone wax
Pack

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3
Q

What is surgicel?

A

Oxidised cellulose
Acts as a framework for clot formation
Promotes haemostatis

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4
Q

If bleeding profusely post XLa, what must you rule out?

A

Bleeding disorders:
Haemophilia
VWD
Liver disease
Antiplacelets/anticoags

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5
Q

Protocol if excessive bleeding + pt has bleeding disorder

A

Contact haematologist

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6
Q

Protocol if excessive bleeding + pt is on warfarin

A

INR from GMP
Urgent referral to hospital

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7
Q

What tooth should you be wary to use surgicel for?

A

Lower 8 region as acidic - damage to IAN

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8
Q

List some examples of Haemostatic agents

A

La w adrenaline
Surgicel
Gelatin sponge
Fibrin foam

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9
Q

List some examples of systemic haemostat agents

A

Vitamin K
Tranexamic acid (anti-fibrinolytic)

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10
Q

How does tranexamic acid work?

A

Anti-fibrinolytic
Prevents clot breakdown/stabilises clot

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11
Q

List some damage to nerves that can occur (5)

A

Anaesthesia - numbness

Paraesthesia - tingling

Dysaesthesia - pain

Hypoaesthesia - reduced sensation

Hyperaesthesia - inc sensation

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12
Q

List management for a small/sinus intact OAC (4)

A

If small or sinus intact
- Encourage clot
- Suture margins
- Abx
- Post op instructions

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13
Q

List management of an OAF (4)

A
  • Excise sinus tract
  • Buccal advancement flap
  • Buccal fat pad with buccal advancement flap
  • Palatal flap
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14
Q

Tx for root in sinus

A
  • Confirm radiographically by OPT, occlusal or PA
  • Make a decision on retrieval from xray
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15
Q

Retrieval of root in sinus

A
  • OAF approach/thru socket
  • Flap design
  • Suction
    Small curettes
  • Irrigation
  • Close as for OAC
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16
Q

Define osteomyelitis

A

Infection of bone Invasion of bacteria into cancellous bone causing ST inflammation and oedema

17
Q

What jaw is osteomyelitis more common in?

A

Mandible as has one main artery supply - IA artery

Poorer bs more likely ot become ischaemic and infected

18
Q

Predisposing factors to osteomyelitis

A

Immunocompromised
Dental infections + fractures of mandibles

19
Q

Radiographic appearance of osteomyelitis

A

Moth eaten appearance

20
Q

Antibiotic indicated to Osteomyelitis

A

Penicillin
OR
Clindamycin

Chronic osteomyelitis requires aggressive abx and surgical tx

21
Q

Surgical tx for osteomyelitis

A
  • Drain pus if possible
  • Remove any non-vital teeth in area of infection
  • Remove any loose pieces of bone
  • Excision of necrotic bone
22
Q

What is actinomyces

A

Rare bacterial infection

23
Q

Define infective endocarditis

A

Infection of the endocardium
Particularly affecting the heart valves

24
Q

What patients are at increased risk of IE

A
  • Acquired valvular heart disease with stenosis
  • Hypertrophic cardiomyopathy
  • Structural congenital heart disease
  • Valve replacement
  • Prev IE
25
Q

Name examples of structural congenital heart disease that are excluded from the increased risk

A

Atrial septal defect
Fully repaired ventricular septal defect

26
Q

List examples of invasive dental procedures (8)

A
  • Placement of matrix bands
  • Subgingival restos
  • Endo tx
    -SSC
  • 6PPC
  • Sub PMPR- Incise + drain abscess
  • XLa’s
27
Q

List examples of non invasive dental procedures

A
  • Infiltrations/IDB
  • BPE
  • Supragingival PMPR
  • Supragingival fillings
  • Removal of sutures
28
Q

When is amoxicillin contraindicated?

A

Allergy to penicillin

29
Q

Side effects of amoxicillin (3)

A
  • Hypersensitivity
  • Anaphylaxis
  • Abx related colitis
30
Q

ABX dose for prophylaxis cover

A

Amoxicillin 3g oral powder

GIVE: 3g 60m before

31
Q

ABX dose if penicillin contraindicated

A

Clindamycin capsules 300mg
GIVE: 600mg (2 capsules) 60 mins before procedure

32
Q

Signs of IE (5)

A

Temp >38
Breathlessness
Weight loss
Fatigue
Chest pain

Oral Surgery (10 decks)

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