Oral surgery lecture 8
Complications of teeth extractions1-Failure to secure local anesthesia:- a- Faulty technique...DUE TO Incorrect technique or insufficient amount of L.A. b-The use of expired date L.A. agent c- Individual variation such as anatomical or physiological variation ( high pain reaction and low pain threshold ). d-Presence of acute infection.
Complications of teeth extractions
2-Failure to complete tooth extraction SO ... OPEN EXTRACTION3-Fracture of crown during extraction :- Week tooth (Caries or large restoration) , Incorrect forceps application ,Wrong forceps, Uncontrolled movement or force ,Unexpected movement of the patient’s head
4-Fracture of the root :- a-All factors that cause crown fracture can cause root fracture b-Complex root pattern ( dilacerations or severe root curvature )
ALL root fragments should be removed , BUT can be left in some cases . . .
5-Fracture of the labial or buccal cortical plate :- a-Accidental grasping of the alveolar plate b-The use of excessive force in buccal direction c-The shape of alveolus as in canine region
6-Fracture of the maxillary tuberosity due to:- a-Weakness of the tuberosity by the antrum ( isolated , over erupted ) b-False gemination between erupted 7 and unerupted 8 C-Use of excessive distal force by mesial elevator application
This accident is usually due to the invasion of the tuberosity by the antrum which is common when an isolated maxillary molar is present . It occur when the tooth is partially erupted or over erupted rather than un erupted .
7-Fracture of adjacent or opposing tooth 8-Extraction of wrong tooth ..DUE TO a-Dentist negligence b-Misdiagnosis of the tooth causing pain c-Multiple neighbor teeth are badly carious d-Referred pain
9-Fracture of the jaw :- a-Extreme force applied to the lower jaw especially when there is ankylosis , hypercementosis , or impacted teeth b-If the mandible is weakened by a pathological process such as cyst ( okc)
10-Dislocation of the adjacent tooth or its restoration. 11-Dislocation of TMJ ??? MAY BE DUE TO a- patient with previous history of recurrent dislocation b-When the lower jaw is not supported during extraction
TMJ dislocation : causes ,diagnosis and treatment ?
Mosul university- College of dentistry-oral & maxillofacial surgery departmentTMJ dislocation Dislocation
Clinical features: Inability to close mouth Pain Facial swelling Palpable depression Jaw will deviate away Jaw displaced anteriorMandibular Dislocation
Treatment: Muscle relaxant Analgesic Closed reduction in the emergency roomMandibular Dislocation
Avoid excessive mouth opening Soft diet Analgesics Oral surgery follow up
12-Displacement of tooth or root into the soft tissues :- a-Buccal roots of upper posterior teeth into the mucobuccal fold b-Roots of lower 8 displaced into the pterygomandibular space or sublingual region
13-Oro-antral communication or fistula
Preventive measures include :- a-Pre-extraction radiograph b-Never use the elevator or forceps blindly c-Apical 1/3 of the palatal root of maxillary molar should be left if it is retained during forceps extraction d-If root apex removal is indicated, then open extraction is performedDIAGNOSIS of OAC is by NBT
Treatment of OACOROANTRAL COMMUNICATION
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