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Complication of extraction 1
This document discusses potential complications that can arise from tooth extraction procedures. It outlines various local complications that can occur immediately, delayed, or late after an extraction. Immediate complications include failure of local anesthesia, inability to remove the tooth, fracture of tooth or surrounding bone, oro-antral communication, soft tissue displacement, hemorrhage, TMJ dislocation, and damage to nerves. Delayed complications involve pain, swelling, bleeding, dry socket, osteomyelitis, infection, oro-antral fistula, and failed socket healing. Late complications are chronic osteomyelitis, osteoradionecrosis, and nerve damage. The document provides details on causes and management of several specific complications.
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Complication of extraction 1
- 1. Complication of Extraction IslamKassem ikassem@dr.com
- 2. Dealing with localcomplications
- 3. Complications of toothextraction • Local complications • Immediate: • Failure of LA • Failure to move the tooth • Fracture of tooth, alveolus, mandible • Oro-antral communication • Displacement in soft tissues • Hemorrhage • TMJ dislocation • Damage to V1,2,3
- 4. • Delayed • Exessivepain, swelling, and trismus • Bleeding • Dry socket • A. osteomyelitis • Infection • Oro-antral fistula • Failure of the socket to heal • Nerve damage
- 5. • Late • Chronicosteomyelitis • Osteoradionecrosis • Nerve damage • Chronic pain
- 6. • Systemic complications •Immediate • Faint • Hypoglycemia • Hyperventelation/panic attack • Fits • MI • Addisonian crisis • Respiratory obstruction
- 7. Complications of toothextraction • Local complications • Immediate: • Failure of LA • Failure to move the tooth • Fracture of tooth, alveolus, mandible • Oro-antral communication • Displacement in soft tissues • Hemorrhage • TMJ dislocation • Damage to V1,2,3
- 8. 1-Failure of Anesthesia toosmall a dose Improper injection technique: Not waiting long enough for anesthesia to act; before commencing the surgery ikassem@dr.com
- 9. Complications of toothextraction • Local complications • Immediate: • Failure of LA • Failure to move the tooth • Fracture of tooth, alveolus, mandible • Oro-antral communication • Displacement in soft tissues • Hemorrhage • TMJ dislocation • Damage to V1,2,3
- 10. 2-Failure to movethe tooth ikassem@dr.com
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- 30. Complications of toothextraction • Local complications • Immediate: • Failure of LA • Failure to move the tooth • Fracture of tooth, alveolus, mandible • Oro-antral communication • Displacement in soft tissues • Hemorrhage • TMJ dislocation • Damage to V1,2,3
- 31. 3-Fracture of thetooth Force, technique, root anatomy Caries Fracture of the alveolus ikassem@dr.com
- 32. • Fracture of: -tooth being extracted -alveolar bone -maxillary tuberosity -adjacent teeth -mandible
- 33. • Damage to: -gum , lips , tongue , palate , floor of the mouth. - inferior dental nerve.
- 34. Fracture of AlveolarProcess Fracture of the Buccal or Lingual Cortex Cause Inadequate exposure & excessive force Prevention Adequate bone removal & eposure
- 36. Fracture of MaxillaryTuberosity Cause Excessive force Prevention Proper support and controlled force Management If still attached; dissect and remove the tooth If detached; smooth bone edges & suture
- 38. Fracture of theMandible Cause Excessive force Prevention Proper bone removal & controlled force
- 39. Photoelastic model ofthe mandible, showing the development of stress during a luxation attempt of the third molar when insufficient bone has been removed from the tooth peripherally
- 40. Fracture of themaxillary tuberosity Large antrum, large root, fusion 3rd molar with 2nd molar root Small fragments, large segment
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- 47. Complications of toothextraction • Local complications • Immediate: • Failure of LA • Failure to move the tooth • Fracture of tooth, alveolus, mandible • Oro-antral communication • Displacement in soft tissues • Hemorrhage • TMJ dislocation • Damage to V1,2,3
- 48. Oro-antral communication Large antrum Lone-standingtooth in an atrophic maxilla Large splayed roots Fracture of tuberosity History of antral involvement
- 49. Cause During extraction ofan impacted maxillary canine -Excessive bone removal -Failure to locate the tooth Prevention -Proper preoperative radiographic evaluation -Proper bone removal -Controlled force
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- 51. Plastic Closure ofOroantral Fistula
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- 54. Complications of toothextraction • Local complications • Immediate: • Failure of LA • Failure to move the tooth • Fracture of tooth, alveolus, mandible • Oro-antral communication • Displacement in soft tissues • Hemorrhage • TMJ dislocation • Damage to V1,2,3
- 55. Displacement of thetooth into: -soft tissues -maxillary sinus -beyond the pharynx
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- 58. Root Displacement Into: • MandibularCanal • Lingual Pouch • Infratemporal Space • Maxillary Sinus
- 59. Complications of toothextraction • Local complications • Immediate: • Failure of LA • Failure to move the tooth • Fracture of tooth, alveolus, mandible • Oro-antral communication • Displacement in soft tissues • Hemorrhage • TMJ dislocation • Damage to V1,2,3
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- 61. Local Measures: Irrigationof wound with Tranexamic acid
- 62. Local Measures: Suturingthe wound
- 63. Local Measures: Pressurewith oral packs
- 64. Local Measures: Surgicel(Oxidised Regenerated Cellulose)
- 65. Local measures: Gelfoamwith activated thrombin
- 66. Local Measures: Avitene(Microfibrillar Collagen)
- 67. Local Measures: Etik Collagen(Packed collagen)
- 68. Local Measures: Tranexamicacid 5%
- 69. Local Measures: Tranexamicacid 5% in Syringe
- 70. • Excessive bleeding: -during extraction. - postoperatively.
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- 73. Tearing Mucosal Flap Causes Dueto an inadequately sized flap which is retracted beyond the tissue`s ability to stretch. As with a short envelope flap when the area of surgery is at the apex.
- 74. Prevention -Adequately sized flaps -GentleRetraction Management Reposition the flap & suture If the tear is jagged, trim it before suturing
- 75. Puncture Wound ofSoft Tissue Cause Instrument Slippage Prevention Controlled force Management Suturing to prevent infection & allow healing to occur
- 76. Stretch or AbrasionInjury Cause Bur shank or retractor injury Prevention Care Management Keep it moist ( ointment ) Heals within 5 – 10 days
- 77. Complications of toothextraction • Local complications • Immediate: • Failure of LA • Failure to move the tooth • Fracture of tooth, alveolus, mandible • Oro-antral communication • Displacement in soft tissues • Hemorrhage • TMJ dislocation • Damage to V1,2,3
- 78. Definition: Locked jaw inopen bite with deviation (unilat.) or protrusion (bilat.) The condyle moves forward out of the fossa, does not return back. Mandibular Dislocations
- 80. Clinical features Severe pain Lockjaw in class III position Central ….. (Bilateral). Cross bite …. (Unilateral). Concavity in front of the ear. Dislocation
- 81. TRISMUS • Trismus isthe inability to normally open the mouth • It is a fairly common complication of local anesthesia, particularly while giving pterygomandibular block • Causes : A. Primary Cause Trauma to muscles (medial pterygoid, temporalis, and masseter) during insertion of the needle ikassem@dr.com
- 82. Complications of toothextraction • Local complications • Immediate: • Failure of LA • Failure to move the tooth • Fracture of tooth, alveolus, mandible • Oro-antral communication • Displacement in soft tissues • Hemorrhage • TMJ dislocation • Damage to V1,2,3
- 83. Injury to InferiorAlveolar Nerve Cause -Excessive extraction force in case of curved roots -Sectioning the tooth all the way inferiorly Prevention -Proper exposure & bone removal -Controlled force -Careful setioning, leaving a shell of the tooth
- 84. Injury to theLingual Nerve Cause -Placement of the retromolar incision far lingually -Sectioning the tooth all the way to the lingual cortex Prevention -Proper incision -Careful sectioning, leaving a shell of the tooth
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- 86. • Contemporary Oral& maxiallofacial surgery • Page 185-199 ikassem@dr.com
- 87. • You canget it form • http://www.slideshare.net/islamkassem
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