Exodontia or Extraction is the painless removal of whole tooth or tooth root with minimal trauma to the investing tissues, so that the wound heals uneventfully and no post-operative prosthetic problem is created.
Brief notes on the inflammation of Alveolar bone that surrounds a tooth that has recently been extracted. It occurs as a complication of tooth extraction.
Brief notes on the inflammation of Alveolar bone that surrounds a tooth that has recently been extracted. It occurs as a complication of tooth extraction.
brief description on posterior superior alveolar nerve block.
its uses in dentistry, technique and action. locating PSA nerve is easy and this is the most used nerve block in dentistry.
One of the most painful but easy-to-treat dental emergencies is a dry socket.
• Dry socket symptoms are experienced after a tooth extraction.
• This condition requires follow-up care by the doctor who performed the surgery, an oral surgeon or a dentist who is familiar with how to treat it.
For more information, contact :-
Dr Sachdeva's Dental Aesthetic And Implant Institute,
I 101, Ashok Vihar Phase 1, Delhi- 110052
Contact us at
• Phone : +919818894041,01142464041
• Our Websites:
• www.sachdevadentalcare.com
• www.dentalclinicindelhi.com
• www.dentalimplantindia.co.in
• www.dentalcoursesdelhi.com
• www.facialaestheticsdelhi.com
#drysocket #management #thirdmolarextraction #extractioncomplications
brief description on posterior superior alveolar nerve block.
its uses in dentistry, technique and action. locating PSA nerve is easy and this is the most used nerve block in dentistry.
One of the most painful but easy-to-treat dental emergencies is a dry socket.
• Dry socket symptoms are experienced after a tooth extraction.
• This condition requires follow-up care by the doctor who performed the surgery, an oral surgeon or a dentist who is familiar with how to treat it.
For more information, contact :-
Dr Sachdeva's Dental Aesthetic And Implant Institute,
I 101, Ashok Vihar Phase 1, Delhi- 110052
Contact us at
• Phone : +919818894041,01142464041
• Our Websites:
• www.sachdevadentalcare.com
• www.dentalclinicindelhi.com
• www.dentalimplantindia.co.in
• www.dentalcoursesdelhi.com
• www.facialaestheticsdelhi.com
#drysocket #management #thirdmolarextraction #extractioncomplications
Complications occur During Dental Extraction and their ManagementIraqi Dental Academy
This simplified lecture explain briefly the Complications occur During Dental Extraction and their Management.
It is presented to the level of mind of undergraduate students
EXODONTIA CAN BE DEFINED AS THE PAINLESS REMOVAL OF THE WHOLE TOOTH OR A TOOTH ROOT WITHOUT TRAUMA TO THE INVESTING TISSUES, SO THAT THE WOUND HEALS UNEVENTFULLY AND NO POST OPERATIVE PROSTHETIC PROBLEM IS CREATED.
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
www.indiandentalacademy.com
This journal club presents a case of prosthetic
rehabilitation of an amputated thumb. It emphasizes that
prosthetic replacement is a better option for aesthetic and
psychological improvement, particularly in cases where the
victim is unwilling to undergo complicated surgical procedures for reconstruction of thumb or where functioning
of thumb cannot be restored even by multiple surgeries. In
the present case, a 20 years old female patient, with
missing thumb of her right hand was rehabilitated aesthetically by a non-invasive and cost effective prosthetic
procedure by using heat temperature vulcanizing silicone
material. The prosthesis (the thumb) was attached using
medical adhesives. On 3 months recall appointment, no
complications were observed. The prosthesis was in good
shape and required no further intervention. The prosthetic
thumb lacks the sensation of a normal or reconstructed
thumb, although it does not require the multiple procedures
of surgical reconstruction and the accompanying loss of
time for rehabilitation and healing
When treating a patient with a removable partial denture, the natural and artificial teeth, both functionally and esthetically, must co-exist in a harmonious relationship.
Occlusal harmony between a removable partial denture and the remaining natural teeth is a major factor in preservation of the surrounding structures.
In removable partial dentures, because of the attachment of the denture to abutment teeth, occlusal stresses can be transmitted directly to the abutment teeth and other supporting structures, which results in sustained stresses that may be more damaging than those transient stresses found in complete dentures.
Altered Cast Impression Technique for Fabrication of Maxillary Obturator- Jou...Dr. Prathamesh Fulsundar
An obturator is a maxillofacial prosthesis that is used to close an acquired tissue opening, primarily of the hard palate, and/or a contiguous alveolar or soft tissue structure that has been removed by surgery. (GPT-8)
This clinical report describes the prosthodontic rehabilitation andfabrication of an obturator used for a partially edentulous patient with anacquired unilateral maxillary defect.
The impression was made in 2 steps in a similar manner as the altered castimpression technique.
Precise impression of the resection defect despite trismus was possible, thus providing this patient an accurately fitting obturator prosthesis.
A removable partial denture or complete denture that covers & rests on one or more remaining natural teeth, the roots of natural teeth, &/or dental implants (GPT-8)
The elderly population is rapidly increasing, as is their need for dental treatment.
Considering the number of partially or completely edentulous patients, various types of treatment may be indicated, including conventional complete dentures and both tooth-supported and implant-supported overdentures.
A RPD derives support from two main sources periodontally sound natural teeth & residual alveolar processes and associated soft tissues.
A RPD that is supported by healthy natural teeth possesses adequate stability and retention to resist functional displacement.
However, a RPD that is not entirely bounded by natural teeth will move when a load is applied.
A single complete denture is a complete denture that occludes against some or all of the natural teeth, a fixed restoration, or a previously constructed removable partial denture or a complete denture.
Opposing natural teeth that are sufficient in number and do not necessitate a fixed or removable partial denture.
Opposing a partially edentulous arch in which the missing teeth have been or will be replaced by a fixed partial denture.
Opposing arch with an existing complete denture.
Prosthetic rehabilitation of a xerostomia patient with a mandibularsplit salivary reservoir denture
Xerostomia is defined as dryness of the mouth due to lack of normal secretions of saliva
Mucosal lubricants eg. wet mouth (ICPA Health Products Ltd),aqwet (Cipla Ltd)
Salivary stimulants eg. colgate dry mouth relief.
Healthy diet intake.
Salivary substitutes ( liquid or gel form ).
Chewing gums.
Proper water intake.
Salivary reservoirs
One of the objectives in complete denture prosthetics is to produce a harmonious appearance of the denture when in the patient’s mouth.
A denture usually perceived as esthetics when the teeth and bases are in harmony with the facial musculature as well as the size & shape of the head.
The selection of artificial teeth & their arrangement to meet esthetic requirements demand artistic skill in addition to scientific knowledge.
Fabrication of removable palatal augmentation prosthesis on a complete denture to reduce weight and maintain hygiene
The retention of a palatal augmentation prosthesis (PAP) is negatively affected by its weight thus, making this device as light as possible is important for clinical success.
However, hollowing the device to reduce weight may cause hygiene issues due to moisture intrusion.
An alternative technique with a removable veneer-type PAP for a complete denture was developed.
This resulted in positive outcomes in terms of reducing the weight and maintaining the hygiene of the prosthesis.
There have been several changes since inception in the field of dental ceramics. Need for newer materials with improved aesthetics, flexural strength and optical properties made it necessary for introduction of advanced technology in fabrication of dental ceramics.
The threshold between microstomia and a normal mouth
opening is defined as an interlabial measurement less
than 45 mm and/or an interincisal distance less than 40
mm.20 Zweifel et al6 further refined that statement by
defining the average vertical mouth opening as 40 to 50
mm, a functional opening as 25 to 35 mm, and a severely
limited opening as 10 to 24 mm. However, no definitive
description has been presented of the width of mouth
opening that should prompt the use of a foldable or
sectional denture.
Mouth opening exercises have been described for
patients with scleroderma but not for those with facial
exercises and appliances used long after facial burns is
scarce, but exercises may be of value in the treatment of
these patients.
The use of sectional trays and record bases may be
essential to obtaining accurate impressions of a patient
with microstomia. An accurate tray and record base is
required to consistently obtain the position of the tray
and record base related to the reference anatomic
structures.
While maxillary bone resorbs toward the center of the
maxilla, mandibular bone resorbs laterally in posterior
areas and lingually in the anterior region. This may allow
the fabrication of maxillary dentures with a smaller width.
To provide support, however, the buccal flanges of
mandibular complete dentures should overlay the bone
horizontally at the buccal shelf region, which may extend
buccally 10 mm or more from the residual ridge top.
These factors explain the presence of several mandibular
collapsible or foldable dentures in the literature versus
few articles describing techniques for maxillary sectional
dentures. The use of implants may allow less extension of
the borders, providing comfort and ease of use for
patients with microstomia.26
Gypsum Products commercially available are hemihydrate form of calcium sulfate. Gypsum products used in Dentistry are broadly classified into 5 types
Type 1- Impression Plaster
Type 2- Model Plaster
Type 3- Dental stone
Type 4- Die Stone high strength low expansion
Type 5- Die Stone high Strength High Expansion
Non fluid wax technique to record Posterior Palatal Seal Area, uses mixture baseplate wax and sticky wax. shows superior handling characteristics and better dimensional stability as compared to Correcta wax and other waxes used in fluid wax technique.
Assesment of Self Evaluation Of Dental Appearance Among Non-Dental Undergradu...Dr. Prathamesh Fulsundar
Orthodontist routinely evaluate patients and prescribe treatment plans in order to satisfy the often stated goals of good dental function, stability of teeth & jaw position & dental aesthetics. however aesthetics has variability in individual judgments, it can differ for patients and dentists making it difficult to make generalized statements hence the aim of this study was to assess the self evaluation and satisfaction of dental appearance among non dental undergraduate students and their attitude towards orthodontic treatment.
Long treatment duration has been a major drawback of the conventional fixed orthodontic treatment. Cyclic Loading (Vibrations within physiological limits) has proved to be effective in accelerating the rate of tooth movement.
Treatment of oral submucous fibrosis can be done by using various natural remedies and plant extracts. The article describes some of these therapies for the treatment of OSMF
The greater treatment time is one of the major drawbacks associated with fixed orthodontic therapy.Micro-osteoperforation has proved to be effective in reducing the duration of conventional orthodontic treatment.
Homeopathic Arnicai to Control Orthodontic Pain-A Substitute to Conventional...Dr. Prathamesh Fulsundar
Pain and discomfort associated with fixed orthodontic treatment has always been a major factor in causing patient dropouts, the conventional method of using NSAID's hampers the tooth movement, as a result a need for newer alternatives to control pain has developed. Arnica montana serves as an effective substitutes to control pain and discomfort without hampering the rate of orthodontic tooth movement.
Photobiomodulation technique uses low intensity lasers and light in the red to near infrared zone (600 to 1000 nm wavelength) which brings about biological changes at the cellular level thus initiating the bone remodeling. As a result accelerates orthodontic tooth movement without causing any harm to the periodontal tissues
Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
Anti ulcer drugs and their Advance pharmacology ||
Anti-ulcer drugs are medications used to prevent and treat ulcers in the stomach and upper part of the small intestine (duodenal ulcers). These ulcers are often caused by an imbalance between stomach acid and the mucosal lining, which protects the stomach lining.
||Scope: Overview of various classes of anti-ulcer drugs, their mechanisms of action, indications, side effects, and clinical considerations.
- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
The prostate is an exocrine gland of the male mammalian reproductive system
It is a walnut-sized gland that forms part of the male reproductive system and is located in front of the rectum and just below the urinary bladder
Function is to store and secrete a clear, slightly alkaline fluid that constitutes 10-30% of the volume of the seminal fluid that along with the spermatozoa, constitutes semen
A healthy human prostate measures (4cm-vertical, by 3cm-horizontal, 2cm ant-post ).
It surrounds the urethra just below the urinary bladder. It has anterior, median, posterior and two lateral lobes
It’s work is regulated by androgens which are responsible for male sex characteristics
Generalised disease of the prostate due to hormonal derangement which leads to non malignant enlargement of the gland (increase in the number of epithelial cells and stromal tissue)to cause compression of the urethra leading to symptoms (LUTS
Report Back from SGO 2024: What’s the Latest in Cervical Cancer?bkling
Are you curious about what’s new in cervical cancer research or unsure what the findings mean? Join Dr. Emily Ko, a gynecologic oncologist at Penn Medicine, to learn about the latest updates from the Society of Gynecologic Oncology (SGO) 2024 Annual Meeting on Women’s Cancer. Dr. Ko will discuss what the research presented at the conference means for you and answer your questions about the new developments.
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
ASA GUIDELINE
NYSORA Guideline
2 Case Reports of Gastric Ultrasound
ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdfAnujkumaranit
Artificial intelligence (AI) refers to the simulation of human intelligence processes by machines, especially computer systems. It encompasses tasks such as learning, reasoning, problem-solving, perception, and language understanding. AI technologies are revolutionizing various fields, from healthcare to finance, by enabling machines to perform tasks that typically require human intelligence.
Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
MANAGEMENT OF ATRIOVENTRICULAR CONDUCTION BLOCK.pdfJim Jacob Roy
Cardiac conduction defects can occur due to various causes.
Atrioventricular conduction blocks ( AV blocks ) are classified into 3 types.
This document describes the acute management of AV block.
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Ve...kevinkariuki227
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
2. EXODONTIA
According to Geoffrey L. Howe –
Exodontia or Extraction is the painless removal of whole
tooth or tooth root with minimal trauma to the investing
tissues, so that the wound heals uneventfully and no post-
operative prosthetic problem is created.
4. 1-INTRAOPERATIVE
COMPLICATIONS
SOFT TISSUE INJURIES
1-Tearing of Mucosal Flap
2-Puncture wound of soft tissue
3- Abrasion injury
COMPLICATIONS WITH TOOTH BEING EXTRACTED
1-Root Fracture
2-Root Displacement
3-Tooth lost into Oropharynx
INJURIES TO ADJACENT TEETH
1-Fracture of Adjacent restoration
2-Luxation of Adjacent teeth
3-Extraction of Wrong teeth
INJURIES TO OSSEOUS STRUCTURES
1-Fracture of Maxillary Tuberosity
INJURIES TO ADJACENT STRUCTURES
1-Injury to Regional Nerves
2-Injury to Temporomandibular joint
6. SOFT TISSUE INJURY
1-TEARING OF MUCOSAL FLAP-
•It is one of the most common soft tissue injury during
extractions.
•It occurs as inadequately sized envelope flap is retracted
beyond the tissues ability to stretch.
Prevention
Create adequately sized flaps to prevent excess tension on
the flap
Use small amounts of retraction forces on the flap.
8. 2-PUNCTURE WOUND OF SOFT TISSUE
The instruments such as straight elevator or periosteal
elevators may slip from surgical field and puncture
into adjacent soft tissue.
PREVENTION
Use of controlled force
Special attention should be given to finger support and
instrument stabilization
Use of other hand to retract tissues from surgical field
9. CLINICAL APPEARANCE
MANAGEMENT
Apply a local hemostat in order to prevent bleeding
Prevent infection at the site of injury
Wound is usually not sutured
10. 3-ABRASION INJURY
Abrasions or burns of lips and corners of mouth usually
occurs due to rotating shank of the burs
PREVENTION
When the surgeon is focused on cutting end the
assistant should beware of location of shank in
relation to cheeks and lips
11. Management
Scars produced due to thermal injuries can be managed by the
application of petroleum jelly or topical antiseptic/analgesic.
These abrasions usually take 5 to 10 days to heal.
Clinical appearance
12. FRACTURE OF THE TEETH DURING
EXTRACTION
Causes
Application of wrong forceps
Improper application of forceps
Extensively carious tooth
Endodontically treated tooth
Curved or hypercementosed root
Ankylosed root
Prevention
Proper radiograph assessment of the tooth to be extracted
Proper forceps technique
13. Management
When the fracture involves the crown of the tooth appropriate
restoration should be placed.
Clinical appearance
14. FRACTURE OF TOOTH ROOT
Causes
Improper technique
Application of improper instrument and force.
Ankylosed or Hypercementosed teeth
Excessively curved roots
Endodontically treated root
Uncooperative patient
Consequences of retained roots
Retained roots may acts as a source if infection. They might
be chronic source of irritation giving rise to Neuralgic Pain.
Large retained tooth may interfere with the proper
functioning of prosthesis.
15. Methods of retrieval of fractured root
Using appropriate elevators, forceps with slender beaks and
Reamers for removal of fractured root at various levels.
Clinical appearance
16. DISPLACEMENT OF TOOTH INTO
MAXILLARY SINUS
Causes
The roots of the maxillary posterior teeth are always in a close
proximity to the maxillary sinus
With advancing age the antral walls become very thin. Thus
eventually the roots being covered only by thin lamellae of bone
which fracture easily and result in the displacement of the root
tip during its removal.
Sometimes the tooth may slips into the maxillary antrum like
the ‘popping of an orange seed’ once the extraction forceps are
applied.
17. Prevention
Application of appropriate force and proper handling of forceps.
Avoid injudicious instrumentation to remove a broken tip.
Proper radiographs should be taken before the extraction to access the
proximity of the root tip to the sinus
Support the alveolus adequately before the extraction.
Management
Confirm the presence and location of the tooth or root tip in the sinus
using radiograph.
Once the location is confirmed, keep a nozzle connected to a powerful
suction devise at the entrance of the fistula to recover tooth
Pack a piece long roller gauze into the sinus through the opening and
remove it with a jerk, the root tip might get removed with the gauze.
If none of the above procedure works, then Caldwell-Luc operation is
carried out.
19. TOOTH LOST INTO OROPHARYNX
Causes
Careless handling of the instruments
Improper technique.
Management
Confirm the presence of teeth in the GIT.
Confirm the expulsion of the tooth using serial radiographs.
21. INJURIES TO ADJACENT TEETH
1-LUXATION OF ADJACENT TEETH
Causes
Improper instrumentation.
No support to the adjacent structures during extraction
Prevention
Proper technique and careful handling of the instruments.
Support the adjacent teeth adequately before extraction.
Management
Reposition the tooth inside the socket and splint it
The tooth should be treated endodontically after one
week.
23. 2-FRACTURE OF ADJACENT RESTORATION
Causes
Presence of large restorations on adjacent teeth
Improper instrumentation
Application of excessive forces
Management
Patient should be informed about his fractured restoration
Prevent the restorative material from entering the tooth
socket
A temporary restoration should be done followed by a
permanent restoration after 3 to 4 days.
24. 3-EXTRACTION OF WRONG TEETH
Management
Inform the patient
Replace the tooth inside the socket as soon possible and
splint.
If immediate replacement is not possible, place the tooth in a
proper medium like saliva, milk or water.
Follow up as for re-implantation.
25. INJURES TO OSSEUS STRUCTURES
1-FRACTURE OF MAXILLARY TUBEROSITY
Causes
In cases where the antrum extends into the tuberosity, the
extraction of the third molar can result in fracture of
tuberosity.
Exertion of excessive force and improper force application
Fusion of the roots of second molar with the un-erupted third
molar (concrescence)
Divergent and hypercemetosed roots of the third molar.
Prevention
Proper analysis of the radiograph of tooth and surrounding
structures.
Correct technique of extraction with careful force application
Support to the alveolus during extraction.
26. Management
In case of small fractured segment, a mucoperiosteal flap is
elevated and the tuberosity is removed with tooth, followed by
wound closure.
In case of large fractured segment, it should be replaced and
splinted
Removal of tooth should be done after the healing of fractured
site.
Clinical appearance
27. FRACTURE OF MANDIBLE
Causes
Atrophic mandible as in old age.
Existence of any bony pathology.
Excessive force application
In case of removal of vertically impacted third molar.
Prevention
Proper preoperative assessment of the type of impaction and
the density of the bone before extraction
Proper support of the jaw during extraction
Do not use excessive force.
28. Management
Inform and reassure the patient.
The surgeon should make sure that the soft tissues
has been replaced and repositioned over the bone
structure to facilitate rapid healing.
Radiographic appearance
29.
30. INJURIES TO ADJACENT
STRUCTURES
INJURY TO REGIONAL NERVES
The branches of the 5th cranial nerve
• Mental nerve
• Buccal nerve
• Lingual nerve
• Nasopalatine nerve
which innervate the mucosa & skin are mostly injured
during extraction.
31.
32. NASOPALATINE & BUCCAL NERVE
Theses nerves are usually sectioned during the
creation of flaps for removal of impacted teeth.
They reinnervate easily & thus can be surgically
sectioned without sequelae or complication.
MENTAL NERVE
During surgical removal of mandibular
premolar roots or impacted premolar and
periapical surgery in that area, care should be
taken not to injure vthe mental nerve along its
course.
If injured the patient may have paresthesia or
anesthesia of the lip and chin.
33. PREVENTION OF NERVE INJURY
BE AWARE OF NERVE ANATOMY IN
SURGICAL AREA.
AVOID MAKING INCISIONS OF AFFECTING
PERIOSTEUM IN NERVE AREA.
34.
35. LINGUAL NERVE
Lingual nerve located directly against the
lingual aspect of the mandible in the
retromolar pad region rarely regenerates if
severely traumatized.
Incisions made for surgical removal of
impacted mandibular3rd molars should be well
enough to the buccal aspect.
INFERIOR ALVEOLAR NERVE
IAN is very commonly traumatized during
mandibular 3rd molar extractions, patients
should be made aware of the possiblity of the
nerve injury.
36. Injury to temporomandibular joint
Removal of mandibular molar teeth requires
application of substantial amount of force. If jaw is not
supported adequately during extraction the patient
may experience pain in this region.
The use of bite block on the contralateral side may
provide adequate balance of forces so that injury &
pain do not occur.
If pain is experienced the surgeon recommends use of
moist heat, rest for the jaw, a soft diet, 1000mg aspirin
every 4hrs for several days.
37.
38.
39. PREVENTION OF INJURY TO TMJ
SUPPORT MANDIBLE DURING
EXTRACTION.
DO NOT OPEN MOUTH TOO WIDELY.
40. OROANTRAL COMMUNICATION
If maxillary sinus is large, no bone exists between the
roots of the teeth & maxillary sinus, if roots are widely
divergent, then it is probable that a portion of the
bony floor of sinus will be removed with the tooth.
This may lead to postoperative maxillary sinusitis and
oroantral fistula.
41.
42. MANAGEMENT OF OROANTRAL
COMMUNICATION
If communication is small<2mm in diameter or
less surgeon should ensure formation of high
quality blood clot in socket & advice patient to
take sinus precautions. Patient adviced to to
avoid blowing the nose, violent sneezing,
sucking on straw, smoking.
If communication is moderate size 2-6mm
additional measures should be taken. To ensure
maintenance of blood clot in the area figure 8
suture should be placed. Antibiotics like
penicillin or clindamycin should be prescribed
for 5 days.
43.
44. If the communication is large 7mm or larger,
the surgeon should consider closing the sinus
communication with a flap procedure. Most
commonly used flap is buccal flap.
PREVENTION
Preoperative radiographs must be evaluated.
If tooth roots are near the sinus floor closed
forceps extraction is avoided & surgical removal
with sectioning of tooth roots is done.
Avoid excess apical pressure.
45.
46.
47. Postoperative bleeding
Extraction of teeth presents severe challenge to the
body’s hemostatic mechanism.
If the postoperative bleeding continues for more than
a day then it is a matter of concern.
Prevention of bleeding is achieved by thorough
medical history of the patient.
Patient should be enquired about any medication they
might be taking such as anticoagulants, anticancer
chemotherapy or alcoholism. These tend to increase
the postoperative bleeding.
48.
49. Patient suspected with bleeding disorders is
evaluated to determine severity of disorder by
measuring the status of intentional
anticoagulation with use of the International
Normalized Ratio (INR)
Normal= 2.0-3.0
50. MANAGEMENT OF POSTOPERATIVE
BLEEDING AFTER EXTRACTION
Different materials placed in the socket to gain
hemostatsis.
• Most commonly used, least expensive,
absorbable gelatin sponge. (e.g.Gelfoam)
• Oxidized regenerated cellulose.(e.g. Surgicel)
• Liquid preparation of topical thrombin.
(prepared from bovine thrombin)
• Collagen. (e.g. micro collagen- Avitene, plug
type collagen-Collaplug, tape type collagen-
Collatape)
• Damp tea bag. (tannin in tea stops bleeding)
51.
52.
53.
54. PREVENTION OF POSTOPERATIVE BLEEDING
Obtain history of bleeding.
Use atraumatic surgical technique.
Obtain good hemostasis at surgry.
Provide excellent patient instructions.
55. PREVENTION OF POSTOPERATIVE BLEEDING
Obtain history of bleeding.
Use atraumatic surgical technique.
Obtain good hemostasis at surgry.
Provide excellent patient instructions.
57. PREVENTION OF POSTOPERATIVE BLEEDING
Obtain history of bleeding.
Use atraumatic surgical technique.
Obtain good hemostasis at surgry.
Provide excellent patient instructions.
58. INFECTION
Most common cause of delayed wound healing
but rare complication after routine extraction,
primarily seen after oral surgery.
59. WOUND DEHISCENCE
Wound dehiscence is the
separation of the layers of a surgical wound; it may be
partial or only superficial, or complete with sep
aration of all layers and total disruption.
Wound dehiscence caused in these conditions- soft
tissue flap replaced & sutured without an adequate
bony foundation, suturing the wound under tension.
60.
61. PREVENTION OF WOUND DEHISCENCE
Use aseptic technique.
Perform atraumatic surgery.
Close incision over intact bone.
Suture without tension.
62. DRY SOCKET
Clinically the tooth socket appears to be empty,
with a partially or completely lost blood clot, &
bony surface of the socket are exposed.
There is dull aching pain, usually throbs,
radiates to the ear. The area of socket has a bad
odor, patient has bad taste.
Caused due to fibrinolytic activity.
This condition in routine extraction is rare but
frequent in removal of impacted mandibular 3rd
molars.
63.
64. MANAGEMENT OF DRY SOCKET
Gentle irrigation of the tooth socket with
saline, entire blood clot not lysed, excess saline
suctioned, iodoform gauze soaked with
medication inserted in socket.
Medication contains eugenol, benzocaine,
balsam of Peru.
Patient experiences relief from pain within 5
minutes
PREVENTION OF DRY SOCKET
Atraumatic surgery with clean incision & soft
tissue reflection.
Preoperative & postoperative rinces with
antimicrobial mouth rinces- chlorhexidine
65. FRACTURE OF MANDIBLE
Fracture of mandible during extraction associated with
surgical removal of impacted 3rd molars.
Mandibular fracture result of application of force
exceeding that is needed to remove tooth with use of
dental elevators.