Prevention and Management of Extraction Complications

complication

A secondary disease or condition aggravating an already existing one.

prevent

The best way to manage a surgical complication is to ..... it from happening.

preop assessment/treatment planning; careful execution

prevention of surgical complications is minimized through thorough ..... and .... of the procedure

unimpeded

The tooth to be removed should have an .... pathway for removal.

finesse; force

tooth extraction should utilize .... not ....

tear of a mucosal flap

the most common soft tissue injury that occurs during extraction of a tooth is ....

stretch

the tear of a mucosal flap is caused by retraction of the flap beyond the ability of the tissue to ....

uncontrolled force

a puncture wound often results from use of .... with a straight elevator or periosteal elevator

allowed to heal; dressed with antibiotic ointment

abrasion/burns in the mucosal area should be .... and in the skin/vermillion should be ....

maxillary sinus

if a root is displaced into the ....:

-Stop procedure

-Pack surgical site with gauze

-Obtain radiograph, in order to Verify displacement and

- Determine size of root fragment

pathology; sinus

important factors in the displacement of a root into the maxillary sinus include:

- .... associated with the tooth

- condition of the ....

panoramic

when a root is displaced into the maxillary sinus you should take a .... radiograph

yes

can a small, noninfected displaced root be left in the maxillary sinus

submandibular space

when a root is displaced into the ....:

-Stop procedure

-Pack surgical site with gauze

-Obtain radiograph

-Inform patient

-Call OMS

-Antibiotics

caldwell-luc

removal of a tooth into the maxillary sinus will require .... procedure for removal

infratemporal space

the displacement of a tooth into the ..... occurs when the surgeon fails to visualize the impacted maxillary third molar during the entirety of the elevation/extraction process.

surgeon; floor; coughing

if a tooth is displaced into the pharyngeal area turn the patient toward the .... and with the mouth facing the .... and encourage ......

2-4

when an object is swallowed it is highly probable that it will be passed through the GI tract in .... days

yes

is an aspirated object a medical emergency

fracture; dislodgement; severly carious

The most common injury to adjacent teeth is the inadvertent ..... or .... of a restoration, or damage to a ...... tooth.

buccal

to avoid damage to adjacent teeth use a the elevator on the ... aspect or not elevating at all

narrow

to prevent luxation of adjacent teeth in crowded dentition, extractions with ... beak forceps is advised

indefensible

a major cause of malpractice for dentists in extraction of the wrong tooth and is typically ....

buccal

the most common locations for fracture of the alveolar process during tooth extraction is at the ... plate of the maxillary canine or molars

surgical

if there is a high probably of alveolar fracture during tooth extraction, than use a .... approach

maxillary tuberosity

fracture of the .... can result in a significant defect, and occurs with extraction of the last molar in the maxillary arch.

5

The branches of the ..... cranial nerve are the adjacent neural structures most likely to be injured during extraction.

no

will the lingual nerve regenerate if traumatized

bucccal

to avoid lingual nerve injury, flap design should always be on the ... side of the mandibular 3 molars

yes

do the majority of injuries to the IAN resolve

nasopalatine; buccal

The ..... and ..... nerves are frequently severed or stretched during flap reflection.

mandibular molars

Injury to the TMJ typically results from removal of ....

maxillary sinusitis; oroantral fistula

if there is communication between the oral cavity and maxillary sinus after maxillary molar extraction the two major areas of concern are:

- Postoperative .....

-the formation of an ......

no

should you probe to check for maxillary sinus communication

<2

when a communication with the maxillary sinus is ....mm conservative measure may be exercised

salivary enzymes

bleeding may persist in an extraction socket due to ... lysing the clot int he surgical site prematurely

<2.5; one day

for oral surgery, INR should be ... and checked ... prior to planned surgery

coumadin

the typical brand name for warfarin is ....

no

is INR used if a patient takes medication that affect platelet function

hemostatic

.... materials include:

- Absorbable gelatin sponge (Gelfoam)

- Oxidized regenerated cellulose (Surgicel)

- Collagen (Collatape, Collaplug)

- Topical thrombin

45

if secondary bleeding is occurring and not controlled within .... minutes, have the patient come back to office

BP

when a patient has persistent bleed it is important to be aware of ....

hematoma

..... form due to bleeding into adjacent soft tissue

ecchymosis

- Commonly referred to as a bruise,

- this refers to a

subcutaneous or submucosal

discoloration that results from extravasation of blood into the soft tissues.

infection

The most common cause of delayed wound healing is .....

bony foundation; tension

wound dehiscence occurs when:

- A soft tissue flap is replaced and sutured without an adequate ......

-Suturing a wound under ......

no

is a dry socket associated with infection

md molars

dry sockets most commonly occur following the removal of ....

3-4

dry sockets develop on day .... following extraction

doxycycline; chlorhexidine

dry sockets can be minimized by the use of .... powder or perioperative .....