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Peri-operative Complications - Oral Surgery

Terms in this set (14)

Pre-operative complications
Medical emergencies
Local anaesthetic failure
Lack of co-operation
Wrong patient
Intra-operative complications (13)
Collapse in dental chair
Needle stick injury
Wrong site surgery
Damage adjacent tooth/anatomical structure/soft tissues
Damage to nerves
Oroantral communication
Trauma to TMJ/dislocation
Fracture of tuberosity
Fracture tooth or apex
Fracture alveolar bone
Fracture of mandible
Displacement of instruments or roots into adjacent tissues
Broken instruments
What nerves can be damaged by extraction of the lower third molars, and occasionally second mandibular molars
Inferior alveolar nerve
Lingual nerve (rarely)
What type of tooth is highest risk of OAC
Lone standing molars
If OAC occurs in extraction how is it repaired immediately
Buccal advancement flap
If patient present post extraction with OAC what steps should be taken?
Preventative sinus regime - avoid nose blowing, sneeze with mouth open, no use of wind instruments, no smoking.
Prescribe decongestants (ephedrine nasal drops) and steam inhalations +/- antibiotics if systemic involvement, pus discharge or swelling
Post operative review in 2-3 weeks
If extraction expected to be prolonged +/- history of TM dislocation what can be used to assist patient comfort
Patient bites on medium sized mouth prop
Fracture of tuberosity is most common with what type of teeth
Maxillary lone standing molars
Steps to prevent the fracture of tuberosity
Move on to surgical if there's no mobility during attempted extraction
Watch out for tears in palatal mucosa
If fracture of the tuberosity occurs and bony fragment is attached to periosteum....
May have to leave in situ and splint tooth & bone.
Reattempt surgical extraction in 6-8 weeks
When should a fractured apex not be removed from the socket
If retained root is <3mm - risk of removing it outweighs benefit
What are the risks of attempting to remove a fragment of tooth from the socket?
Into maxillary sinus
Lingual tissue space
How is a fracture of alveolar bone treated?
If loose, may need to remove fragment
Fracture of the mandible is rare and requires... if it occurs?
Referral to OMFS trauma clinic
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