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Management of-extraction-complications
This document summarizes potential complications that can arise from tooth extractions. It discusses soft tissue injuries, problems that can occur with extracting a tooth like root fractures, injuries to adjacent teeth, osseous structures, and other adjacent structures. It also outlines complications like oroantral communications, postoperative bleeding, delayed healing, infections, and mandible fractures. The document references two studies conducted on dry socket prevalence and risk factors at dental centers in Palestine and Jordan.
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Presentation by Weam Faroun and Rasha Hamdallah for Dr. Kareem Abu Libdeh; outlining topics like soft tissue injuries, tooth extraction problems, and complications.
Discusses types of soft tissue injuries: mucosal flap tears, puncture wounds, and abrasions, which can occur during surgery.
Outlines issues during tooth extraction, including root fractures, displacements, and cases where a tooth may be lost into the pharynx.
Details risks to nearby teeth during procedures, including restoration dislodgment, tooth luxation, and the extraction of the wrong tooth.
Examines bony injuries during extraction, specifically fractures of the alveolar process and maxillary tuberosity.
Describes potential injuries to regional nerves and the temporomandibular joint during dental procedures.
Addresses oroantral communications post-extraction and emphasizes the importance of preventing postoperative bleeding.
Highlights factors causing delayed healing post-extraction, including infections, wound dehiscence, and dry sockets.
Presents study data on tooth extractions, dry socket incidences among smokers/non-smokers, single/multiple extractions, and age effects.
Describes the rare occurrence of mandible fractures during tooth extraction, primarily related to extracting impacted third molars.
Lists references including literature on dry socket frequencies and clinical studies for further exploration of oral surgical risks.
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Management of-extraction-complications
- 1. Done by : WeamFaroun Rasha Hamdallah Submit to : DR. Kareem Abu Libdeh
- 2. CONTENTS : SOFTTISSUE INJURIES PROBLEMS WITH A TOOTH BEING EXTRACTED INJURIES TO ADJACENT TEETH INJURIES TO OSSEOUS STRUCTURES INJURIES TO ADJACENT STRUCTURES OROANTRAL COMMUNICATIONS POSTOPERATIVE BLEEDING DELAYED HEALING AND INFECTION FRACTURES OF THE MANDIBLE
- 3. SOFT TISSUE INJURIES •Tear of a Mucosal Flap • Puncture Wound • Stretch or Abrasion
- 4. TEAR OF AMUCOSAL FLAP The most common soft tissue injury , as the surgeon tries to gain needed surgical access .
- 5. PUNCTURE WOUND Thisinjury is the result of using uncontrolled force . Instruments such as a straight elevator or a periosteal elevator may slip from the surgical field and puncture or tear into adjacent soft tissue.
- 6. STRETCH OR ABRASION Abrasions or burns to lips, corners of the mouth, or flaps usually result from the rotating shank of the bur rubbing on soft tissue or from a metal retractor coming in contact with soft tissue .
- 7. PROBLEMS WITH ATOOTH BEING EXTRACTED Root Fracture Root Displacement Tooth Lost into the Pharynx
- 8. ROOT FRACTURE Long,curved, divergent roots that lie in dense bone are the most likely to be fractured .
- 9.
- 10. TOOTH LOST INTOTHE PHARYNX
- 11. INJURIES TO ADJACENTTEETH •Fracture or Dislodgment of an Adjacent Restoration •Luxation of an Adjacent Tooth •Extraction of the Wrong Tooth
- 12. FRACTURE OR DISLODGMENTOF AN ADJACENT RESTORATION
- 13. LUXATION OF ANADJACENT TOOTH
- 14. EXTRACTION OF THEWRONG TOOTH A common reason for removing the wrong tooth is that a dentist removes a tooth for another dentist. If the wrong tooth is extracted and the surgeon realizes this error immediately, the tooth should be replaced quickly into the tooth socket . When the wrong tooth is extracted, it is important to inform the patient, the patient’s parents or caregivers (if the patient is a minor), and any other dentist involved with the patient’s care .
- 15. INJURIES TO OSSEOUS STRUCTURES Fractureof the Alveolar Process Fracture of the Maxillary Tuberosity
- 16. FRACTURE OF THEALVEOLAR PROCESS The most likely cause of fracture of the alveolar process is the use of excessive force with the forceps, which fractures the cortical plate .
- 17. FRACTURE OF THEMAXILLARY TUBEROSITY The maxillary tuberosity is important for the construction of a stable retentive maxillary denture.
- 18. INJURIES TO ADJACENT STRUCTURES 1)Injuryto Regional Nerves. 2)Injury to the Temporomandibular Joint
- 19. 1)INJURY TO REGIONALNERVES. The nasopalatine and buccal nerves are frequently sectioned during the creation of flaps for removal of impacted teeth. Surgical removal of mandibular premolar roots or impacted mandibular premolars or periapical surgery in the area of the mental nerve and mental foramen must be performed with great care.
- 21. flap three-cornerflap is to be used in the area of the mental nerve, the vertical-releasing incision must be placed far enough anteriorly to avoid severing any portion of the mental nerve.
- 22. Incisions madein the retromolar pad region of the mandible should be placed so as to avoid coming close to lingual nerve complication
- 23. inferior alveolarnerve may be traumatized along the course of its intrabony canal. The most common place of injury is the area of the mandibular third molar
- 24. 2)INJURY TO THETEMPOROMANDIBULAR JOINT
- 25.
- 28.
- 29. Prevention ofPostoperative Bleeding 1. Obtain a history of bleeding. 2. Use the atraumatic surgical technique. 3. Obtain good hemostasis at surgery. 4. Provide excellent patient instructions
- 32. DELAYED HEALING ANDINFECTION 1. infection 2. Wound dehiscence 3.dry socket
- 33. INFECTION The mostcommon cause of delayed wound healing is infection. Infections are a rare complication after routine dental extraction and are primarily seen after oral surgery that involves the reflection of soft tissue flaps and bone removal.
- 34. 2)WOUND DEHISCENCE Ifa soft tissue flap is replaced and sutured without an adequate bony foundation, the unsupported soft tissue flap often sags and separates along the line of incision. A second cause of dehiscence is suturing the wound under tension.
- 35. DRY SOCKET Drysocket or alveolar osteitis is delayed healing but is not associated with an infection. This postoperative complication causes moderate to severe pain but is without the usual signs and symptoms of infection such as fever, swelling, and erythema.
- 36. DENTAL TEACHING CLINICSOF AL QUDS UNIVERSITY STUDY During this study, 1305 permanent tooth extractions were performed in 805 patients. 58% male patients and 42% female patients. Data were collected over a period of 16 months, from October 1st 2006 to January 28th 2008.
- 37. dry socketincidence: non-surgical extraction of teeth was 1.7 % surgical extraction was 12%
- 38. Dry socket: innon smoker 2.1% in smoker 5.1%
- 39. DRY SOCKET: INSINGLE-EXTRACTION7.3% MULTIPLE EXTRACTION 3.4%
- 40. DRY SOCKET: INSINGLE-EXTRACTION7.3% MULTIPLE EXTRACTION 3.4%
- 41. Dry socket: in(18-33) year is 4.8 % in (34-49) year is 2.9% In more than 50 year is 1.6%
- 42. Study of thePrevalence, clinical picture, and risk factors of dry socket in a Jordanian dental teaching center. CONCLUSION of the study: Smoking and surgical trauma are associated with an increased incidence of dry socket. Moreover, patients who had single extractions were more likely to develop dry socket than those who had multiple extractions in the same visit.
- 43. Fracture ofthe mandible during extraction is a rare complication; it is associated almost exclusively with the surgical removal of impacted third molars. FRACTURES OF THE MANDIBLE
- 44. REFERENCES James RHupp ,Edward ellis lll , Myron R. Tucker , six edition , Contemporary oral and maxillofacial surgery. Palestinian study : Abu Younis MH1, Abu Hantash RO., Published online 2011 Feb 7 , Dry Socket: Frequency, Clinical Picture, and Risk Factors in a Palestinian Dental Teaching Center, Pubmed (electronic site ) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3089956/ Jordanian study : Nusair YM1, Younis MH. , 2007 Mar 1 Prevalence, clinical picture, and risk factors of dry socket in a Jordanian dental teaching center, Pubmed (electronic site ) https://www.ncbi.nlm.nih.gov/pubmed/17351682