Complications Flashcards
Bone complications
alveolar osteitis
sequestrum
exposed bone
MRONJ
ORN
What is alveolar osteitis
inflammation rather than infection
Pathogenesis of alveolar osteitis
- complete absence - blood clot
formation initial clot subsequently lysed - inflammed alveolar bone
release of tissue activators
dry socket risk factors
women
smoking
trauma
medications - OCP, antipsychotics, antidepressants
anatomy - mandibular third molars
infection
inadequate OH
spitting, sucking through straw, coughing or sneezing
flap extent and design
surgical trauma
dry socket presentation
extraction
onset any, 2-3 days
worsening pain compared with better
refractory to analgesia
dull aching throb
bad taste
discharge
halitosis
dry socket management
la ideally, exploration socket
void, debris, sequestrum?, irrigation - saline, sedative dressing, blood clot?, do nothing
what is a sequestrum?
small fragments lost from the extraction site
Bone disorders
MRONJ, osteoporosis, bone metastasis, primary malignancy, Paget’s disease
RANKL inhibitor
denosumab
anti-angiogenic
bevacizumab, sunitinib, alibercep
What is ORN
osteoradionecrosis
ORN features
non-healing bone, severe pain, recurrent infections, halitosis, oral-facial fistula, suppuration, pathological fracture
trismus mechanisms
pain, muscular,haematoma, infection, chronic limitation, trauma
