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BDS3 Oral surgery > Complications > Flashcards

Complications Flashcards

(45 cards)

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1
Q

Immediate complications?

A
  • FailureofLA
  • Failuretomovethetooth
  • Fractureofthetoothorrootbeingremoved * Fractureofalveolus
  • OroAntralCommunication(OAC)
  • Displacementofatoothorrootintotissues * Lossoftoothorroot
  • Damagetosurroundingtissues&teeth
  • Thermalinjury/chemicalinjury
  • Haemorrhage
  • TMJinjury
  • Fractureofthemandible
  • DamagetotheTrigeminalnerve
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2
Q

What do you call communications with the maxillary sinus?

A

oro antral communication

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3
Q

Artery in the lip?

A

Superior labial artery

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4
Q

Delayed complications?

A
  • Excessive pain, swelling, trismus * Haemorrhage
  • Dry socket
  • Oro Antral Fistula (OAF)
  • Osteomyelitis / osteonecrosis * Failure of the socket to heal * Nerve damage
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5
Q

Oro antral fistula?

A
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6
Q

Why can’t we extract the 8?

A

partially erupted, impacted on distal of the 7, chunky root

Surgical procedure

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7
Q

Management depends on what?

A
  • Amount fractured: apex or whole root
    – Medical history of patient
    – Presence of infection
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8
Q

Can you remove the crown and leave the root?

A

no, blood clot cannot form on top of it

Can leave small apical area of root

Can only leave a small root - 4mm can be left

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9
Q

If there is a periapical area, what can happen to the root?

A

alveolar bone has resorbed - can flick the apical root out

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10
Q

Problem with tuberosity?

A

attached to molar

Can break

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11
Q

If you fracture the tuberosty, what can occur?

A

oro antral fistula

Into middle meatus - difficult to clean antrum if blood gets there

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12
Q

When can the tuberosity fracture?

A

Usually Lone standing upper molar
- bone becomes denser due to increased function

Hypercementosis

Bulbous roots

Splayed roots

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13
Q

What to do if lone standing ,auxiliary molar needs extracted - dense bone indicated on X-ray?

A

elective surgical procedure

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14
Q

Fractured bone?

A

fractured tuberosity

Fractured alveolus

Fractures mandible

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15
Q

TMJ injuries presents how?

A

dislocation presents as a malocclusion/trismus

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16
Q

TMJ painful?

A

no

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17
Q

What happens in TMJ dislocation?

A

Condylar head slides forward on to the articular emminence and beyond

Gel lid fossa to in front of the articular eminence

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18
Q

Do you check TMJ after extraction?

A

yes

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19
Q

How to put put TMJ back?

Study These Flashcards
A

Pt keep calm

Wrap gauze around things

Push down on mandibular molars

Wrap bandage around head

20
Q

Sedatives?

Study These Flashcards
A

benzodiazalines

= diazepam

= midazolam

21
Q

OAC?

Study These Flashcards
A

oro-antral communication

22
Q

What is an oro-antral communication?

Study These Flashcards
A

pathological communication between the maxillary antrum and the oral cavity

23
Q

What happens if OACs don’t heal?

Study These Flashcards
A

they become an oro-antral fistula

24
Q

Other causes of OAC?

Study These Flashcards
A

osteomyelitis/osteonecrosis, maxillary fracture, sinus tumour, osteoradionecrosis, endodontics, dental implant placement

25
A vs B
A = oro-antral communication B = epithelialised and now a oro-antral fistula
26
Type of X-ray?
Occipito- mental X-ray Taken to look at mid-face
27
Arrow pointing to what?
fluid - pus / blood Fluid in right antrum Oro-antral fistula
28
Called what?
buccal advancement flap Used for oro-antral communication Ring up oral surgery department Regent sinusitis
29
Where can displaced roots be?
– Inhaled – Swallowed – Antrum – Buccal/Palatal mucosa – Floor of nose – Infratemporal fossa – Lingual pouch
30
Who would you give antibiotics?
swelling Lymphopayhy Systemic signs - fever
31
Main oro-facial infection?
pericoronistis Periapical abscess Periodontal abscess
32
Less common oro-facial infections?
* Infected cysts * Acute ulcerative gingivitis * Cancrum oris * Necrotising fasciitis * Osteomyelitis * Non-specific lymphadenitis * Fungal infections (immunocompromised patients)
33
Lidwigs angina?
* Bilateral sublingual, submandibular and submental space infections * Raised swollen tongue = Pyrexia, dysphagia, dysarthria, dyspnoea * Potentially life threatening * Treatbydrainage,I.Vantibiotics * Mayneedtracheostomyforairway management
34
What to do if pt shows signs of Ludwig’s angina?
sent to hospital
35
Symptoms of Ludwig’s angina?
Bilateral sublingual, submandibular and submental, space infections Raised swollen tongue Prexia, dysphagia, dysarthria, dyspnoea
36
Signs that a lt can’t swallow?
Drooling
37
Treatment for Ludwig’s angina?
Treatbydrainage,I.Vantibiotics * May need tracheostomy for airway management * Drain pus & remove source - Extraction or pulpectomy * Antibiotics empirically then MC&S - Pen V & Metronidazole * Analgesia * In severe cases: - Hospital admission, IV antibiotics, GA drainage, blood tests
38
Pus aspiration, what to watch out for?
facial nerve Marginal mandibular shown here - drooping of corner of mouth
39
Cause of Ludwig’s angina?
oral infection Poor oh
40
What is occuring here?
Cavernous sinus infection Can travel to brain Increased pressure in brain Meningitis Cerebral abscesses
41
How to know if a swelling is more serious?
hard - pus
42
Severely immune-compromised pts?
transplant pts Cancer pts - chemo/radiotherapy HIV
43
Where to make impression to remove submandibular infection?
w finer space under jaw
44
Raise complications of infection?
* Airway obstruction * Pus aspiration into lungs * Spread; – septicaemia – orbital cellulitis – Septic cavernous sinus thrombosis – encephalitis, meningitis * Acute necrotising fasciitis * Mediastinal spread * Death
45

BDS3 Oral surgery (5 decks)

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