Poorly controlled diabetic: changes to appointment
No treatment until they reach THEIR maximum control
Well controlled diabetic: changes to appointment
No changes needed
End-stage Renal: changes to appointment
Risks from Leukemias and Lymphomas (2)
-Infection from low fxning white cells -Thrombocytopenia
Cardiac disease: changes to appointment
No treatment until stable post 6 months?
Risks from Cardiac problems: (3)
-Bleeding -Acute MI -CVA
Pregnancy: When do we do extractions
Drugs of concern: Anti-coagulants and 3 more
1. Corticosteroids 2. Immunosuppressive 3. Chemo
Risks for patients with history of radiation AT site of extraction and possible treatment?
-Osteoradionecrosis -Hyperbaric O2 treatment
Highly anxious people: changes to appointment
Complications for extraction due to Infection (2)
1. Hard to get numb 2. Hard to open mouth fully
Surgical options for treating pericornitis? -Mild -Severe (4)
-Mild: Extract -Severe: 1. Debride 2. Irrigate 3. Anti biotics 4. Extract IF it is in occlusion on gingival tissue
Causes of limited opening
1. Trismus 2. TMD 3. Muscular Fibrosis
What may cause teeth to be Ankylosed? (3)
-Submerged primary molars that have no permanent Tooth. -Endo-treated teeth -History of trauma
*Just for fun.... *Which arch is more susceptible to osteoradionecrosis?
Mandible! less substantial blood supply
Which tooth most commonly has risk of oral antral fistula?
MAXILLARY 1st Molar
High Risk cases for Oral antral fistulas? (2)
1. Indentation of the sinus at the roots of molar 2. Teeth related to sinus are Isolated. This increases the risk of fracture of these teeth and maxillary tuberosity into the sinus.
Fracture risk: -Pointed apices vs rounded apices
Pointed: more likely to fracture Rounded: Hard to extract with less risk of fracture
Risks for endo-treated tooth
-Brittle (more brittle longer it is after endo-treatment) -Endo treated teeth that were avulsed or replanted are at risk of ankylosis.
Extraction concerns for primary molars
Removal of Permanent tooth bud with the primary molar -recommend sectioning for careful extraction
The more dense the bone, the greater risk for:
Root fracture -?(and apparently alveolar bone fracture too?)
What properties of a tooth lead to greatest risk of injury to inf alveolar N? Overall risk in %?
Most posterior (3rd molar) Impacted (not erupted) *1% RISK
What is the orientation/position of the 3rd mand molars and the inf alveolar canal.
The canal is buccal to the 3rd molars