Complications of Dental Extractions include
- Inability to move the tooth
- Fracture of the tooth
In both these cases, take a radiograph and consider transalveolar method.
3. Fracture of alveolar process – if large piece of bone fractures, replace the bone in position with the periostium intact. Suture the mucosa.
4. Fracture of maxillary tuberosity – check oroantral communication and if present, manage accordingly. If tuberosity has periosteal attachment, reposition it back and suture.
5. Fracture of Jaws – reduction and fixation
6. Mucosal laceration – avoid by holding instruments with proper support. Manage by approximation and suturing.
7. Luxation of adjacent tooth – replace the luxated tooth to its original position and splinting made for a period of 3 – 6 weeks.
8. Oroantral communication – small opening, no treatment, do good suturing of the extraction site. Large opening needs surgical closure and coverage of opening by stent/other materials till healing.
9. Displacement of tooth into the facial spaces – removal of the tooth/root indicated.
10. Nerve injury – patient should be informed and routine follow up done.
11. Hemorrhage – if from soft tissue, (pressure pack/LA pack/sutures/cautery) if from artery, (ligation) if from bone (gel foam/oxidised cellulose/ bone wax)
12. Dislocation of jaw – avoided by supporting the jaw during extraction.
13. Root tip left – leave if deeply buried, give antibiotics and review. However if large pieces of root remains, remove.
a) primary – occurs due to inadequate hemostasis at surgery.
b) reactionary – occurs within 48 hours due to rise in BP or slippage of sutures.
C) secondary – 7 days postoperatively usually due to infection
Agents used as packs –
- Resorbable mesh (oxidised cellulose)
- Transexemic acid
- Epsilon amino capriac acid
- Bismuth iodine paraffin paste
- Whiteheads varnish
2. Pain and swelling – edema maximum on second day and then it subsides. Administration of anitobiotics and analgesics.
3. Dry socket (Alveolar osteitis) – loss of blood clot and socket appears empty and dry. Irrigation of the site and placement of obtundent dressing.
Dr Iswarya V
Oxford Clinical Dentistry