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26 Cards in this Set
- Front
- Back
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what are pre-operative complications? (2)
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1. spread of infection
2. collapse |
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what are peri-operative complications? (11)
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1. wrong tooth
2. tooth fracture 3. mandible fracture 4. maxillary tuberosity fracture 5. haemorrhage 6. damage to adjacent restorations 7. soft tissue damage 8. inhaled tooth/instrument 9. OAC 10. failed LA 11. facial palsy with parotid/facial n. damage |
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what are post-operative complications? (11)
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1. bruising
2. bleeding 3. swelling 4. pain 5. infection 6. trismus 7. dry socket 8. ORN, BRONJ (some pt) 9. nerve injuries (paraesthesia) 10. TMJ complications: subluxation, dislocation 11. pain |
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when can u leave a root?
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1. <3mm
2. no apical infection 3. no chance of distant infection 4. high risk damage to IAN, sinus etc 5. patient declines |
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what do you do if there is a maxillary tuberosity fracture?
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if the bone is still attached to periosteium it is still vital so place splint and bone back in place
heal for 6-8 weeks remove splint |
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principles of extraction (4)
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1. bone as fulcrum
2. adequate vision 3. stabilization and support 4. no damage to major structures |
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what to do if inhaled tooth/instrument? (2)
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1. CXR to see if it was aspiried (avoic bronchopneumonia)
2. refer to hospital for bronchoscopy |
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where do inhaled objects usually lodge?
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right main bronchus
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what can cause an OAC? (6)
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1. pneumatization
2. lone standing molar 3. bone atrophy 4. difficult exo 5. periapical pathology 6. pushing too hard on elevation |
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signs of OAC (4)
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1. fluid coming out through nose when drink something
2. bubbles of air and blood when gently 3. difficulty smoking 4. difficulty eating |
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how do you treat an OAC if small?
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1. if it is small (<4-5 mm) then it will heal spontaneously (might need to suture)
2. avoid nose blowing, do not hold in sneeze, do not drink through straw, avoid causing pressure. 3. nasal decongestant oxymethazoline 4. broad spectrum antibiotics 5. analgesics |
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how do you treat an OAC if large?
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>5mm
buccal advancement flap broad spectrum antibiotics |
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what is a dry socket?
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occurs when there is disruption of the healing process in an extraction site after clot formation but before wound organization.
it results in the degeneration of the blood clot and subsequent exposure of the walls of the bony socket to bacteria and saliva. severe pain and foul odour, food debris, red/tender mucosa. |
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how do you treat a dry socket? (6)
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1. LA for pain
2. warm saline solution to remove debris 3. antiseptic: alvogyl (eugenol, iodine, LA) for 24-48 hours which will shed spontaneously. 4. mouth rinse 5. analgesia 6. check up and review |
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what do you do if a px comes back with post-op haemorrhage?
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1. gauze 20-30mins
2. check MH and meds for cause 3. remove blood clot 4. determine site of bleeding 5. give LA with vasoconstrictor 6. place surgicel (resorbable cellulose) to encourage clotting 7. gauze 7. give after hours numbers |
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other treatments for haemorrhage?
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1. diathermy
2. spongostan/gelfoam 3. bone wax 4. tranexamic acid (anti-fibrinolytic) |
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what causes trismus?
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1. reactionary pain
2. haematoma in medial pterygoid muscle |
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how do you treat trismus?
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1. resolves with time
2. try opening with spatulas |
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what is absolute trismus?
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when they can't open mouth at all
this can be a sub-masseteric abscess |
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how does post-op infection occur?
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it is rare but can occur with dental abscess in socket and spread to soft tissue spaces.
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how do you treat post-op infection?
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open up suture and drain, give antibiotics
admit to hospital if severe |
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what is Osteoradionecrosis?
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irreversible, progressive devitalisation of irradiated bone
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how to prevent ORN? (3)
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1. full dental assessment including radiographs and OPG
2. extract every tooth that has a doubtful prognosis at least 14 days before their radiotherapy 3. if px has already had radiotherapy contact their head and neck surgeon etc and consider hyperbaric oxygen and antibiotic prophylaxis |
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what are 5 bisphosphonates?
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1. alendronate (fosamax)
2. risedronate (actonel) 3. zolderonic acid (zometa) 4. etidronate 5. sodium pamidronate (bonefos) 6. palmidronate (aredia) |
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risk factor for BRONJ
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1. >3 years bisphosphonate use
2. IV 3. age 4. drugs: CCS 5. med conditions: anaemia |
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symptoms of BRONJ
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1. severe pain or numbness
2. swelling and infection 3. loosening of teeth and bone |
