Home » Prevention and Manage of Surgical Complications
POSTOPERATIVE BLEEDING
Extraction of teeth Is a surgical procedure that presents a severe challenge to the- body’s hemostatic mechanism. Several reasons exist for this change First, the tissues of the mouth and jaws are highly vascular. Second” the extraction of a tooth leaves an open wound, with both soft tissue and bone open, which allows additional oozing and bleeding. Third, it is almost imp
OROANTRAL COMMUNICATLONS
Removal of maxillary molars occasionally results in comt munication between the oral cavity and the maxillary sinus. If the maxillary sinus is large, if no bone exists between the roots of the teeth and the maxillary sinus, and if the roots of the tooth are widely divergent, then it is increasingly probable that a portion of the bony floor of the sinus will be removed with the tooth.
INJURIES TO ADJACENT STRUCTURES
During the process of tooth extraction, it is possible to injure adjacent tissues. The prudent surgeon preoperatively evaluates all adjacent anatomic areas and designs a surgical procedure to prevent injury to these tissues.
FIG. 11-10 Tuberosity removed with maxillary second molar, whicheliminates important prosthetic retention area and exposes maxillarysinus. A, Buccal view of b
INJURIES TO OSSEOUS STRUCTURES
Fracture of Alveolar Process
The extraction of a tooth requires that the surrounding alveolar Done be expanded to allow an unimpeded pathway for tooth. removal. However, in some situations the bone fractures and is removed with the tooth instead of
expanding. The most likely cause of fracture of the alveolar process is the use of excessive force with forceps, which fractures larg
INJURIES TO ADJACENT TEETH
When the dentist extracts a tooth, the tocus ot attention is on that particular tooth and the application of forces to luxate and deliver it. When the surgeon’s total attention is thus focused, likelihood of injury to the adjacent teeth increases. The surgeon should mentally step back from time to time to survey the entire surgical field to prevent injury to adjacent teeth.
Fr
COMPLICATIONS WITH THE TOOTH BEING EXTRACTED
Root Fracture
The most common complication associated with the 00 h being extracted is fracture of its roots. Long, ed, divergent roots that lie in dense bone are most
of be fractured. The main method of preventing
FIG. 11-2 Small straight elevator can be used as shoehorn to luxatebroken root. When straight elevator is used in this position, handmust be securely suppo
SOFT TISSUE INJURIES
Injuries to the soft tissue of the oral cavity are almost always the result of the surgeon’s lack of adequate attention to the delicate nature of the mucosa and the use of excessive and uncontrolled force. The surgeon must continue to pay careful attention to the soft tissue while working primarily on the bone and tooth structure (Box 11-1).
Tearing Mucosal Flap
The most common soft
PREVENTION OF COMPLICATIONS
It is axiomatic that the best and easiest way to manage a comphcatlon is to prevent it from happening. Prevention of surgical complications is best accompllshed by a thor~hpreoperative assessment and comprehensive treatment plan. Only when these are routinely performed can fie surgeon expect to have minimal complications. It is I portant to realize that even with such planning, co
INJURIES TO ADJACENT STRUCTURE
During the process of tooth extraction, it is possible to injure adjacent tissues. The prudent surgeon preoperatively evaluates all adjacent anatomic areas and designs a surgical procedure to prevent injury to these tissues.
FIG. 11-10 Tuberosity removed with maxillary second molar, whicheliminates important prosthetic retention area and exposes maxillarysinus. A, Buccal view of b
INJURIES TO OSSEOUS STRUCTURE
Fracture of Alveolar Process
The extraction of a tooth requires that the surrounding alveolar Done be expanded to allow an unimpeded pathway for tooth. removal. However, in some situations the bone fractures and is removed with the tooth instead of
expanding. The most likely cause of fracture of the alveolar process is the use of excessive force with forceps, which fractures lar
