Summary ORAL SURGERY - Chapter 5

Pontillas, Kyla Ma a. - Manag m nt:
 Cai fully i posntion d onc th suig iy ns
aMa 5y1-1
compl t d
 Excns th dg s of toin fap to ci at a
smooth fap maignn
PREVENTION ANa MANAGEMENT OF EXTRACTION
COMPLICATIONS PUNCTURE WOUNa

COMPLICATIONS - Caus s:
 Usnng uncontioll d foic duinng usnng th
 Soft tissu nnuuin s nnstium nts such as stianght l iatoi oi a
 Piobl m wnth th tooth b nng xtiact d p inost al l iatoi whnch may slop fiom th
 Inuuin s to th aduac nt i stoiation suigncal fi ld and punctui oi t ai nnto
 Inuuin s to th aduac nt stiuctui s aduac nt soft tissu s
 Oioantial communncation - Pi i ntion:
 Post op iatii bl dnng  Us of contioll d foic
 a lay d h alnng and nnf ction  Usnng fing i i sts
 Inuuin s of th mandnbl  Suppoit fiom th opposnt hand nf slnppag
ns anticnpat d
- Ti atm nt:
 Pinmaiy anm ns pi i ntion of nnf ctions and
SOFT TISSUE INJURIES
allownng h alnng to occui
 Caus s  If wound bl ds xc ssni ly h mostasns
 Suig on’s lack of ad quat at ntion to th l ft op n unsutui d h alnng by s condaiy
d lncat natui of th mucosa nnt nsnon
 At mpts to do suig iy wnth nnad quat
STRETCH OR ABRASION
acc ss
 Rushnng duinng suig iy - Common snt s
 Us of xc ss and uncontioll d foic s  Lnps, coin is of th mouth
- T ai of mucosal fap - Caus s
- Punctui wounds  Abiasnon oi buins fiom th iotating shank
- Sti tch oi abiasnon of th bui iubbnng on soft tissu
 M tal i tiactoi comnng nnto contact wnth
TEAR OF FLAP
th soft tissu s
- Th most common soft tissu nnuuiy duinng oial - Pi i ntion:
suig iy  Suig on should focus on th cutng nd of
- Caus s: nnad quat ni lop fap foicnbly bui as w ll as th location of shank and
i tiaction b yond th abnlnty of th tissu to shaft nn i lation to th soft tissu s
sti tch (to gann n d d suigncal acc ss) - Ti atm nt:
t ainng  Cl an th ai a wnth i gulai oial innsnng
- Pi i ntion:  Usually such wounds h al nn 4-7 days
 Ci ating ad quat ly snz d fap to pi i nt wnthout scaiinng
xc ss t nsnon on th fap  If such abiasnon oi buin do s d i lop on
 Usnng contioll d amounts of i tiaction sknn adins d to k p nt monst wnth antibnotic
foic on th fap onntm nt (5-10 days)
 Ci ating i l asnng nncnsnons wh n nndncat d

, - If thns t chnnqu fanls – no addntional suigncal
pioc dui should b p ifoim d
PROBLEMS WITH TOOTH BEING EXTRACTEa - Manag m nt:
 Root fiactui - If swallow d no coughnng oi i spniatoiy
 Root dnsplac m nt dnsti ss tiai l down GIT OUT
- If aspniat d pnsod s of coughnng and dyspn a
 Tooth lost nnto th phaiynx
ch st and abdomnnal iadnogiaphs manntann
aniway tooth i moi d thiough bionchoscopy

ROOT FRACTURE IF LARGE FRAGMENT OR ENTIRE TOOTH IS aISPLACEa
INTO THE MAXILLARY SINUS OR THE TOOTH ROOT IS
- Most common piobl m INFECTEa
- Pi dnsposnng factois
 Long, cuii d, dni ig nt ioots - Caldw ll-lac appioach nnto th maxnllaiy snnus nn
 Roots that ln nn d ns bon th cannn fossa i gnon
 Ankylosns - Follow d by i moial of th tooth
- Pi i ntion  ansplac m nt nnto th nnfiat mpoial spac
 Always consnd i th possnbnlnty (duinng l iation of th l iatoi may foic th
 Us suigncal xtiaction nf hngh possnbnlnty of a tooth post inoily thiought th p inost um nnto
fiactui xnsts th nnfiat mpoial fossa)
 aon’t us stiong apncal foic on a biok n  ansplac m nt nn to th submanndubulai spac
ioot (fiactui d mandnbulai molai ioots that ai
- Ti atm nt : bon cutng b nng i moi d wnth apncal pi ssui may b
dnsplac d thiough th lnngual coitical plat nnto
ROOT aISPLACEMENT th submandnbulai spac

- Most commonly dnsplac d tooth ioot nnto INJURIES TO THE AaJACENT TEETH
unfaioiabl anatomncal spac ns maxnllaiy molai
ioots  Fiactui s oi dnslodg m nt of an aduac nt
- ansplac d nn to maxnllaiy snnus i stoiation
- Ti atm nt  Luxation of an aduac nt tooth
 Suig on should ass ss  Extiaction of th wiong tooth
 1. snz of ioot lost nnto th snnus
FRACTURE OR aISLOaGEMENT OF AaJACENT
 2. ass ss wh th i th i has b n any
RESTORATION
nnf ction of th tooth oi p inapncal tissu s
 3. ass s th pi op iatii condntion of th - Pi i ntion:
maxnllaiy snnus  Aiond applncation of nnstium ntation and
foic on th i stoiation
St p 1: Radnogiaph  Stianght l iatoi should b us d wnt hgi at
St p 2: Iiingat thiough th small op nnng nn th sock t cai oi not usnng nt all
ap x - Manag m nt:
 R plac m nt of dnsplac d ciown
St p 3: suction th niingating solution fiom th snnus ina  Plac m nt of a t mpoiaiy i stoiation
th sock t  Pati nt should b nnfoim d

- Small tooth fiagm nt (2-3mm)
- Tooth and snnus hai no pi xnsting nnf ction