ORAL SURGERY 1 2nd SEM
DMD 5AA MIDTERMS
—---------------------------------------------------------------------------------------------------------------------—
● most of the time impacted lower
PREVENTION
TEAR OF A MUCOSAL FLAP
● Most common soft tissue injury Surgeon should focus on the cutting end of the bur as well
● Usually results from an initially inadequately sized as the location of the shank and shaft in relation with the
envelope flap, which is then forcibly retracted soft tissue
beyond the ability of the tissue to stretch
MANAGEMENT
PREVENTION lN LACERATION 1. clean area with regular oral rinsing
2. wounds usually heals in 4-7 days without scaring
1. creating adequately sized flaps to prevent excess tension
on the flap 3. if such abrasion or burn does develop on the skin advised
2. using controlled amount of retraction force on the flap to keep it moist with antibiotic ointment ( 5-
3. creating releasing incisions, when indicated. 10 days)
● Place the tip of the retractor to the bone and it will become stable PROBLEMS WITH TOOTH EXTRACTION
MANAGEMENT
● Carefully reposition once the surgery is completed ROOT FRACTURE
● Excise the edges of torn flap to create a smooth 1. Long, curved, divergent roots
flap margin 2. Roots that lie in a dense bone
3. Ankylosis
PUNCTURED WOUND
● Ankylosis in radiograph: no periodontal space so it means bone to
● Second most common tissue injury bone ang kanilang connection.
● Clinically: produced dull sound
● Result of using uncontrolled force
● it is caused by the needle PREVENTION
● Avoid using strong apical force on a broken tooth
● Use surgical extraction if high possibility of a
PREVENTION
fracture exist
1. use of controlled force
MANAGEMENT
2. use of finger rest or support from the opposite hand to
avoid slippage ● Bone cutting
● use finger rest to avoid stipping
ROOT DISPLACEMENT
● Most commonly displaced tooth root into
STRETCH OR ABRASION
unfavorable anatomical space is the Maxillary
● Usually results from the rotating shank of the bur molar roots
rubbing the soft tissue ● Displaced into Maxillary Sinus
● Metal retractor coming to contact with the soft
tissue ● Which root is usually displaced in the maxillary sinus? Mesiobuccal,
disto buccal and palatal
● Longest three roots in maxillary first molar?????? Look for the answer
COMMON SITE
1. lips
MANAGEMENT
2. corners of the mouth
1. Radiograph
2. irrigate thru the small opening in the socket apex
CENTRO ESCOLAR UNIVERSITY - MANILA
, ORAL SURGERY 1 2nd SEM
DMD 5AA MIDTERMS
—---------------------------------------------------------------------------------------------------------------------—
3. suction the irrigating solution from the sinus via socket
MANAGEMENT (if swallowed)
1. check if there is coughing or respiratory distress, if none
2 it will eventually travel down the GIT
MANAGEMENT (IF ASPIRATED)
1. Episodes of coughing and dyspnea
2. Chest and abdominal radiographs
3. Removal of tooth thru Bronchoscopy
MANAGEMENT
1. CALDWELL-LUC approach into the maxillary sinus in the
canine fossa region
2. Removal of tooth
● when you do it make sure its above the apex of the tooth
FRACTURE OR DISLODGEMENT OF AN ADJACENT
RESTORATION
PREVENTION
● Avoid application of instrumentation and force on
the restoration
● Elevators should be used with great care
MANAGEMENT
● Replacement of the displaced crown
● Placement of temporary restoration
CENTRO ESCOLAR UNIVERSITY - MANILA
DMD 5AA MIDTERMS
—---------------------------------------------------------------------------------------------------------------------—
● most of the time impacted lower
PREVENTION
TEAR OF A MUCOSAL FLAP
● Most common soft tissue injury Surgeon should focus on the cutting end of the bur as well
● Usually results from an initially inadequately sized as the location of the shank and shaft in relation with the
envelope flap, which is then forcibly retracted soft tissue
beyond the ability of the tissue to stretch
MANAGEMENT
PREVENTION lN LACERATION 1. clean area with regular oral rinsing
2. wounds usually heals in 4-7 days without scaring
1. creating adequately sized flaps to prevent excess tension
on the flap 3. if such abrasion or burn does develop on the skin advised
2. using controlled amount of retraction force on the flap to keep it moist with antibiotic ointment ( 5-
3. creating releasing incisions, when indicated. 10 days)
● Place the tip of the retractor to the bone and it will become stable PROBLEMS WITH TOOTH EXTRACTION
MANAGEMENT
● Carefully reposition once the surgery is completed ROOT FRACTURE
● Excise the edges of torn flap to create a smooth 1. Long, curved, divergent roots
flap margin 2. Roots that lie in a dense bone
3. Ankylosis
PUNCTURED WOUND
● Ankylosis in radiograph: no periodontal space so it means bone to
● Second most common tissue injury bone ang kanilang connection.
● Clinically: produced dull sound
● Result of using uncontrolled force
● it is caused by the needle PREVENTION
● Avoid using strong apical force on a broken tooth
● Use surgical extraction if high possibility of a
PREVENTION
fracture exist
1. use of controlled force
MANAGEMENT
2. use of finger rest or support from the opposite hand to
avoid slippage ● Bone cutting
● use finger rest to avoid stipping
ROOT DISPLACEMENT
● Most commonly displaced tooth root into
STRETCH OR ABRASION
unfavorable anatomical space is the Maxillary
● Usually results from the rotating shank of the bur molar roots
rubbing the soft tissue ● Displaced into Maxillary Sinus
● Metal retractor coming to contact with the soft
tissue ● Which root is usually displaced in the maxillary sinus? Mesiobuccal,
disto buccal and palatal
● Longest three roots in maxillary first molar?????? Look for the answer
COMMON SITE
1. lips
MANAGEMENT
2. corners of the mouth
1. Radiograph
2. irrigate thru the small opening in the socket apex
CENTRO ESCOLAR UNIVERSITY - MANILA
, ORAL SURGERY 1 2nd SEM
DMD 5AA MIDTERMS
—---------------------------------------------------------------------------------------------------------------------—
3. suction the irrigating solution from the sinus via socket
MANAGEMENT (if swallowed)
1. check if there is coughing or respiratory distress, if none
2 it will eventually travel down the GIT
MANAGEMENT (IF ASPIRATED)
1. Episodes of coughing and dyspnea
2. Chest and abdominal radiographs
3. Removal of tooth thru Bronchoscopy
MANAGEMENT
1. CALDWELL-LUC approach into the maxillary sinus in the
canine fossa region
2. Removal of tooth
● when you do it make sure its above the apex of the tooth
FRACTURE OR DISLODGEMENT OF AN ADJACENT
RESTORATION
PREVENTION
● Avoid application of instrumentation and force on
the restoration
● Elevators should be used with great care
MANAGEMENT
● Replacement of the displaced crown
● Placement of temporary restoration
CENTRO ESCOLAR UNIVERSITY - MANILA
