Complications of Dental Extractions Dr. Sylvia Ongeri DDS

The complications can be divided into 3 main categories: There are a number of complications that occur when an extraction is carried out. The complications can be divided into 3 main categories: Pre-extraction During extraction Post extraction

Pre-extraction Difficulty in achieving anesthesia Poor clinical technique Difficulty in cooperation Difficulty in access i.e. Trismus, reduced aperture of the mouth crowded or misplaced teeth

During Extraction: Abnormal resistance e.g. diverged roots, thick alveolar bone, hypercementosis, lone standing teeth Example of Hypercementosis:

Damage to other teeth Extracting the wrong tooth Dislocation of adjacent tooth/ or restoration of adjacent tooth Fracture of teeth

Oro- Antral communication The relationship between the maxillary teeth and the Maxillary sinus floor. The causes of oro-antral communication during extraction are varied. It can be caused by: Fracture of the wall of the sinus Apical infection Perforation during attempts to recover root apices.

Pre extraction IOPA of tooth 16

Post extraction IOPA of tooth 16 area

Clinical Picture of Oro-antral communication

Damage to soft tissue Damage to nerves Fracture of Alveolar bone Fracture of basal bone Dislocation of the TMJ

Post Extraction Hemorrhage –prolonged haemorrhage occurs as primary, reactionary and secondary haemorrhage. Infection- mainly due to contamination of the extraction wound due to either oral bacteria, poor infection control or bone sequestra Pain Swelling Trismus Hematoma

Alveolar Osteitis The early loss of a blood clot can lead to an acutely painful condition known as alveolar osteitis or dry socket

Possible causes of Alveolar Osteitis The etiology of this condition is unclear although a blood clot failing to form can be due to an number of reasons: Decreased blood supply to the area e.g. osteomyelitis Smoking Large doses of vasoconstrictor used during the extraction from the local anesthetic

Treatment of Alveolar osteitis Current trends in treatment for this condition is to: Irrigate the extraction socket with saline Pack the socket with Alvogyl Medicate on Antibiotics and review in 7 days.

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