1. Complications of Dental Extractions
Dr. Sylvia Ongeri
DDS

2. 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

3. 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

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

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

6. 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.

7. Pre extraction IOPA of tooth 16

8. Post extraction IOPA of tooth 16 area

9. Clinical Picture of Oro-antral communication

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

11. 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

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

13. 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

14. 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.

15. Thank You