Download Complications of Dental Extractions

Dr. Sylvia Ongeri
DDS
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There are a number of complications that occur
when an extraction is carried out.
The complications can be divided into 3 main
categories:
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Pre-extraction
During extraction
Post extraction
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Difficulty in achieving anesthesia
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Poor clinical technique
Difficulty in cooperation
Difficulty in access i.e.
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Trismus,
reduced aperture of the mouth
crowded or misplaced teeth
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Abnormal resistance e.g. diverged roots, thick
alveolar bone, hypercementosis, lone standing
teeth
Example of Hypercementosis:
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Damage to other teeth
Extracting the wrong tooth
Dislocation of adjacent tooth/ or restoration of
adjacent tooth
Fracture of teeth
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Oro- Antral communication
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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.
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Damage to soft tissue
Damage to nerves
Fracture of Alveolar bone
Fracture of basal bone
Dislocation of the TMJ
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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
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The early loss of a blood clot can lead to an
acutely painful condition known as alveolar
osteitis or dry socket
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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
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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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