10 – Oral Surgery

10

Oral Surgery

Michael L. Ellis, DDS, Sterling R. Schow, DMD, and R. Gilbert Triplett, DDS, PhD

Postoperative Bleeding

Although most patients do not suffer prolonged postoperative bleeding following extractions or other oral surgical procedures, there are times when a patient will contact the dentist with a complaint of prolonged bleeding following a routine procedure. Phone consultations are, at best, difficult to sort through and compromise the clinician’s ability to correctly diagnose the problem. Definitive diagnosis requires physical examination; however, professional judgment will dictate whether the patient needs to be seen immediately. When in doubt, an examination is wise.

Alveolar Osteitis (Dry Socket)

Alveolar osteitis, or dry socket, is a common occurrence following the surgical removal of mandibular molars—occurring in 20% to 25% of patients—but is rarely observed in the maxilla. The suspected mechanism involves lysis or loss of the blood clot following extraction of a tooth. The incidence appears to increase in smokers and in those taking oral contraceptives.

Oroantral Communication

Surgical procedures in the posterior maxilla can result in an oroantral communication. This complication can lead to fluids passing freely from the oral cavity into the maxillary sinus. Defects of less than 5 mm often will heal spontaneously with local measures, whereas large exposures require surgical intervention. Anatomical considerations that predispose patients to such complications include dilacerated roots, retained palatal root tips, a thick buccocortical plate, and maxillary sinus pneumatization.

Jan 5, 2015 | Posted by in General Dentistry | Comments Off on 10 – Oral Surgery
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