Complications during Tooth Extraction

Study Notes

Possible complications during tooth extraction

Complications can arise during or after tooth extraction.
Immediate and post-operative complications can occur due to error in judgment, misuse of instruments, exertion of excessive force, or anatomic causes.
Careful diagnosis and planning can prevent many complications.
Failure to secure anesthesia can occur due to faulty technique, insufficient dosage, expired anesthesia, or acute infection.
Failure to remove the tooth with forceps or elevator may require further evaluation and surgical extraction.
Fracture of crowns and roots is the most common complication during tooth extraction.
Factors related to the tooth, bone, or operator may lead to crown or root fracture.
Fracture of alveolar bone frequently occurs when extraction is difficult, especially during extraction of upper canine and molar teeth.
Alveolar bone fracture may be due to thin bone, accidental inclusion within forceps blades, configuration of roots, shape of alveolus, or pathological/physiological changes.
Maxillary tuberosity fracture may occur during extraction of maxillary 2nd or 3rd molars.
Fracture of maxillary tuberosity may lead to oro-antrum communication and difficulties in denture retention.
Fracture of adjacent or opposing teeth may occur due to careless use of dental forceps or elevator.

Nerve Membrane and Impulse Generation: A Summary

The nerve membrane consists of two layers of lipid molecules and associated proteins, lipids, and carbohydrates. It is selectively permeable and exhibits differences in ion concentrations between the intracellular and extracellular environments.
An insulating lipid-rich layer of myelin covers the nerve membrane in some nerves. The outermost layer of myelin consists of the Schwann cell cytoplasm and its nucleus, with a gap between two adjoining Schwann cells and their myelin spirals called the node of Ranvier.
Impulses are initiated by chemical, thermal, mechanical, or electrical stimuli and are carried by the nerve in the form of electrical action potentials.
In the resting state, the nerve membrane possesses a negative resting potential (-70mV) that comes from different ion concentrations on either side of the membrane.
When a stimulus excites a nerve, it leads to an increase in permeability of the membrane to Na ions, causing depolarization of the nerve membrane from the resting level to its firing threshold of approximately (-50) to (-60) mV.
The firing threshold is the magnitude of the decrease in negative membrane potential required to initiate an action potential (impulse). When firing threshold is reached, permeability of the membrane to sodium increases dramatically, and at the end of depolarization, the electrical potential of the nerve is reversed.
Repolarization is achieved by an increase in permeability to K ions, leading to the efflux of K ions and membrane repolarization. This process takes 0.7 milliseconds.
The movement of Na ions to the inside of the nerve during depolarization and the subsequent movement of K ions out of the nerve during repolarization are passive processes that do not require energy.
After repolarization, a slight excess of Na ions exists within the nerve cell and a slight excess of potassium exists extracellularly, leading to a period of metabolic activity called the sodium pump.
An action potential is a transient membrane depolarization resulting from a brief increase in the permeability of the membrane to sodium and a delayed increase in the permeability to potassium.
Individual nerve fibers (axons) are covered with perineurium and separated by the endoneurium. The perineurium binds these nerve fibers together into bundles called fasciculi, which are contained within the epineurium.
Local anesthetics diffuse through the loose connective tissue of the epineurium and are absorbed by nutrient blood vessels and lymphatics, removing them from the nerve. Mantle bundles, located near the surface of the nerve, are the first ones reached by the local anesthetic and are exposed to a higher concentration of it.

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Think you know all about tooth extraction? Test your knowledge on possible complications that can arise during or after this common dental procedure. From failed anesthesia to fractured crowns and roots, this quiz covers it all. Learn about the factors that can lead to complications and how careful diagnosis and planning can prevent them. Challenge yourself and see if you're ready to handle any potential complications that may arise during tooth extraction.

Complications during Tooth Extraction

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Questions and Answers

What is the most common complication during tooth extraction?

What can cause failure to secure anesthesia during tooth extraction?

What can cause fracture of alveolar bone during tooth extraction?

What is the most common cause of maxillary tuberosity fracture during tooth extraction?

What can happen if a tooth is not removed with forceps or elevator during extraction?

What can cause fracture of adjacent or opposing teeth during tooth extraction?

What can prevent many complications during tooth extraction?

What is the resting potential of the nerve membrane?

What is the magnitude of the decrease in negative membrane potential required to initiate an action potential?

What is the process by which the nerve membrane is repolarized?

What is the name of the gap between two adjoining Schwann cells and their myelin spirals?

What is the name of the bundles that perineurium binds individual nerve fibers together into?

What is the name of the metabolic activity that occurs after repolarization?

What is the process by which local anesthetics are absorbed by nutrient blood vessels and lymphatics?

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