Oral Surgery Techniques and Complications

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Questions and Answers

What is a possible complication when no improvement is noted within 7 days?

Applying a cold compress

Gently pressing the mouth open under GA (correct)

Immediate surgical repair

Prescribing antibiotics

What might indicate insufficient knowledge of the region's anatomy during a local anesthetic injection?

Complete numbness in the targeted area

Faster recovery from anesthesia

Prolonged sensation after anaesthesia

Failure to achieve anesthesia at the desired site (correct)

Which condition may arise from injecting an anesthetic at the site of nerve trauma?

Decreased healing time

Immediate recovery

Facial nerve paralysis (correct)

Increased pain sensitivity

What is a common side effect of inadequate anesthetic delivery?

Trismus, or difficulty in opening the mouth Signup and view all the answers

What should be done if an abscess is formed following an injection?

Incision and drainage Signup and view all the answers

Which of the following is NOT a complication of local anesthetic use?

Shorter recovery times Signup and view all the answers

How long does it generally take for most paresthesia cases to resolve?

2 to 3 months Signup and view all the answers

What complication is associated with a contaminated needle during local anesthetic administration?

Trismus Signup and view all the answers

What should be avoided following an instance of nerve trauma?

Inject anesthetic at the nerve trauma site Signup and view all the answers

Which of the following symptoms may develop after local anesthetic administration?

Dysesthesia Signup and view all the answers

Which of the following is classified as a primary complication of local anaesthesia?

Pain during the procedure Signup and view all the answers

What type of complication is classified as severe and requires definite treatment?

A pronounced allergic reaction Signup and view all the answers

Which of the following complications is associated with needle insertion?

Syncope Signup and view all the answers

What should be done to minimize the incidence of local complications during anaesthesia administration?

Ensure strict asepsis and sterilization. Signup and view all the answers

Which is NOT classified as a local complication attributed to the solution?

Trismus Signup and view all the answers

What is a common symptom of trismus related to local anaesthesia?

Difficulty opening the mouth Signup and view all the answers

Which symptom indicates a severe allergic reaction to local anaesthesia?

Shortness of breath or anaphylaxis Signup and view all the answers

What is NOT a recommended action when preparing for local anaesthesia?

Ignoring the patient's medical history Signup and view all the answers

Which of the following classifications refers to complications that leave no residual effect?

Transient complications Signup and view all the answers

Which of the following complications is associated with prolonged anaesthesia?

Needle breakage Signup and view all the answers

Study Notes

Needle Insertion and Retrieval

If a needle is not fully embedded, retrieve it with a hemostat.
Otherwise, refer the patient to an oral and maxillofacial surgeon for OPG or CT scan to locate and remove the fragment.
Avoid inserting the needle until the hub is fully in place.
Use a suitable gauge needle.
Be aware of patient movement, especially children and uncooperative patients.

Intravascular Injection

Take short notes on what was learned in the lecture and practical sessions.

Complications Associated with Jet Injectors

Take short notes on what was learned in the lecture and practical sessions.

Neurotrophic Ulcers

Lip mucous membrane ulcers after mandibular injection due to vasoconstrictor effects.
Often caused by prolonged ischemia from a concentrated vasoconstrictor (epinephrine 1:50,000 or higher).
Nor-epinephrine can also cause ulcers.
Abscesses may form on the palate.

Desquamated Ulcers

Resulting from superficial injections that damage the mucous membrane's upper layer forming ulcers.
Common in areas with thin mucoperiosteum like the lingual mandible and anterior palate.

Traumatic Ulcers

Caused by lip biting, especially in children, mentally handicapped or psychiatric patients.
Typically self-limiting, resolving within 3 to 10 days.

Self-injuring of Lower Lip/Tongue

Take short notes on what was learned in the lecture and practical sessions.
Self-inflicted injuries may involve the lower lip or tongue.
A cotton placed to protect the lip is a common solution..

Needle Breakage

A rare complication with modern, flexible disposable needles.
Broken needles can damage tissue or migrate (less common).
Causes often include using old or bent needles, or jerky needle movements.

Visual Disturbances: Facial Nerve Paralysis

Take short notes on what was learned through the lecture and practical sessions.
Conditions like facial or partial nerve paralysis can result from anaesthetic solution reaching the facial nerve.
This may cause symptoms such as difficulty closing the ipsilateral eye or a drooping ipsilateral upper lip.

Nausea and Vomiting

May occur if the lesser palatine nerve is affected by the anaesthesia.
Block the greater palatine nerve anterior to the foramen to limit this effect.

Ischemia (Bleaching)

Take short notes on what was learned through the lecture and practical sessions.
Bleaching of tissues at or distal to the injection site might be observed. Take notes .

Sloughing of Tissues and Ulcers

Possible causes include allergic reactions (cotton roll), excessive cleaning, or topical anaesthetic intolerance using tinctures of iodine.

Failure to Obtain Anaesthesia

Infiltration: solution deposited too far from the bone, or penetrating deeply into soft tissues.
Intra-block (block LA): problems similar to infiltration, but also include insufficient anatomy knowledge, individual variations, or inappropriate insertion site.

Prolonged Anaesthesia (Paresthesia)

Take notes on what was learned through the lecture and practical sessions.
Abnormal sensation including tingling, pricking, or numbness.
- Can last for one to three months.
- If ongoing, surgical repair might be necessary.

Facial Nerve Paralysis

Take short notes on what was learned in the lecture and practical session.
Facial nerve may damage from incorrect insertion or contaminated materials causing nerve paralysis

Hematoma

Take short notes on what was learned in the lecture and practical session.
May result from traumatic injection, contaminated solution, or allergic mechanisms.

Infection

Can be caused by a contaminated needle or injecting into an inflamed area.
Trismus (difficulty opening the mouth) may result.
Antibiotics should be given.

Postanesthetic Lesions

May include recurrent aphthous ulcers. Take notes

Local Complications of Local Anaesthesia

Pain or burning during injection
Swelling (edema)
Take notes on what was learned in lecture and practical sessions.
Classification of complications (primary/secondary, mild/severe, transient/permanent).
Factors attributed to solution (toxicity, allergy, idiosyncrasy, etc), or to needle insertion (pain, swelling, haematoma, ecchymosis, nerve damage etc.)
Steps to avoid complications.

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Description

This quiz covers essential techniques in oral surgery, focusing on needle insertion and retrieval, intravascular injections, and complications associated with various techniques. Learn about the management of neurotrophic and desquamated ulcers, and enhance your understanding of proper needle usage and patient care considerations.