The complications of tooth extraction are some local diseases directly caused by or caused by the trauma of tooth extraction surgery.

 Dental extraction is the oral surgery is the most basic and the most commonly used treatment, its complications are many, more common bleeding, infection, root residue, oral maxillary sinus traffic, etc., the factors affecting its occurrence not only with local anatomical differences and physiological, pathological condition, also is closely related to the surgeon's experience and operation skills.

 Therefore, it is necessary to analyze the causes of the representative complications during and after tooth extraction, and put forward targeted preventive measures and disposal.

 Complications during tooth extraction

1. Halo

Due to fear, pain and other reasons, syncope sometimes occurs. The causes, clinical manifestations and prevention principles are the same as those of local anesthesia. After proper treatment and recovery, the operation can generally continue.

 2. Broken tooth roots

Root fracture is a common complication in tooth extraction, and there are many reasons for root fracture.

 Such as: the tooth extraction crown damage extensive, or have larger filling body, for some of the elderly teeth, dead pulp teeth, root canal treatment after teeth, tooth tissue brittleness, easy to break, root shape variation, bending, root end hypertrophy, thick root, extra root, root bifurcation, etc., root bone because of various pathophysiological factors (chronic apical inflammation, the elderly, etc.) dense, reduced elasticity or root fixation are easy to cause root fracture (for short less than 5mm short root, root without inflammation, remove trauma, can not remove, later observation).

 3. Soft-tissue damage

Gingival injury, mostly laceration, is also one of the main causes of postoperative bleeding;

Adjacent soft-tissue damage.

 4. Bone tissue damage

A. In the alveolar process fracture, when the maxillary third molar is removed, the maxillary nodule fracture is easily caused. When the mandibular third molar is split or protruding, the glossal bone plate fracture can be caused. When the maxillary cusx is removed, the labral bone flap fracture is easy to occur.

 b. Mandibular fracture, as a complication of tooth extraction, mandible fracture is extremely rare and prone to occur during the extraction of the third mandibular molar.

 5. adjacent teeth, damage to jaw teeth

The adjacent teeth have large fillings, and the whole crown restoration is prone to restoration loss, the damage of the adjacent teeth, and the jaw damage is likely to occur in the anterior teeth, because the final dislocation force of the mandibular teeth is upward.

 6. The nerve injury of the

The nerves that may be damaged during tooth extraction are mental nerve, lingual nerve, nasal and palate nerve, buccal nerve and inferior alveolar nerve. The naso-palatal and buccal nerves are frequently cut during flap surgery. For injury to the inferior alveolar nerve, can use drugs to promote nerve recovery, such as vitamin B1, B6, B12, etc., can also be physiotherapy. The inferior alveolar nerve can be restored within half a year, and the lingual nerve damage is slow, so efforts should be made to avoid it.

 7. TMJ injuries

The temporomandibular joint may have dislocation due to excessive opening and too long time, especially in patients with a history of dislocation of the temporomandibular joint, so it is very important to fix the lower jaw during surgery.

 8. Broken root displacement

The broken root shift generally has the following cases:

A. Low base position of the maxillary sinus or apical lesions destroy the sinus base bone prone to broken root migration into the maxillary sinus.

 B. The bone plate on the lingual side of the lower alveolar process is more and more weak, so the broken root of the mandibular molar and even the whole tooth are easy to be pushed to the lingual side, enter the subperiosteal of the lingual side of the mandible, or break the periosteal into the hypoglossal space, and the submandibular space. c. When the maxillary teeth are extracted, the teeth or roots can occasionally enter the nasal cavity.

 9. Oral and maxillary sinus traffic

Oral maxillary sinus traffic occurs in maxillary molar root into the maxillary sinus, sinus floor perforation, can also be due to the molar apical lesions to bone loss of sinus base, scratching lesions through the sinus base, such as small perforation (2mm diameter) can according to the conventional treatment after tooth extraction, make the alveolar socket formed with high quality blood clot, make its natural healing.

 Complications after tooth extraction

1. Bleeding after tooth extraction

Half an hour after tooth extraction, if there is still obvious bleeding, said bleeding after tooth extraction.

 Bleeding causes: the vast majority are local factors. Local factors include residual inflammatory granulation tissue in the alveolar socket, soft tissue tear, alveolar bone fracture, fracture of small blood vessels in the alveolar, damage of large well-known blood vessels, rupture of the following alveolar or posterior upper alveolar vessels, etc. Blood clot shedding can also cause bleeding. The bleeding of tooth extraction was stopped, and the bleeding caused by other causes, such as wound infection, is called secondary bleeding. Occasionally, the bleeding after tooth extraction is caused by systemic factors.

 Treatment: should start from the local and systemic aspects at the same time, if necessary, should cooperate with the physician diagnosis and treatment. The bleeding caused by systemic factors should be based on prevention, detailed inquiry of medical history and examination can often find these systemic factors.

 2. Dental extraction and infection

Generally, complex tooth extraction and impacted tooth extraction are prone to tooth extraction infection, which is divided into acute infection, dry groove disease and chronic infection.

 A. Acute infection

It is related to large local trauma of tooth extraction, focal infection before tooth extraction, and diabetes. Most cases occurred on the second day after tooth extraction, with local or facial pain, swelling, and limited mouth opening. Preventive teeth and cases of boneless or severe trauma can have obvious cheek swelling and pain reaction within 12 to 24 hours after surgery, but it can gradually subside after 3 to 5 days, not acute infection.

 Prevention and treatment: adhere to aseptic operation during tooth extraction to minimize surgical trauma. There are local infection focus after tooth extraction is strictly prohibited to rough scratching, so as not to cause the spread of infection. Diabetic patients can only have tooth extraction when the condition is under control. Antibiotics were given before and after surgery.

b. alveolalgia

Dry groove is another type of acute infection with tooth extraction, which is more common in mandibular posterior teeth, especially after extraction of the third impacted molar. Under normal circumstances, even for the flap, the pain of the wound will gradually disappear after 2 to 3 days. If there is severe pain after 2~3 days after tooth extraction, the pain radiates to the temporal part to the ear, submandibular area or the top of the head, and can not be relieved with general analgesic drugs, dry trough may occur. Clinical examination can be emptiness in the alveolar socket, or corrupt blood clot, gray white. The necrotic material covered in the alveolar socket wall has a stench, and the probe can directly touch the bone surface with sharp pain. There is no obvious maxillofacial swelling, no obvious limitation of mouth opening, and lymph node enlargement and tenderness. Histopathology shows superficial osteitis of the alveolar bone wall or mild localized osteomyelitis.

 Prevention and treatment: dry groove disease is related to surgical trauma and bacterial infection. Therefore, the aseptic operation should be strictly followed during the operation to reduce the surgical trauma. Once the dry trough disease occurs, the treatment principle is to complete debridement and isolation of the external stimulation of the alveolar socket, to promote the growth of granulation tissue.

 C. chronic infection

It is mainly caused by local factors, such as residual roots in the alveolar socket, granulation tissue, calculus, broken tooth pieces or broken bone pieces. The clinical manifestations are tooth extraction for a long time, leaving a small wound, the gingival tissue around the wound is red and swollen, visible a small amount of pus discharge or granulation tissue hyperplasia, generally without obvious pain.

 Prevention and treatment: the tooth socket should be carefully cleaned after tooth extraction, especially the teeth of chronic apical periodontitis, apical inflammatory lesions do not scrape clean, can occur bleeding after tooth extraction, can also form chronic inflammation and long-term recovery. Left-over of residual roots should be prevented during the removal of multiple roots. In case of chronic infection, X-ray should be taken to understand the lesions in the alveolar socket, whether there is foreign matter left, the healing of the alveolar socket, etc., and then scrape the alveolar socket under local anesthesia, let the blood is filled, disinfect gauze cotton roll compression and stop bleeding, and give oral antibiotic treatment.