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Tooth extraction is a common dental procedure performed for various reasons, including severe decay, periodontal disease, orthodontic needs, or impacted teeth. While generally considered safe and routine, tooth extractions can involve a range of complications that may impact the patient’s recovery and overall oral health. This article explores the common and uncommon complications associated with tooth extractions, highlighting their causes, risk factors, prevention strategies, and management approaches. Complications may be intraoperative or postoperative. lntraoperative issues include excessive bleeding, root fracture, injury to adjacent teeth or tissues, and displacement of the tooth or root fragments into adjacent anatomical spaces such as the maxillary sinus. Postoperative complications are more frequent and include alveolar osteitis (dry socket), infection, prolonged bleeding, delayed healing, nerve injury resulting in paresthesia, and trismus. Systemic complications, although rare, may occur in patients with underlying medical conditions or compromised immune systems. Factors influencing the likelihood of complications include the difficulty of the extraction, the patient’s age, oral hygiene status, smoking habits, and systemic health conditions such as diabetes or bleeding disorders. Preventive measures such as proper surgical technique, thorough preoperative assessment, and appropriate postoperative care instructions are essential to minimize risks. This article underscores the importance of clinician awareness and patient education in reducing complications. Timely diagnosis and intervention are critical for effective management and improved outcomes. By understanding the potential complications and their underlying mechanisms, dental professionals can ensure safer, more predictable tooth extractions and enhance patient care quality.
1. Salem S. Tooth extractions complications: Risks after a tooth removal procedure.
2. Porto OCL, Silva BSF, Silva JA, Estrela CRA, Alencar AHG, Bueno MDR, Estrela C. CBCT assessment of bone thickness in maxillary and mandibular teeth: an anatomic study. J Appl Oral Sci. 2020;28:e20190148.
3. Devlin H, Horner K, Ledgerton D. A comparison of maxillary and mandibular bone mineral densities. J ProsthetDent.1998 Mar;79(3):323-7.
4. Breeland G, Aktar A, Patel BC. StatPearls [Internet]. StatPearls Publishing; Treasure Island (FL): Apr 1, 2023. Anatomy, Head and Neck, Mandible.
5. Chang CL, Wang DH, Yang MC, Hsu WE, Hsu ML. Functional disorders of the temporomandibular joints: Internal derangement of the temporomandibular joint. Kaohsiung J Med Sci. 2018 Apr; 34(4):223-230.
6. Saka B, Wree A, Henkel KO, Anders L, Gundlach KK. Blood supply of the mandibular cortex: an experimental study in Gottingenminipigs with special reference to the condyle. J Craniomaxillofac Surg. 2002 Feb;30(1):41-5.
7. Choi DY, Hur MS. Anatomical review of the mandibular lingula for inferior alveolar nerve block. FoliaMorphol (Warsz). 2021;80(4):786-791.
8. Somayaji KS, Rao MK. Anatomy and clinical applications of the maxillary nerve in dentistry: a literature review. Dent Update. 2012 Dec;39(10):727-30, 733-5.
9. Shafique S, Das JM. StatPearls. StatPearls Publishing; Treasure Island (FL): Jun 5, 2023. Anatomy, Head and Neck, Maxillary Nerve.
10. Ghatak RN, Helwany M, Ginglen JG. StatPearls. StatPearls Publishing; Treasure Island (FL): May 1, 2023. Anatomy, Head and Neck, Mandibular Nerve.
11. Kim C, Hwang KG, Park CJ. Local anesthesia for mandibular third molar extraction. J Dent Anesth Pain Med. 2018 Oct;18(5):287-294.
12. Fagan SE, Roy W StatPearls. StatPearls Publishing; Treasure Island (FL): May 8, 2023. Anatomy, Head and Neck, Lingual Nerve.
13. Khandelwal P, Hajira N. Management of Oro-antral Communication and Fistula: Various Surgical Options. World J Plast Surg.2017 Jan;6( 1):3-8.
14. Broers DLM, Dubois L, de Lange J, Su N, de Jongh A. Reasons for Tooth Removal in Adults: A Systematic Review. Int Dent J. 2022 Feb;72(1):52-57.
15. Aida J, Ando Y, Akhter R, Aoyama H, Masui M, Morita M. Reasons for permanent tooth extractions in Japan. J Epidemiol. 2006 Sep;16(5):214-9.
16. Nayyar J, Clarke M, O’Sullivan M, Stassen LF. Fractured root tips during dental extractions and retained root fragments. A clinical dilemma? Br DentJ. 2015 Mar 13;218(5):285-90.
17. Suri L, Gagari E, Vastardis H. Delayed tooth eruption: pathogenesis, diagnosis, and treatment. A literature review. Am J OrthodDentofacialOrthop. 2004 Oct;126(4):432-45.
18. Wali GG, Sridhar V, Shyla HN. A study on
dentigerous cystic changes with radiographically normal impacted mandibular third molars. J Maxillofac Oral Surg. 2012 Dec;l 1(4):458-65.
19. Sarka I, Derindag G, Kurtuldu E, Naralan ME, Caglayan F. A retrospective study: Do all impacted teeth cause pathology? Niger J ClinPract. 2019 Apr;22(4):527-533.
20. Garvey MT, Barry HJ, Blake M. Supernumerary teeth–an overview of classification, diagnosis and management. J Can Dent Assoc. 1999 Dec;65(11):612-6.
21. Araujo TM, Caldas LD. Tooth extractions in Orthodontics: first or second premolars? Dental Press J Orthod. 2019 Aug01;24(3):88-98.
22. Fernandez-Barrera MA, Medina-Solis CE, Casanova-Rosado JF, Mendoza-Rodriguez M, Escoffie-Ramirez M, Casanova-Rosado AJ et al. Contribution of prosthetic treatment considerations for dental extractions of permanent teeth. PeerJ. 2016;4:e2015.
23. Taysi M, Yildirim S. Should the teeth in the line of jaw fractures be extracted? J Istanb UnivFac Dent. 2015;49(1 ):61-65.
24. Nyimi BF, Yifang Z, Liu B. The Changing Landscape in Treatment of Cystic Lesions of the Jaws. J IntSocPrev Community Dent. 2019 Jul Aug;9(4):328-337.
25. Thorn JJ, Hansen HS, Specht L, Bastholt L. Osteoradionecrosis of the jaws: clinical characteristics and relation to the field of irradiation. J Oral Maxillofac Surg. 2000 Oct;58(10):1088-93; discussion 1093-5.
26. Pick L, Bauer J. Dentistry and epilepsy. Nervenarzt. 2001Dec;72(12):946-9.
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