European International Journal of Multidisciplinary Research
and Management Studies
86
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TYPE
Original Research
PAGE NO.
86-92
DOI
OPEN ACCESS
SUBMITED
17 December 2024
ACCEPTED
19 January 2025
PUBLISHED
21 February 2025
VOLUME
Vol.05 Issue02 2025
COPYRIGHT
© 2025 Original content from this work may be used under the terms
of the creative commons attributes 4.0 License.
Complications After
Wisdom Tooth Extraction
in The Upper and Lower
Jaw
Chakkanov Fakhritdin Khusanovich
Assistant Department of orthopedic dentistry, Samarkand State Medical
University, Samarkand, Uzbekistan
Abstract:
The more complicated the operation and the
worse the condition of the wisdom teeth, the higher the
likelihood of postoperative complications. Even the
most experienced dentist cannot guarantee their
complete absence, since certain negative consequences
are practically mandatory and are considered the norm.
But there are also specific possible complications that
arise due to the patient's fault in the postoperative
period or due to the inexperience of the doctor.
Keywords:
Wisdom Tooth, Upper and Lower Jaw.
Introduction:
The more complicated the operation and
the worse the condition of the wisdom teeth, the higher
the likelihood of postoperative complications. Even the
most experienced dentist cannot guarantee their
complete absence, since certain negative consequences
are practically mandatory and are considered the norm.
But there are also specific possible complications that
arise due to the patient's fault in the postoperative
period or due to the inexperience of the doctor.
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European International Journal of Multidisciplinary Research and Management Studies
Indications for the removal of eighth teeth wisdom
teeth
Eights begin to grow much later than the rest of the
permanent teeth, as a result of which they often do not
have enough space in the jaw. The lack of space
provokes all kinds of curvature of the roots and
crowns. Doctors recommend removing such molars.
Here is another list of problems where extraction is
indicated.:
A pronounced tilt of the figure of eight towards the
seventh tooth or cheek.
Hypercementosis (excessive deposition of secondary
cement, in which the tooth root thickens and deforms).
Incomplete tooth eruption or its location in the bone
(retention).
Destruction of the crown or the roots of the figure of
eight, as well as adjacent teeth (after injury or caries).
Granuloma (granulation in the form of cystic sacs with
pus located in the periodontium).
Rotation of the tooth around its axis or horizontal
position (dystopia).
Deformation of the roots (they can bend in every
possible way, even twist into a spiral or form a 90°
angle).
The close location of the roots of the upper eights to the
nasal maxillary sinuses.
In the presence of pericoronitis (an acute inflammatory
process in the area of the figure of eight, accompanied
by pain, increased ESR in blood tests).
An improperly growing 8 tooth can damage the facial
nerves and provoke neuritis, which is expressed by
sharp pain radiating to the ears, neck, temple, and can
lead to facial paralysis.
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The occurrence of complications
Figure-of-eight operations are considered complex
dental procedures that are caused by:
difficult access;
frequent retention;
unpredictable structure;
features of the location of the mandibular alveolar
nerve.
Such procedures are very traumatic, which creates the
prerequisites for the occurrence of complications of
general and specific types.
Common
The nature of the complications largely depends on the
location of the tooth: on the upper or lower jaw. But
there are also common complications that occur in
almost everyone, regardless of the location of the
figure of eight and its initial condition. The most
common common consequences are listed below.
Painful sensations
Approximately 2-3 hours after the extraction of the
molar, there will be noticeable pain in the gums. This is
a normal div reaction to injury, which is dental
surgery. During it, soft tissues are torn or cut, bone is
injured (if the tooth is located under it), blood vessels
and nerves are disrupted. The painful sensations should
disappear completely after 2-4 days, and in some cases
they disappear in a few hours. They can be reduced with
the help of pain medications prescribed by the dentist.
If the soreness persists, and the cheek is severely
swollen, it means that the healing process of the gums
is complicated.
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Swelling of the tissues of the face and neck
Often, after the extraction of the figure eight,
especially retinated, there is swelling of the soft tissues
of the gums or cheeks. This is also a reaction to injury,
which can be called a normal consequence of a dental
procedure. In addition to edema, the following
symptoms may occur::
swelling of lymph nodes;
discomfort when swallowing;
painful sensations during mouth movements, radiating
into the ear.
Normally, severe edema should go away completely in
2-3 days, and if it does not go away, then we can talk
about more dangerous consequences. If the condition
worsens every day, breathing difficulties occur,
fainting, fever rises and the skin becomes covered with
a rash, then such swelling is provoked by allergies and
it can lead to anaphylactic shock.
Hematomas
A hematoma due to extraction is usually expressed by
a minimal cyanosis of the cheek, which resolves after a
few days. But there are situations when the
appearance of a bruise is accompanied by severe pain,
swelling, and fever. In such a situation, medical care is
necessary.
Hematomas form after vascular damage in people with
increased capillary fragility, as well as in the presence
of hypertension in the patient.
Alveolitis
complications after wisdom tooth extraction
Alveolitis is often provoked by non-compliance with the
doctor's recommendations after medical procedures. It
is a local inflammation of the gums with the following
additional symptoms:
the gum swells, turns red;
there is a local and headache;
sore throat;
fever, muscle aches;
the lymph nodes become inflamed, most often the
submandibular.
If there is inflammation, the cause is often the loss of a
blood clot from the hole and infection. Various
infections that enter the wound if hygiene is not
followed can provoke extensive inflammation. In
advanced cases, the above complication develops into
osteomyelitis, which is expressed by:
increased stable temperature;
poor general health;
severe migraine-like pain;
nausea;
other signs of intoxication of the div.
Increased div temperature
A slight increase in div temperature to 37.5-38 ° C also
often occurs in the postoperative period. This
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complication occurs due to a reaction to inflammation.
The temperature should return to normal within the
first day, and if it continues to rise and rise, it means
that more serious pathologies have arisen and you
need to go to the hospital again.
The bleeding
The dentist will never release a patient with severe
bleeding, especially if it is complicated. After removing
the figure of eight, the bleeding is stopped in the
hospital, and then released home with a gauze swab
on the hole. If blood clotting is normal, then the
bleeding will stop in 10-15 minutes, after which the
tampon must be removed.
Severe prolonged bleeding is provoked by:
rupture of large vessels;
fragility of capillaries;
hypertension.
Damage to the roots of adjacent teeth
Such a complication is extremely rare and only if the
patient has not undergone an X-ray diagnosis before
the procedure. This procedure is mandatory for all
people with indications for the removal of eights and
allows you to fully assess the condition, location, as
well as other features of the tooth and its roots.
The flux
The flux in the postoperative period develops in cases
when the gum is infected due to the fault of the dentist
or the patient, after which the infection quickly
reaches
the
periosteum
and
provokes
its
inflammation. This complication is not considered
normal and acceptable, it must be treated. The main
signs of flux:
redness, suppuration, and swelling of the gums;
severe shooting pain;
temperature rise;
weakness.
Others
Among other common complications, the following are
most often observed:
displacement of the seventh tooth (2 molars);
mouth tear; gum or cheek cut;
jaw injuries.
In addition, complex extraction of the 8th tooth can
cause cyst formation. This is a small neoplasm located
at the root of the tooth and filled with fluid. The cyst
often serves as an insulator for infected cells from
healthy ones. To prevent its appearance, the dentist
prescribes antibiotics, and the treatment in this case (if
the cyst is located at the roots of the tooth) will be
resection.
On the lower jaw
Standard and non-standard complications after pulling
out eights on the lower jaw occur more often than on
the upper one. The lower jaw has a number of features,
and there are many obstacles in the area of the wisdom
teeth.
Nerve damage
The mandibular and lingual nerves are at risk of injury,
as they pass close to the wisdom tooth. Such damage
causes paresthesia, which is manifested by impaired
sensitivity.:
sensory;
painful;
gustatory;
temperature control.
In the most severe cases, nerve damage negatively
affects vision, hearing, and also provokes paralysis.
Patients compare paresthesia with numbness of the jaw
in the area of the removed molar. In most cases, this
complication disappears on its own in a few days, but
sometimes additional medication is required.
Fracture of the alveolar process
A fracture of the alveolar process of the lower jaw
occurs when the dentist incorrectly grips the jaw and
exerts more force than necessary. This is an unlikely
complication, as the lower jaw is quite strong. The
treatment is performed under conduction anesthesia
and consists of repositioning and fixing the fragment in
the correct position.
Jaw damage
a snapshot of the jaw
Jaw injuries (dislocations and even fractures) are also
often caused by the doctor if the tooth is pulled out too
intensively or abruptly. During surgery, a significant
amount of the mandibular bone has to be removed to
provide access to the problematic molar. Because of
this, the sections of the jaw are weakened, which
increases the risk of fracture if excessive force is applied.
A crack or fracture does not always appear immediately.
It happens that the patient notices the first symptoms in
the form of pain, swelling, and impaired mobility already
at home. Sometimes it takes a week before they appear.
Statistics show that jaw injuries during medical
procedures account for no more than 0.2% of all
fractures.
Soft tissue injuries
By pulling out the molar, the doctor may injure the soft
tissues surrounding the molar. It's not just about the
gum, but also about the cheek, tongue, and lips.
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Injuries are inflicted with dental instruments (scalpel,
drill, forceps). The lip is also often injured by the thread
used to suture the gums. This is due to the doctor's
inattention or the patient's restlessness.
To avoid complications, you need to sit quietly in the
dental chair and not distract the doctor.
On the top
The most common complication of the extraction of
eights in the upper jaw is a puncture of the base of the
maxillary sinus (maxillary sinus).
Puncture of the sinus floor of the upper jaw
The dental roots of molars number three in the upper
jaw are located too close to the base of the sinus, and
sometimes even grow into it. Chronic inflammation of
the periapical tissue provokes resorption of the axillary
septum, which causes the roots of the molars to fuse
with the mucous membrane inside the sinus. It is most
often ruptured during extraction of the right or left
tooth. You can notice this complication by the
following symptoms::
nasal discharge, bleeding, air bubbles;
Nosebleed from the figure of eight.
In such a situation, urgent medical care is necessary.
CONCLUSION
No one is immune from complications after the
extraction of the upper and lower wisdom teeth. It is
possible to significantly reduce the likelihood of their
occurrence and alleviate the condition in the
postoperative period.
It is necessary to choose a dentist carefully before the
procedure and follow all the recommendations that he
should give after the operation.
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