Complications With Extractions

Complications involving cheek teeth extractions are prevalent. More than half of all cheek teeth extraction cases have a potential for complication. Complications may involve surrounding bone, sinus, soft tissue (peridontium, vascular, nerves, etc), and teeth. The extraction process should never be viewed as a simple one-stop procedure. In contrast, an extraction should be a process that involves (1) presurgical/extraction evaluation, (2) treatment planning, (3) contingency treatment planning, (4) the extraction, and (5) postsurgical/extraction evaluation. To avoid or minimize complications, a systematic approach involving intraoral and radiographic examinations should always be instituted. Additional modalities for evaluation such as computed tomography, endoscopy, histopathology, cytology, and microbiology may be indicated before attempting an extraction procedure. Potential complications would include (but are not limited to) palatine artery laceration, iatrogenic mandible fracture, dilacerated roots, reactive cementum from chronic apical disease, alveolar bone sequestration, alveolar plug failure, oroantral fistula, iatrogenic dental fracture, retained or fractured roots, iatrogenic maxillary fracture, lingual laceration after a long-acting nerve block, collateral damage during the extraction process, and nonhealing mandibular fracture due to alveolar involvement and severe periodontal disease.