Surgery and Healing in the Developing World - Dartmouth-Hitchcock

Dentistry
Figure 9. Using an inclined pane elevator (Ref. 1, pg. 21).
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Complications of Extraction
1. If the tooth breaks and large piece (greater than 1/3) is left in the socket, it
should be extracted by leverage with an inclined plane elevator. Smaller
fragments may be left in the jaw (Fig. 9).
2. Fracture of the maxilla can form a fistula opening to the maxillary antrum.
A mucoperiosteal flap is required (see Ref. 5).
A dry socket means that a blood clot has not formed properly. Clean socket with
a syringe of sterile, warm water. Insert cotton wool soaked in iodoform antiseptic
and instruct the patient to rinse with warm saline daily and remove the dressing
after three days.
Bleeding socket. After 24 hours of continued bleeding, suture the socket.
Acknowledgements
We would like to thank Dr. Nebu Philips, BDS for assistance with the preparation
of this manuscript, and the production of photographs. Figures 1,2,5,6 and 9
are adapted with kind permission of the MMA.
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