© Non-classified materials. An illustrated manual of implant dentistry.
Main » Errors and Complications

4.5 Problems in the early post-operative period (before the prosthetic procedure)
Problems in the early post-operative period (before the prosthetic procedure) Problems in the early post-operative period (before the prosthetic procedure) Problems in the early post-operative period (before the prosthetic procedure) Problems in the early post-operative period (before the prosthetic procedure) Problems in the early post-operative period (before the prosthetic procedure) Problems in the early post-operative period (before the prosthetic procedure) Problems in the early post-operative period (before the prosthetic procedure) Problems in the early post-operative period (before the prosthetic procedure) Problems in the early post-operative period (before the prosthetic procedure) Problems in the early post-operative period (before the prosthetic procedure)
 

The most common problem of the early post-operative period is hematomas, which can differ as to their volume and site.

Unfortunately, there is no sure way to avoid formation of hematomas. To prevent them, you can use the safe and proven method of local application of cold and (or) a pressure bandage. To accelerate resolution of the hematoma apply Troxevasin or Actovegin.

! It would be better to warn the patient during the discussion before the surgery that there might be “a small hematoma” and some soreness for the first couple of days. If this does not happen, thank goodness! But if it does, you have warned. Only don’t overdo it and dramatize too much.

Sometimes 3-7 days after the surgery there appears an oedema and tension under one of the flaps lifted during the surgery, which then develops into a purulent process. All clinical signs resemble those of dental periostitis. In 9 out of 10 cases, the process begins in the lower jaw. Thinking it over I’ve come to a conclusion that it must be caused by the following factors: the surgeon is traditionally situated on the right side of the chair and the nurse on the left side, during the whole operation she holds the dental aspirator in one hand and the retractor hook in the other.

why under the flap, where there is no active aspiration, accumulate fragments of bone chips, epithelium, etc. With a certain bacterial and immune background it creates favourable environment for pus formation. And if your nurse (assistant) is right-handed and stands behind the patient, she usually holds the aspirator in her right hand and the retractor hook in her left hand. That’s why in the third quadrant the aspirator is situated under the lingual flap and in the fourth quadrant under the buccal flap.

As a result, the inflammatory process, vice versa, develops under the buccal flap in the third quadrant and under the lingual flap in the fourth quadrant. That’s why before suturing the wound, carefully flush the area under both flaps with saline solution with simultaneous aspiration!

4.5 1

► A hematoma after implant surgery in the area of teeth #32, 31, 41 and 42.

4.5 2

► A hematoma of the upper and lower eyelid and the nasolabial fold after surgery in the area of tooth #23.

4.5 3

► From time to time, there appear small clearly defined purulent pustules immediately above the implant. If you penetrate it with a probe or a small excavator and touch the implant cover, you may see that the implant is stable and causes no pain when you try to rock it slightly. You’d better dissect the pustule.