How To Manage a Maxillary Tuberosity Fracture - Oral Surgery Complications

Honey, I Broke The Tuberosity!
I hate this oral surgery complication - it has happened to me just once (thankfully a small one) and hopefully after this podcast, you will feel better about preventing and managing a maxillary tuberosity fracture.
Thanks again for Dr Chris Waith for the Oral Surgery Complications Group Function episodes - check out his Oral Surgery course: theoralsurgerycourse.co.uk/
00:00 Introduction
1:40 Risk factors of tuberosity fractures
3:57 How to manage the Tuberosity Fracture
6:35 High risks patients
9:07 Management Strategies
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[@rajashekargopinath8575]

Thanks for your informative Podcasts, As GDP's we tend to fracture Maxillary Tuberosity when we apply distal pressure using a Cryer Elevator or a spade elevator. Problem is when we solely depend on elevators. We should use elevator just to luxate, once luxated its better to use Forceps with Buccal force!
Thanks once again❤🎉

[@protrusive]

great input doc thank you!

[@ebzzzz1]

Thank you for your videos Jaz !!

[@narad8165]

in the absence of lower third molar, if the upper third molar has not over erupted,it can be sign of ankylosing with tuberosity. Better use a handpiece on the distal to free it.

[@protrusive]

great point!!!

[@cynthiariley8290]

Does this mean in the case of over eruption, the probability of tuberosity fracture lessens?

[@narad8165]

@@cynthiariley8290 yes, that's a dream wisdom ext. We can charge for impaction.

[@cynthiariley8290]

Thanks for the reply. I am a patient with an over-erupted maxillary third molar. However, it does have curved roots. I’m a bit anxious about upcoming removal due to having known someone who experienced tuberosity fracture

[@narad8165]

@@cynthiariley8290 once I fractured a tuberosity. Along with tuberosity some portions of the palatal bone also fractured. Small muscles which lodge there were also hanging. I cut those muscles from the bone(s) and removed the bone. Then I sutured the gaping soft palate. That night I didn't sleep well. However it healed very well. When I removed the suture after 3 weeks, the wound was healed. I saw the patient again after a year, when even the tuberosity seemed to have rebuilt itself. Don't worry, this is very rare and the tuberosity is the most useless bone you will ever have.

[@ErMr-1998]

Today in Surgery happend,terrible yes,thank you for the video.
We expected ,can happend, removing a Wisdom tooth at 37 Years old woman.
Was my first time I saw that.❤️
All the bests.

[@protrusive]

it was mean to be - hope you managed OK

[@furbyinthemicrowave5344]

in my 22 years experience I have found upper 8's that are palatally placed are the ones to be careful of .
If a 7 is the most distal tooth then the worst thing you can do is put your elevator between the 6 and 7 and try to elevate distally.

[@protrusive]

great contribution, thank you for sharing your wisdom!

[@kvgolfa]

So how should you extract the 7?

[@protrusive]

@@kvgolfa with care, using sectioning if appropriate and reflecting slightly the soft tissues first to help you if this sometimes unavoidable complication happens

[@benlloyd3155]

Agreed. Much better to simply remove the crown and then deliver the roots separately.

[@hollyharris2139]

There is a bone firmly attatched to "something" where my 15th molar was extracted lol the 2nd dentist broke it off 3 days post op. There was so much pain. .and then realized it was not going to come out after I let him know I could feel everything even after being numbed 5x. Need to see a surgeon now but Appts are weeks out and now its infected. 😅 .. so idk. Watching this helped me understand what could have potentially caused this bone on the upper side of my gum.. 🎉 when my dentist said "...Im going to try one more time" I wish I had said nevermind.

[@dr.amratasrivastava2284]

Today only ..I got tuberosity fracture .. 🥺 .Thankfully , less soft tissue fracture ..
Thanx for video . Would always try use buccal forces more ..Thanx

[@protrusive]

it happens bud - we learn! wishing you all the best

[@latifah5150]

I'm a new subscriber :-)

[@protrusive]

welcome Doc!

[@buney]

My dentist broke the end of jaw off removing a wisdom tooth then continued to try and pull it through my rear gums tearing the flesh with it! I woke up in hospital where they tried to do the same!

[@protrusive]

so sorry to read this hope you're OK - wisdom teeth can be a real nuisance

[@prithvijith2831]

Sir i have a doubt....why artificial tooth should not be placed on tuberosity?

[@protrusive]

you mean like an implant?

[@MariaBKBK]

​@@protrusive Dr. I think he means in removable dentures, they teach us not to replace a terminal tooth if it's going to be mounted at tuberosity level, and to always leave that space in the wax and eventually in the final dentures.

[@tiffanybutler2331]

How long does it take for the patient to heal ?

[@protrusive]

like most bony fractures, 4-6 weeks to stabilise

[@saradayarlagadda9379]

So scary