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rior pillar of the fauces. Blind dissection and groping for objects in this area can be complicated by massive hemorhage or nerve damage.
     In the third molar region of the mandible, the lingual surface of the mandible curves laterally, close to the apices of this tooth. Therefore it is not difficult to dislodge a root tip inferiorly into this space when the lingual plate is fractured. When a root tip is displaced in this area, a finger should be placed inferior to the root tip (in the mouth) to stabilize the tip against the lingual plate of the mandible. Access to this area is gained by making a mucoperiosteal flap on the lingual side of the mandible and extending anteriorly enough that the tissues can be retracted lingually for good vision.
     Recovery of a root tip in the mandibular canal is principally a problem of access and vision.     Usually it is difficult to remove bone overlying the canal from within the depths of the wound, which is usually the third molar socket. Access may be gained by removal of bone from the buccal plate and by careful removal of bone that overlies the canal. If one of the vascular components of the canal has been injured, it may be necessary to pack the socket with gauze, allowing 10 minutes for control of the hemorrhage. If hemorrhage cannot be controlled in this manner, the injured vessel should be severed completely and allowed to retract into the canal. At this time the socket is again packed, and hemorrhage control is usually accomplished.

POSTEXODONTIC COMPLICATIONS
    
     Postoperative hemorrhage is the most common complication after exodontics. If the patient calls from home to report that hemorrhage has started again, he should be advised first to clear the mouth of any blood clots with a gauze sponge and then rinse the mouth with warm salt water. All excessive blood clots should be removed from the vicinity of the socket, but the clot in the socket should not be removed. The patient is instructed to bite firmly on a sterile gauze sponge that has been folded so that pressure is exerted on the area of surgery. If a sterile gauze sponge is not available, the patient may use a tea bag that has been placed in cold water to soften the tea leaves. The patient is advised to bite (not chew) on the pad or tea bag for 20 minutes. If bleeding persists at the end of this period, the patient should be seen by the dentist.
     In cases of persistent hemorrhage, gauze sponges and hemostatic agents such as Gelfoam, topical thrombin, oxidized cellulose, and Avitene may be helpful for the local control of hemorrhage in addition to an adequate armamentarium.
     The patient is seated and a local anesthetic administered. The clot that has formed within the socket is removed. Next, the area of hemorrhage is located. If the hemorrhage is coming from a bone bleeder within the socket, the dull side of a curet is used to burnish the bone in the area of hemorrhage. If generalized bone bleeding is present, the socket is packed with a hemostatic agent such as Gelfoam soaked in thrombin, and a purse-string suture is applied to hold the hemostatic agent in place. The patient is asked to bite on a moist gauze sponge. If the hemorrhage is from the surrounding soft tissue, a tension suture is placed to apply pressure to the area.
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