Incidence of Iatrogenic Injuries During Dental Procedures at Selected Tertiary Institutions in South West Nigeria

Iatrogenic injuries occurring during dental procedures represent a significant clinical risk that can compromise patient safety, increase treatment complexity, and generate medicolegal consequences. Such injuries, including fractured root tips, displaced teeth into fascial spaces, instrument breakage, oro-antral communication, and nerve damage, are infrequently reported in Nigerian clinical literature. This retrospective descriptive study examines the incidence, types, and management of iatrogenic injuries during dental procedures at three tertiary institutions in the South West geopolitical zone: University College Hospital Ibadan, Lagos University Teaching Hospital, and Obafemi Awolowo University Teaching Hospital Ile-Ife. Clinical incident records, operative notes, and referral documentation from 2020 to 2024 were reviewed. Among 4,200 documented dental procedures, 73 iatrogenic incidents were identified, representing an overall rate of 1.74%. Root tip displacement and oro-antral communication were the most common categories. Cases involving operators with less than two years of clinical experience were associated with higher incidence rates. Most complications were identified and managed immediately, but a subset required referral to the maxillofacial surgery unit for definitive care. The study recommends the development and implementation of a structured dental incident reporting and learning system across Nigerian teaching hospitals and advocates for close clinical supervision of junior operators. Keywords: iatrogenic injuries, dental complications, oro-antral communication, South West Nigeria, patient safety.