What is the ruling on performing istinja' with perfumed tissues or a tissue moistened with water?

Performing istinja' with perfumed or moistened tissues is not sufficient if they are not dry, due to the moisture on them reaching the impurity, which increases its spread rather than reducing it. Then, to remove the impurity, one must use pure water. And Allah the Almighty knows best.

What is the ruling on the fasting of a woman who has reached menopause if menstrual blood flows?

If a woman reaches the age of menopause (which is usually sixty-two) and her menses have ceased, then she sees blood after that, and its duration is not less than a day and a night (24 hours), it is menstruation (hayd). If it is less than a day and a night, she is considered as having non-menstrual vaginal bleeding (mustahada), so she fasts and prays. However, she must perform ablution for every obligatory prayer after its time enters, pray immediately, and be treated as a person with a continuous condition. There is no specific end limit for a woman's menstruation; it is possible as long as the woman is alive. And Allah the Almighty knows best.

How should a person who is afflicted with continued major ritual impurity (incontinence of urine, bleeding outside the monthly period) perform ablution?

Such a person should make ablution for every prayer after its due time and after removing impurities from their body and outfit, and should place a fresh diaper whenever needed so as for the impurity not to spread out. They should also perform prayer immediately even if incontinence of urine continued, and should repeat the aforementioned for every obligatory prayer, then perform optional prayer as much as they want.

Does tooth extraction during the day in Ramadan break the fast?