Basic concepts of exodontia Flashcards
Goals of exodontia
Safe for pt and clinician, efficient <1hour extraction, painless, complete tooth removal
Post-op instructions for pt following extraction
Following your operation to prevent bleeding it is important that you follow these instructions carefully:
- Avoid hot drinks and foods for the rest of the day
- Do not rinse your mouth out or spit repeatedly for the next 24 hours
- No smoking for 48 hours
- No alcohol for 24 hours
- Avoid excessive effort and exercise
- You should take over the counter medication before the numbing injections wear off; paracetamol and ibuprofen are usually efficient if you can take those. Please follow the instructions on the packet carefully. You may need to take pain relief medication for up to 2 weeks
- Blood stained saliva is normal but if obvious bleeding continues then bite down on a clean, damp rolled handkerchief/face cloth for 20 minutes whilst sitting down. If bleeding or oozing continues after this then contact us immediately.
- If you have had GA/Intravenous sedation please do not dry any vehicle, operate any machinery or sign any legal documentation for at least 24 hours following your operation.
Day after the operation and continuing 3/4 days:
- Eat a soft diet such as soup or pasta
- Use salt water mouthwashes after every meal aswell as morning and night. Mix 1 level teaspoon of salt in a glass of warm water and gently bathe teh operation site or socket for several minutes.
- Continue to brush your teeth x2 daily
- Do not hold anything hot against the outside of your mouth. Pain, stiffness and swelling should start to settle within 3-4 days, if this does not happen then please contact us.
Coupland’s elevators
- Coupland sizes 1, 2 and 3
- Elevate the tooth
- Gouge
- Broader and flatter than luxator
- Full rotational forces
- The pressure is applied to dilate the alveolar bone and periodontal ligament
- Used perpendicular to the tooth
Luxator
- Used parallel to the long axis of the tooth
- Push as far apically as possible
- 3mm and 5mm width
- Straight and curved
- They are sharp: use from the side you are working on, finger rest on shank and finger&thumb to support alveolus
Cryers and Warwick James
- Rotational movement
- Working side is at right angles to the handle
- Cutting side and blunt side
- Upper third molars
- Retained roots (when 1 root has been removed)
- Removing interseptal bone - if root is below the alveolar ridge
Maxillary Forceps
- Maxillary incisors and canines number 2, upper straight
- Maxillary incisors and canine roots 113
- Maxillary premolars number 76, upper universal
- Maxillary 1st and 2nd molars 94 (right) 95 (left) beak-to-cheek
- Maxillary 3rd molars 101 bayonet
Mandibular Forceps
- Mandibular incisors, canines and premolars 74, lower universal
- Mandibular incisors, canines and premolar roots 74N
- Mandibular 1st molar 73 beak to beak and mandibular 2nd molars 86 cowhorn
- Mandibular 3rd molars do not use forceps
Correct usuage of forceps
- Support the alveolar with finger and thumb, free hand cuddle the opposite cheek
- Primary movement is apical
- Secondary movement is buccal
- Single roots rotate
- Multiple roots: figure of 8
Technique for lower right extraction using forceps
Stand behind the pt to the right, support alveolus with finger and thumb, apical pressure then buccal movement, rotational on premolars as single rooted and figure of 8 on molars
Technique for lower left extraction
Stand in front of pt to the right, support alveolus with finger and thumb, apical pressure, same as lower right for movements
Technique for upper tooth extraction
Stand up straight, pt’s head at shoulder height, arm straight with forceps and use body weight to push apically
Flap design in oral surgery
Gingival flap design is a procedure where the gums are separated from the teeth and folded back temporarily to allow the dentist to reach the root of the tooth and the bone. It must be broad and the periosteum must be inatct.
