Chapter 16: Princples Of Exodontia Flashcards
Exodontia is defined as?
painless removal of the whole tooth, or tooth root with minimal trauma to the investing tissues, so that wound heals uneventfully and no post operative prosthetic problem is created
1st dentist?
Hesi re
3100-2181 BC
Dental extraction forceps go back to the time of?
Aristotle, 384 to 322 BC
2 types of instruments used in exodontia are?
Elevators and forceps
The most common surgical procedure in dentistry is?
Exodontia
The most common reason for exodontia is
Caries and periodontal diseases
Indications of exodontia:
15:
Caries
Pulpitis/necrosis
Periodontal disease
Orthodontic reasons
Malposed teeth
Cracked teeth
Impacted teeth
Supernumerary teeth
Temporary teeth
Teeth associated with pathologic lesions
Radiation therapy
Teeth involved in jaw fractures
Odontogenic infection
Prosthetic reasons
Financial issues
A tooth is extracted because of caries if:
- severe caries
- non restorable
A tooth is extracted because of pulpitis/necrosis if:
- irreversible pulpitis
- pulpal necrosis
- not candidate to endodontics
- failed endodontics
- pain
A tooth is extracted because of periodontal disease if:
- severe and extensive periodontitis
- periodontal abscess
- excessive bone loss
- irreversible tooth mobility
- hyper mobile teeth
A tooth is extracted because of orthodontic reasons if:
- insufficient arch length
- provide space for tooth alignment
- premolar/ mandibular incisor
A tooth is extracted because it’s malposed if:
- traumatises soft tissues
- can’t be repositioned by Ortho
- 3rd max molar erupted in severe buccal , ulceration
- hyper erupted teeth
A tooth is extracted because it’s impacted if:
- Unable to erupt into a functional occlusion.
- Infections, cysts.
A tooth is extracted because it’s a supernumerary if:
- may interfere with eruption
- resorption
- displacement
- incisors, canines, 3rd molars
A tooth is extracted because it’s a temporary tooth if:
- may interfere with eruption of permanent teeth
- space maintainers
A tooth is extracted because it’s associated with pathological lesions such as
Odonotgenic cysts
Tumours
A tooth is extracted because of radiation therapy: we should do it either
___ days before
Or
____ months after
And should use ?
10, 2 , antibiotics
A tooth is extracted because it’s involved in jaw fractures if:
- tooth is injured, infected, severely luxated, or interferes with proper reduction, and fixation of the fracture
A tooth is extracted because of odontogenic infections: we need to ? Before extraction
Prescribe antibiotics
A tooth is extracted because of prosthetic reasons:
- malposed teeth, hyper eruption, isolation
- to improve occlusion and aesthetic
Contraindications of exodontia can be?
Local or systemic
The local contraindications of exodontia are:
5:
- acute odontogenic infections
- mandibular third molar infections
- infections of the oral mucosa
- teeth located within an area of tumour
- radiated areas
Acute odontogenic infections:
- such as:
- tooth should be removed asap
- limitations:
- delay procedure and provide:
- acute periodontitis , abscess, cellulitis
- difficulty to open mouth, and reach profound anaesthesia
- antibiotic therapy
Mandibular third molar infections (most common case of mandibular infections):
- delay until when
- use ?
- in which case can immediate extraction be performed
- delay until Pericoronaritis has been treated
- irrigations, antibiotics, anti inflammatories
- mild coronaritis
In Severe coronaritis: incidence of complication increases
Infections of the oral mucosa: examples
- necrotising ulcerative stomatitis (NCS) (plaut vincient infection )
- herpetic stomatitis
Teeth located within an area of a tumour:
- why
Bleeding, inadequate healing, dissemination of malignant cells
Systemic contraindications include:
10:
Brittle DM
Uncontrolled cardiac diseases
Uncontrolled leukaemia
Hepatic disorders
Renal diseases, hyperthyroidism, seizures, adrenal insufficiency
Severe bleeding diasthesis
Fever of unknown origin, weakness
Pregnancy
Elderly
Brittle DM:
- why?
- who can be treated
- Infection, bleeding, inadequate healing, hyperglycemia or hypoglycaemia
- Patients with well-controlled diabetes may be treated as reasonably normal patients
Uncontrolled cardiac diseases:
- examples?
- delay for?
- when do we give endocarditis treatment
- Unstable angina pectoris, recent myocardial infarction, malignant hypertension, cardiac
dysrhythmias. - Delay 6 months.
- Prosthetic valve: endocarditis treatment.
Uncontrolled leukaemia:
- what are the potential complications?
infections and excessive bleeding.
Hepatic disorders:
What are the complications?
Bleeding
Renal diseases, hyperthyroidism, seizure disorders, adrenal insufficiency:
Why?
decompensation that worsen the condition.
Severe bleeding diathesis:
Examples?
haemophilia, anticoagulants.
