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OSI Ignacio > Chapter 19: Tooth Extraction Technique > Flashcards

Chapter 19: Tooth Extraction Technique Flashcards

1
Q

Extraction is what kind of process?

A

Expansion

We expand the bone

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2
Q

Why is tooth extraction a traumatic technique?

A

We tear the ligament, we expand the bone

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3
Q

What to take into account for tooth extraction technique:

A
  1. Patient and surgeon preparation
  2. Patient and surgeon position
  3. Role of the opposite hand
  4. Mechanical principles involved in tooth extraction
  5. Procedure for closed extraction
  6. Specific techniques for the removal
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4
Q

Patient and surgeon preparation:
- how should we treat all patients with no exception
- how to provide protection

A
  • All patients must be viewed as having blood-borne diseases that can be transmitted to the surgical team and other patients
  • Surgical gloves, surgical mask, eyewear with side-shields, long sleeved gowns, hair be held in position with barretes, surgical cap , draping, sterile drape put across the patient’s chest, surgical cap, eyewear, and rinse with an antiseptic
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5
Q

Patient and surgeon position:
- what is the best position
- location of arms
- a good position provides?
- wrists should be?
- common mistakes
- is it the same position for maxillary and mandibular extractions

A
  • The best position is one that is comfortable for the patient and the surgeon, and allows the surgeon to maximal control of the force that is being delivered to the patient’s tooth
  • Keep the arms close to the body
  • Provides stability and support
  • Keep the wrists straight enough to deliver the force with the arm and shoulder
  • Common mistakes:
    • Having the chair too high: forces the surgeon to operate with their shoulders raised
    • Lean over the patient: interferes with surgical lighting, the rest of the dentists body
  • no it’s different
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6
Q

For maxillary extractions, the patient and surgeon position should be?

A

• Chair tipped backwards 125 degrees
• Occlusal plane 45 - 60 degrees to the floor
• Height of the chair: the patient’s mouth is at or slightly below the operator’s elbow level
• The patient turns the head to the right or left side

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7
Q

For mandibualr extractions, the patient and surgeon position should be?

A

• Upright position
• Occlusal plane parallel to the floor
• Height of the chair: the patient’s mouth is at or slightly below the operators elbow level

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8
Q

Role of the opposite hand:
- active or passive role in the procedure?
- functions?

A
  • active role
  • functions:
    1. Reflect soft tissues of the cheeks, lips and tongue
  1. Protect other teeth from the forceps
  2. Stabilize the patients head
  3. Support the mandible
  4. Support the alveolar process and provides tactile information of the expansion
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9
Q

For the maxillary approach of canines and molars, the role of the opposite hand is?
- thumb
- index

A

• Thumb: on the palatal surface
• Index finger: on the buccal surface retracting the soft tissue

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10
Q

For the maxillary approach of the premolars, the role of the opposite hand is?
- thumb
- index

A

• Thumb: on the buccal surface retracting lips and cheek
• Index finger: on the palatal surface

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11
Q

For the mandibular approach of the incisors, the role of the opposite hand is?
- thumb
- index
- rest

A

• Thumb: rests on the buccal surface
• Index finger: on the lingual surface
• Rest: support the baseline of the mandible

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12
Q

For the mandibular approach of the molars, the role of the opposite hand is?
- index
- middle finger
- thumb

A

• Index finger: rests on the buccal surface retracting soft tissue
• Middle finger: on the lingual surface retracting the tongue
• Thumb: support the baseline of the mandible

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13
Q

For the mandibular approach of the right side, the role of the opposite hand is?
- index
- thumb

A

• Index finger: rests on the buccal surface retracting soft tissue
• Thumb: on the lingual surface retracting the tongue and lowering the floor of the mouth

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14
Q

The mechanical principles involved in tooth extraction are?

A

3 important principles: lever, wedge, wheel and axle.

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15
Q

Lever:
- which instruments are used as levers
- mechanism for

A

• Elevators are used as levers
• Mechanism for transmitting a modest force into a movement against great resistance

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16
Q

Wedge:
- how are the beaks at the tip
- function of straight elevator
- lever is wedged into?

A

• The beaks are usually narrow at their tips
• Straight elevator luxate a tooth from its socket
• The lever is wedged into the periodontal ligament space

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17
Q

Wheel and axle:
- what part of the elevators serve as the axle and which one serves as the wheel

A

• The handle of elevators serves as the axle
• The tip of elevators acts as a wheel and engages and elevates the tooth from the socket

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18
Q

Which procedure for extraction is the routine one and is given primary considerations for almost every extraction?

A

Closed

19
Q

Open technique:

A

Surgical flap technique , excessive force necessary and substantial amount of crown is missing or covered by tissue

20
Q

Steps for a closed procedure?

A
  1. Loosening of the soft tissue attachment from the cervical portion of the tooth
  2. Luxation of the tooth with a dental elevator
  3. Adaptation of the forceps to the tooth
  4. Luxation of the tooth with forceps
  5. Removal of the tooth from the socket
21
Q

What do u use to loosen the soft tissue attachment from the cervical portion of the tooth?

A

Periosteal elevator: allow the elevator and forceps to be positioned more apically, and ensure that profound anaesthesia has been achieved

22
Q

Luxation of the tooth with a dental elevator:
- usually use?
- causes ?
- inserted?
- forces?
- action?

A

• Usually the straight elevator
• Expansion /dilation alveolar bone, And tearing of the periodontal ligament
• Inserted perpendicular to the tooth into the interdental space and into the periodontal ligament space
• Strong, slow, forceful turning of the handle moves the tooth
• Elevator is advanced apically while being rotated back and forth (wedge action)

23
Q

Inferior portion of the blade rest on the ?While the superior portion of the blade is?

A

• Inferior portion of the blade rest on the alveolar bone
• Superior portion of the blade is turned toward the tooth

24
Q

What happens if an excessive force is applied when Luxation the tooth with a dental elevator?

A

can damage / displace adjacent teeth

25
Q

Adaptation of the forceps to the tooth?
- beaks should?
- location in relation to cervical line?
- what does the beak grasp
- grasping the handle maximises?
- how do you hold the forceps: thumb, palm, pinky?

A

• The beaks should adapt anatomically to the tooth
• Apical to the cervical line (root surface)
• The beaks grasp the root underneath loosened soft tissue
• The surgeon grasps the handles at the ends to maximize mechanical advantage and
control
• How to hold forceps:
Thumb: below the joint
Handle in palm
Little finger: inside the handle

26
Q

Luxation of the tooth with forceps:
- movements:
- force is directed towards?
- major movement is ?
- force is ?
- increase in force is ?

A

• Movements: linguobucal-buccolingual and rotary

• The major portion of the force is directed toward the weakest bone

• The major movement is labial and buccal

• Slow and steady force to displace the tooth buccally

• Gradually increases in force

• The tooth is then moved toward the opposite direction

• The forceps are reseated apically with a strong deliberate motion

• Teeth are not pulled. They are gently lifted from the socket once the alveolar process has
been sufficiently expanded

27
Q

Lingo buccal- and buccolingual movements are for?

A

Luxation

to expand the alveolar socket

28
Q

Rotary movements are for?

A

Removal

Small rotational motions are used to expand the tooth socket and tear the periodontal
ligament

29
Q

Removal of the tooth from the socket:

A

Slight tractional force, usually buccally

30
Q

Specific techniques for the removal: which forceps are used for the maxillary teeth

A
  • all: universal maxillary forceps
  • except 1st molar paired forceps
31
Q

Specific techniques for the removal: which forceps are used for the mandibular teeth

A
  • all: lower universal forceps
  • except: 1st and 2nd molars cowhorn forceps
32
Q

Easiest tooth to extract in the mandible?

A

Premolars

33
Q

Incisors and 3rd molar roots are?

A

Conic

34
Q

Canine roots are?

A

Oblong in cross section

35
Q

Maxillary incisor removal technique:

A

Initial movement slow, steady and firm in the buccal direction
Less vigorous palatal force
Slow and firm rotational force

36
Q

Maxillary canine removal technique:

A

Easy to fracture
Movement: apical - buccal -palatal
Rotational force
Delivered: labial - incisal direction

37
Q

Maxillary 1stPM removal technique:

A

Fracture

Should be luxated as much as possible (likelihood of root fracture)
Initial movement: buccal
Palatal: small amount of force
Avoid rotational force
Delivered: tractional force in occlusal direction

38
Q

Maxillary 2ndPM removal technique:

A

Movements: apically
Strong to the buccal back to the palate
Rotational
Tractional force

39
Q

Maxillary 1stmolar removal technique:

A

Three large and strong roots
Buccal plate: thin
Palatal plate: thick and heavy
Size, curvature and divergence
Maxillary sinus
Tip projections on the buccal (beaks)
Apically as far as possible
Strong buccal and palatal pressures
Rotational forces are not useful

40
Q

Which tooth is usually extracted by elevators alone?

A

Max third molars

41
Q

Mandibular anterior teeth removal technique:

A

Incisors shorter and thinner
Canines longer and heavier
Buccal / Lingual bone: thin
Movements: buccal and lingual directions with equal pressures
Rotational and tractional forces

42
Q

Mandibular PM removal technique:

A

Roots straight and conic
Buccal bone: thin
Lingual bone: heavier
Movements toward buccal
Returning to lingual
Rotating
Deliver: occlusobuccal

43
Q

Mandibular 1st and 2nd molar removal technique:

A

Two roots

Lower molar universal forceps: small tip projections on both beaks to fit into the bifurcation

Strong buccolingual motion

Cowhorn forceps: roots clearly bifurcated

Cowhorn forceps: creates force against the crest on the buccolingual plates and forces the tooth superiorly out of the socket

Buccolingual movements

44
Q

Mandibular 3rd molar removal technique:

A

Fused conic roots
Lingual plate: thinner
Delivered: to lingual plate

OSI Ignacio (10 decks)

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