Exodontia Assessment Flashcards
What are the assessments you must make before undertaking an extraction
- Medical history
- Dental history
- Social history
- Anxiety assessment
- Clinical evaluation/ assessment
- Radiographic evaluation
What must you consider in a clinical evaluation?
- presence of infection
- restriction of mouth opening
- extent of visible caries
- tooth mobility
- tooth alignment in arch
What must you consider in a radiographic assessment?
- acceptable or not acceptable radiograph
- relationship to other vital structures e.g. sinus
- extension of caries
- combined rooth width (for only multirooted teeth)
- previous RCT
- Bone assessment
What is the normal range for mouth opening?
3.5-5.5mm
3 of patients fingers should be able to fit
What are the levels of restricted mouth opening?
- normal mouth opening
- TMJ issues
- mouth opening restricted but forceps can be placed adequately
- mouth opening inadequate for placement of forceps
What are the levels of the extent of visible caries?
- no caries
- decay present but does not influence crown strength
- decay involving most of crown but root intact
- tooth decayed below alveolar bone level
What are the levels of tooth mobility?
- class 3 mobility (vertical and horizontal)
- normal mobility- class 1/2
- no mobility- no suspicion of ankylosis
- no mobility- high potential for ankylosis
class 2 > 1mm horizontally
class 1 <1mm horizontally
How can you identify anklyosis on a radiograph?
fusion between cementum and bone
lack of periodontal membrane
absence of lamina dura
What is ankylosis in a dental context?
destruction of root structure and infiltration of bone tissue
fusion of the rest of the root structure with bone
When assessing tooth alignment in the arch, what should you look for?
- one or both adjacent teeth missing
- tooth normal in arch
- tooth malpositions but can still be grasped by the forceps
- tooth in linguoversion
What is linguoversion?
this is the displacement of a tooth to the lingual side of its proper occlusion position
can make grasping using forceps more difficult
What are the levels of acceptable radiographs taken prior to an extraction?
- multiple views available
- acceptable PA available
- OPG available
- radiograph does not show the entire tooh
When are multiple radiographical views of a tooth indicated for an extraction?
they are especially indicated for malpositioned teeth
What is a low risk relationship to the sinus?
this is where the roots are located below the sinus floor
What is a medium risk relationship to the sinus?
sinus extends into the furcation but the bone is visible around the roots
What is a high risk relationship to the sinus?
the sinus surrounds the apices of the roots
Why are you less likely to observe periapical radiolucencies in the maxilla?
this is because periapical lesions can drain into the sinus
What are the levels for combined rooth width to be considered for exodontia?
- combined apical width is less than the narrowest part of the roots
- combined apical width is equal to the narrowest part
- combined apical width is greater than the narrowest part but less than 25% larger than the narrowest part
- combined apical width is greater than the narrowest part but more than 25% larger than the narrowest
What are the levels of root morphology to be considered for exodontia?
- root is normal length, thickness and rounded apex
- root is longer, slender with rounded apex
- root is long, slender with pointed apex
What are the levels of previous endodontic treament to be considered for exodontia?
- endodontic treatment < 6 months ago
- endodontic treatment > 6 months ago
- endodontically treated totoh with no physiological mobility
What are the alveolar bone assessments to be considered for exodontia?
- bone loss above 1/3 of root
- normal bone density
- intermediate bone density
- dense trabeculation
What should you consider for a lone standing tooth regarding its alveolar bone prior to extraction?
- lone standing tooth- the bone surrounding the tooth becomes denser as the functional forces of that tooth increases (increased cortical strength)
- this means that the bone loses its elasticity and is more likely to break/fracture
