Extraction of teeth Flashcards
Reason for extracting teeth
Unrestorable caries Pulpitis Periodontal disease Trauma Failed restorative treatment including endodontics Orthodontics Teeth involved with pathology Prophylactically e.g. prior to radiotherapy
Instruments used for extraction
Forceps
Elevators
Luxators
Anatomy of forceps
Blades
Hinge
Handles
Application of forceps
Forceps are applied to roots of teeth
Force is applied apically to dilate socket
Cone will be forced out
Cutting PDL
Direction of further movement depends on anatomy
Exodontia prior to radiotherapy
Teeth with poor prognosis - need to have long/ strong roots
Summary of movements
1st movement - always apical
Upper anterior teeth and lower premolars - rotation
Lower anterior teeth - buccal movement
Lower molars - figure of 8 and / or bucally
Upper pre-molars - gentle bucco-palatal movement
Upper molars - buccal movement
Summary of movements
1st movement - always apical
Upper anterior teeth and lower premolars (all cones) - rotation
Lower anterior teeth (oval shape) - buccal movement
Lower molars - figure of 8 and / or bucally
Upper pre-molars (4 has highly variable roots) - gentle bucco-palatal movement (tend to take it buccally for 4)
Upper molars - buccal movement
Upper 6
Apply forceps
Lean on it, wait for bone to expand
Roll tooth out bucally
Upper straight forceps
1 or 2 -upper centrals, laterals and canine -apply forceps at long axis of tooth 29N (narrow blades) -upper anterior roots
Upper premolar and molar forceps
76 for upper premolars
76N (narrow) for upper roots
76H for upper molars
-curve so that handle comes out of the mouth
Beak to Cheek
Full molar forceps
Normal blade on one side, beak on other side in furcation
Read handles
94 for right handers, 95 for left handers
Upper third molar forceps
Bayonettes or 101s
Lower incisors forceps
74
74N for lower roots
Lower premolars and molars forceps
75
Full lower molar forceps
73
Beaks buccal and lingual
Cowhorns
For lower molars
Forces beaks underneath teeth and lifts them in socket
Elevators
Couplands - straight -3 sizes (1-->3) -round handles to hold in palm Cryers -point on the end Warwick James -fine handles
Luxators
Dilating ligament and cutting PDL
Elevators - principles of use
Applied to roots
Rotational movement to remove teeth and roots
Not used as a lever
Potentially dangerous
Dentist position
Support mandible Protect soft tissues Ensure px is seated properly Head is supported, goggles in place Your posture is safe and comfortable Ensure good lighting and visibility Do not bend or crouch
On completion of extraction
Assess contour of sockets Place gauze in mouth Give post op instructions Confirm haemostasis Write notes
Post operative advice/ instructions
Supported by written info leaflet Should cover -bleeding - how to avoid and manage -pain -hygiene -how to access help if required -other info as appropriate
Post op instructions: for 1st day
Avoid -mouth rinsing -hot food or drink -alcohol -smoking -strenuous activity If bleeding develops, bite on clean handkerchief or cloth for 10 mins Take simple analgesics as required
Post op instructions: from 2nd day
Use hot salt mouthwashes - after meals until socket(s) healed over
