extractions Flashcards

1
Q

what do you need for an extraction to be indicated?

A

clinical +/- radiographic assessment

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2
Q

indications for extraction

A
unrestorable tooth
 - gross caries
 - advanced PDD (bleed on ext)
 - tooth/root fracture
 - severe TSL
 - pulpal necrosis
 - apical infection
symptomatic PE teeth
traumatic position
 - e.g. U8s buccally - biting cheek
ortho indications - usually 4/5s
interference with denture construction
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3
Q

upper extraction forceps

A
6 - beaks in line with handles
root
straight
universal
L molar
R molar
3rd molar/Bayonet
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4
Q

straight upper anterior forceps

A

1, 2, (3)

straight handles

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5
Q

upper root forceps

A

v thin beaks

retained roots

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6
Q

upper universal forceps

A

3, 4, 5

curved handle and beak

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7
Q

upper molar forceps

A

“beak to cheek”
engages furcation
2 buccal roots, 1 palatal

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8
Q

lower extraction forceps

A
4 - beaks perpendicular to handles
root
universal
molar
cowhorns
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9
Q

lower root forceps

A

retained roots

v thin beaks

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10
Q

lower universal forceps

A

1,2,3,4,5

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11
Q

lower molar forceps

A

2 beaks

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12
Q

cowhorn forceps

A

broken down molars you can’t easily grip with molar forceps
v narrow and pointy
squeezing action should elevate tooth. if tooth doesn’t come out then move forceps - no mobilisation with cowhorns
use with care as can cause crown or root fractures
often use in younger pts - bone softer

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13
Q

Upper bayonet 3rd molar forceps

A

Z
straight handle
wider tip to allow you to extract U8s
might not give a good grip as anatomy varies a lot

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14
Q

Upper bayonet root forceps

A

curved handle
Z
narrow tips - grab retained upper molar roots

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15
Q

pt positioning lowers

A

quite upright

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16
Q

pt positioning uppers

A

lie back
less likely to inhale as tongue falls back and joins soft palate (partially closes)
- 45 degree dangerous accidental inhales common

17
Q

operator positioning

A

behind pt to their right for LR quadrant

in front of pt to their right for LR, UL, UR quadrants

18
Q

Couplands elevators

A
elevate tooth, widen PDL space
unless mobile tooth always use elevators first before forceps
1 - narrowest
3 - widest
no R+L
19
Q

Warwick James Elevators

A

straight, R+L
- hold so point towards each other
straight like a narrow Couplands - good for tight spaces e.g. 8s where you can’t fit couplands

20
Q

Cryer’s elevators

A

good at lifting up roots from sockets
put down a socket and twist - might lift root up
R+L
- hold with concave surface on top - point towards each other

21
Q

luxators

A

more effective at mobilising teeth
cut PDL
- don’t use for elevating - don’t twist and lift inside socket as will snap or bend tip
only use pushing down action to cut PDL

rounded rather than straight end as in couplands
can harm pt if not used correctly as v sharp

22
Q

Periotome

A

finest version of a luxator you can get
can also get them fitted to US
use in same way as luxator - go round tooth destroying PDL
use when wanting to minimise trauma to bone e.g. future implant
takes a LOT longer to ext a tooth so only if want implant

23
Q

mechanical principles for tooth elevation

A

wheel and axle - rotation
lever
wedge

24
Q

wheel and axle

A

wedge it in - get it as deep as possible

once in twist

25
Q

lever

A

don’t use often - produces a huge amount of force

may fracture jaw - be very careful if use

26
Q

wedge

A

push it down, as it goes in the tooth comes up
might accidentally do this with a luxator - only time you would ever do this
lucky when it happens but rate

27
Q

what should you avoid when using elevators?

A

excessive force

e.g. with bodily movement of elevator rather than rotation

28
Q

points of application for elevators

A

mesial and buccal - used in sequence
others
- distal - rare as often teeth in way and stretches cheek
- superior - never use as would have to drill all of the buccal bone away
- inferior

never use mesial and distal together (bimanual elevation of teeth) - not supporting jaw enough

changing a point of application of force from distal to mesial

29
Q

what should you always do when using elevators for safety?

A

support jaw at all times

thumb and finger either side of tooth