Intro to Extractions Flashcards
what assessment do you need for an extraction
clinical and radiographic assessment
what are the indications for extraction
• Unrestorable teeth ○ Gross caries ○ Advanced periodontal disease ○ Tooth / root fracture(trauma) ○ Severe tooth surface loss ○ Pulpal necrosis ○ Apical infection
• Symptomatic partially erupted teeth
○ Nothing wrong with the teeth themselves but will cause problems for other teeth
• Traumatic position
• Orthodontic indications
○ Usually premolars are the ones extracted
• Interference with construction of dentures
○ Teeth in strange places can affect the manufacture of a denture
name and explain forceps used to extract upper anterior teeth
straight upper anterior forceps
- only perfectly straight instrument
- used from upper canine to upper canine
describe the upper universal forceps
- slight curve in handle
- tip the same as the upper anterior forceps
- different handle to allow more posterior access
- usually single rooted teeth / premolars (buccal and lingual roots)
- wont give good enough grip on molars for extraction
describe the upper molar forceps
- tips have a concave surface to grip the convex roots of molars = enables forceps to grab the tooth and mobilise it
- need forceps to engage 2 buccal roots and 1 palatal root
- curved to allow access posteriorly
- need one for left and right arch, different tips for left and right
why do you need different left and right upper molar forceps
to ensure the tips can properly engage the correct furcation of the tooth
point / triangle tip is designed for the furcation between the 2 buccal roots to engage the groove
= beak to cheek
what do all the lower forceps have in common
have a 90 degrees bend
describe the lower universal forceps
- lower equivalent to the upper universal forceps
- tips are concave on both sides
used on lower anteriors = 5 to 5
describe lower molar forceps
- same lower molar forceps for the left and right as lower molars have a mesial and a distal root
- tips need to have a point (beak) on both sides of the tip to engage both furcations
how is the cowhorn forceps different to the other forceps
these are designed to place the 2 tips into the furcation and then squeeze the handle
2 points go towards each other and cause the tooth to lift out - squeezing action causes the tooth to lift
dont wriggle the tooth - doesnt work as the tips are too smooth to grab the teeth
good for kids more pleasant experience
describe the cowhorn forceps
- unique to lower jaw
- very pointy
- different technique to other molars
- designed for use in 2 root lower molars
- need to place correctly
describe upper bayonet third molar forceps
as lower 8s / wisdom teeth have variable roots you cannot use forceps with pointy beaks as you do not know where the roots will be to engage
- point similar to tip of universal forceps (may not give a good grip)
- easy to access back of mouth due to the bayonet / z shaped pattern
describe bayonet root forceps
- very fine tip
- good for removing little roots that may have been fractured / retained roots
- cannot remove a complete crown
how do dentists work in oral surgery
standing up
where does the dentist stand to extract lower molars
either directly in behind the patient
or
on the right hand side of the patient in front
how does the dentist extract lower premolars
behind the patient, slight to the right of the patient
or
in frot of the patient to their right hand side
how does the dentist extract upper molars
on the right hand side of the patient
lay the patient flatter for this extraction
how does the dentist extract upper anterior teeth
right hand side of the patient in front
what should be used before extractions with forceps and why
elevators
going straight in with forceps will probably cause the teeth to break
these instruments help to loose teeth which will make them easier to extract
even if the crown breaks the roots will still be more mobile and easier to remove
what are coupland’s elavators
- tear the PDL
- kind of like half forceps
- number 2 and 3
what are cryer’s elevators
- left and right
- good for retained roots
- pointless to know difference between the left and right
- concave on one side, convex on the other, have a sharp point
how can you tell the difference between right cryers and left cryers
have concave surface pointing to the ceilng
have the pointy parts pointing to each other
right hand = right
left hand = left
what are warwick james elevators
- comes in sets of 3
- distinguish between left and right same way as with cryer’s
- straight like a really fine coupland’s
- used for wisdom teeth because they are narrower and fit the space better
