Periotomes, Lexators and elevators Flashcards
As we move from the anterior teeht to the posterior teeth what is the difference in buccal plate thickness
Anterior buccal plate is thinner
Posterior buccal plate is thicker
Is the cortical plate thick or thin?
Thick
As we get older or when we do extractions what happens to the mandible?
Gets thinner
What are the 3 principles of exodontia?
Expansion of bony socket
Separation of the attachment of the periodontal ligament
Separation of the attachment of the gingival soft tissue
During post extraction healing the alveolar ridge undergoes what amount of horizontal loss and vertical reduction?
Horizontal loss - 3.8mm
Vertical reduction 2.4mm
Post extraction does the buccal or lingual plate exhibit more resoption?
Buccal
Which of these can impact the healing process?
A. Medical history
B. Social history
C. Dental History
Medical History
What are the 4 key stages to healing?
- Angiogenesis
- Bone formation
- Bone growth
- Re-organisaion of bone
in the first 24-48 hours of healing what occurs?
Clot formation
Fibrin meshwork
In the first 7 days of healing what occurs?
24 - 48 hours - clot formation and fibrin meshwork
7 days - Epithelial migration over the socket
Clot becomes granulation tissue
In the first 20 days of healing what happens?
Granulation tissue becomes collages and early bone
In the first 8 weeks what happens in healing?
Bone marrow occupies the socket replacing woven bone
Extraction of teeth causes trauma, what happens post trauma?
Haemorrhage, bleeding into the socket, platelet aggregation, clot formation
After 2-3 days inflammatory cells migrate and new tissue starts to form
During angiogenesis what occurs?
Healing from the base of the socket upwards
Last area to heal is the top of the mucosa
It takes 6 months for bone to fully reorganise
What are the 3 bone preserving extraction techniques?
- Sever the connective tissue fibres
- Minimuse soft tissue reflection
- Section multi-rooted teeth
What are the 3 key hand instruments used in extraction?
- Periotomes
- Luxators
- Elevators
How are periotomes used?
Use anteriorly
Long axis of the blade is inserted into the inter-proximal region along the long axis
Push the instrument into the PDL along the mesial and distalside of tooth until it severs the PDL immediately below the alveolar crest
Wait 10-20 seconds with periotome insitu
as the tooth is pushed against the alveolus bone with expand
tooth will exit the socket
How wide is the blade of the periotome?
3 - 4mm
What is the length of the blade of the Luxator?
3 - 5 mm
What is the make of the plastic handled luxators?
Directa
What do luxators sever?
Tooth and bone
What do you consider when choosing the size luxator?
Choose a size that is similar to the root diameter 3-5mm
What angle do you use the luxator for anterior and posterior teeth?
Anterior - straight
Posterior - angled
What is the steps to using a luxator?
Apply axial pressure as you work down the root surface
Rock and sever the PDL
As space is created air will fill the apial socket
breaking the vacuum and allowing easy removal of the tooth
What size luxator would you use for anterior teeth?
Size 3
What size luxator would you use for posterior teeth?
size 5
What are the two ways to use an elevator?
Horizontally along the long axis of the tooth rotating around the fulcum
Horizontally along the long axis of the tooth to widen the socket similar to luxation
What are the 3 techniques for elevators?
Lever
wedge
Wheel and Axle
What is the consequece of using an elevator and how can it be avoided?
When using a luxator a lot of pressure can be applied to the adjacent tooth so use luxators to prevent this
Which instrument is this?
Luxator
What instrument is this?
Cryers
Which instrument is this?
Couplands
Which instrument is this?
Warwick James
