Topic 7 - Indications and contra indications of extraction of permanent and primary tooth

Question 1

What is an extraction?

Answer 1

Performing surgical intervention, creating soft tissue and bone wound

Question 2

Before beginning to extract teeth we need to have an indication for extraction and a plan. The extraction steps are as follows:

Answer 2

Before beginning to extract teeth we need to have an indication for extraction and a plan. The extraction steps are as follows:

• Indication
• Surgical plan
• Surgical procedure
• Postoperative care

Also always work with the least risky technique of all, which gives potentially the best result

Question 3

We can extract:

Answer 3

We can extract:

• Damaged and painfull teeth
• Damaged and painless teeth
• In some cases undamaged painless teeth (ortho care)

Question 4

Indications:

Answer 4

Indications:
We have two types of indications:
- Absolute
- Relative
Absolute indications are quite rare, but in case of extraction, every contraindication can be revised.

Question 5

Every extraction requires

Answer 5

Every extraction requires individual assessment, considering several factors like:
The factors:
- Patients general condition
- Systemic diseases
- Inflammation induced by teeth
- Dental status
- Periodontal status

Question 6

Absolute Indications:

Answer 6

Absolute Indications:

• Severe, rapidly spreading dental inflammations
• Phlegmone
• Odontogenic thrombophlebitis
• Odontogenic sepsis

Question 7

Relative indications:

Answer 7

Relative indications:
- Acute or chronic dental inflammations or teeth causing focal infection (only if other treatment is not
possible)
- Teeth with high mobility due to periodontitis (if perio treatment is not effective)
- Teeth which can’t be saved by conservative treatment or can’t be used for prosthetic abutment
- Particular cases of tooth or bone fracture
- Impacted teeth
- Supernumerary teeth, dens connatalis
- Persistent primary teeth which inhibit tooth eruption
- Malposition of teeth or teeth which affect orthodontic treatment
- Prosthetic indications

Question 8

Contraindications:

Answer 8

Contraindications:
We have two types again:
- Absolute
- Relative
These contraindications are less frequent but in base of existence, contraindications are more important than
indications.

Question 9

Absolute contraindications:

Answer 9

Absolute contraindications:
- Acute (cardiac, pulmonal, cerebral) circulatory catastrophe (e.g. heart attack, coronary thrombosis,
stroke, shock)
- Haematological diseases (AML, ALL, agranulocytosis
- Previous radiotherapy of the jaws

Question 10

Relative contraindications:

Answer 10

Relative contraindications:

• Bad general condition (cachexia, anaemia)
• Increased liability to infection (immunodeficiency, immunosuppresion, steroid therapy)
• Acute infective diseases
• Acute oral infections
• Coagulopathy, anticoagulant therapy (without prep)
• Long lasting, high dose bisphosphonate therapy
• Space reservation
• Orthodontic aspects
• Prosthodontic aspect
• Aesthetic aspects
• Financial aspects

Question 11

*EXTRACTION FOR TEETH

Answer 11

EXTRACTION FOR ALL TEETH INCLUDING ALL 3RD MOLARS ARE PERFORMED FROM THE FRONT, WITH THE
EXCEPTION OF THE 4TH QUADRANT WHICH IS PERFORMED FROM THE BACK!!!