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Definition
The ideal tooth extraction is the painless removal of the whole
tooth or tooth root , with minimal trauma to the investing tissues,
so that wound heals uneventfully and no post operative prosthetic
problem is created.
INDICATIONS
When conservative treatment is failed :
Dental caries
Pulpal necrosis
Periapical infection
Severe Periodontal disease
Erosion
Attrition
Abrasion
Hypoplasia
INDICATIONS
Trauma to tooth or jaw
Orthodontic treatment
Prosthetic treatment plan
Indications
Impacted teeth
Supernumerary teeth
Teeth associated with pathologic lesions
Pre radiation therapy
Esthetics
Economics
Contraindications
Two groups
1. Systemic
2. Local
Contraindications
Systemic contraindications
Endocrine disorders
Uncontrolled diabetes mellitus
Adrenal insufficiency
Hypothyroidism
Hyperthyroidism
Contraindications
Cardiac diseases
Ischemic heart disease
Angina pectoris
myocardial infarction
coronary artery bypass grafting
coronary angioplasty
Cerebrovascular accident (stroke)
Dysrhythmias
Heart abnormalities predisposed toward infective endocarditis
Congestive heart failure
Contraindications
Patients on anticoagulant therapy
Patients on corticosteroids
Patient on chemotherapy or Immuno suppressives
Contraindications
Pregnancy
Bleeding and clotting disorders
Severe renal or liver disease
Contraindications
Local contraindications
Acute infection
Teeth in the region of Irradiated jaw
Teeth with in the region of malignant tumour
METHODS OF EXTRACTION
Methods of extraction
1. Forceps extraction or
Intra alveolar extraction
2. Surgical method or
Trans alveolar extraction
Fundamental requirement for good extraction
Adequate access & visualization of the field of surgery
Unimpeded pathway for removal of the tooth
Use of controlled force to luxate & remove the tooth
Forceps extraction
Five general steps make up the Closed technique -
1.
2.
3.
4.
5.
Surgical extraction
Preoperative Assessment
Mobility of tooth
Condition of crown
Preoperative Assessment
Indications for pre operative radiograph
H/o attempted or difficult extraction
Wisdom tooth
Chair Position
Maxillary extraction
Mandibular extraction
Height of chain
operators position
Retained roots which can not be either grasped with forceps or delivered
with an elevator , especially those in relationship to the maxillary antrum
potential difficulties
possible complications
Bone removal
Use of dental bur or
Chisel and mallet
Tooth division
Line of withdrawl in multirooted tooth
Socket toilet