This lecture will initiate with a discussion of the best equipment options for extractions. We will then briefly cover regional anesthesia. The majority of this lecture will cover the techniques necessary for optimal success, minimal operator stress, and atraumatic extraction of teeth. This lecture concludes with a discussion of proper sectioning of multi-rooted premolar and molar teeth. There is something for everyone in this lecture, from new grads to seasoned practitioners.
- Understand the importance of dental radiology
- Learn the techniques of minimally invasive extractions
- Create a step by step guide to successful extractions
- How to use a luxating elevator
- When and where the wheel and axel technique is effective
- Why cutting the gingival attachment is important
- Best style of bur for sectioning and how to use
- Elevation is not effective until held for at least 10 seconds
Q: Why do you recommend luxating elevators?
A: Because they are sharp at the tip. Therefore, they cut as well as stretch the periodontal ligament. In addition, they fit into tight periodontal spaces.
Q: Why do you try to avoid making flaps?
A: Mostly because it increases the chance of complications significantly. It also can be faster
Q: Why are dental radiographs so important?
A: The 2 main reasons are ankylosis and weakened bone secondary to periodontal disease, but there are many others.
Q: Why is it important to hold the elevation for 10 seconds
A: The periodontal ligament is very good at resisting short, intense forces. It acts as a rubber band, and will not be damaged until it is held in position.
Q: Do you suture every extraction site?
A: Almost. In general I do because it decreases bleeding and allows faster healing. Also it looks getter to the client, however, if you make an incision, it MUST be closed without tension.
Q: What is the most important aspect of a successful extraction?
Q: What can happen if extractions are not properly performed?
A: Jaw fracture, oronasal fistula, eye loss, retained roots, roots in nose or mandibular canal. Death can even occur
Q: Why are large extraction forceps not recommended?
A: The majority of root fractures occur when the operator is using an extraction forcep. This applies force above the bone and adds a lever arm, which breaks the root.
Q: When can you perform a crown amputation?
A: When there is no evidence of infection or identifiable remaining root structure.
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