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BDS3 - Oral Surgery > indications for extractions > Flashcards

indications for extractions Flashcards

1
Q

what is needed to determine need for extractions

A
  • clinical and radiographic assessment
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2
Q

what are some causes for unrestorable teeth

A
  • gross caries
  • advanced periodontal disease
  • tooth/root fracture
  • severe tooth surface loss
  • pulpal necrosis
  • apical infection
  • dilaceration of root
  • traumatic position
  • orthodontic indications
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3
Q

what is dilaceration of root

A
  • abnormal bend in the root
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4
Q

what teeth are commonly partially erupted

A
  • wisdom teeth or 2nd premolars that aren’t erupting full need removed
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5
Q

what is an example of a traumatic position causing removal of a tooth

A
  • lingually placed 5 or buccal upper 8 which is traumatising cheek
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6
Q

which teeth are mainly removed for ortho

A
  • premolars
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7
Q

what are straight upper anterior forceps used for

A
  • easy access
  • canine to canine
  • tip for a single root
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8
Q

what are upper premolar forceps

A
  • same beak and tip as straight so for single root

- slightly curved to reach further back in mouth without stretching cheek

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9
Q

what are upper molar forceps

A
  • forceps for each side of mouth as upper molars have two buccal and one palatal root
  • one side has a beak to engage buccal furcation
  • beak to cheek
  • smooth tip for single root
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10
Q

what is different about lower forceps

A
  • 90 degree angle compared to upper
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11
Q

what are lower universal and lower root forceps

A
  • slightly different with root having a narrower tip but both designed to get single root teeth
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12
Q

what are lower molar forceps

A
  • only mesial and distal roots on lower molars so same forceps can be used on each side
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13
Q

what are cowherd forceps

A
  • unique to lower jaw
  • points to engage furcations between mesial and distal root
  • only work on younger individuals and will only work if have lower molars with divergent roots
  • as you squeeze forceps together, points come together and lift tooth
  • can sometimes split tooth in half
  • provides no grip
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14
Q

what are bayonet forceps

A
  • z shape
  • different tips
  • get third molar and root forceps
  • for uppers
  • root ones are narrower and pointier
  • great access for upper 8
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15
Q

where do we stand for extracting lower right side

just gonna do for right handed cause that’s what we all are

A
  • behind patient
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16
Q

where do we stand for extracting lower left side

A
  • in front of patient to the right
17
Q

where do we stand for extracting uppers

A
  • in front of patient to the right
18
Q

what are coupland’s

A
  • elevator
  • most often used
  • used to loosen teeth
  • always use before forceps
  • widen the socket
  • high the rounded surface of a tooth
  • numbers 1-3 = bigger number means wider tip
19
Q

what are Cryer’s

A
  • elevators
  • right and left = only need to know for exams as can use both on either side
  • goof for elevating roots in a socket
  • fit down a socket and twist it and engage the root to rotate and engage root to elevate it
20
Q

what are Warwick James

A
  • elevators
  • set of 3 = straight, right and left
  • for upper wisdom teeth mainly
  • R and L like a mini Cryer’s but not as sharp
  • straight like a mini Coupland’s
21
Q

what are luxators

A
  • very sharp
  • can harm patient or yourself if not used well
  • tears ligament around tooth and widens pdl space
  • mobilise tooth and cut pdl
  • ideally the first instrument to use
22
Q

what is a periotome

A
  • kind of like a luxator
  • very flat
  • not used in oral surgery as takes a long time
  • like a mini blade
  • work it down the pdl and cut the space moving up and tooth gradually moving around tooth
  • good for implants as take tooth out atraumatically
  • get tips for ultrasonic handpieces
23
Q

what are the mechanical principles for tooth elevation

A
  • 3 basic modes of action
  • wheel and axle = rotation
  • lever
  • wedge
24
Q

what is wheel and axle movement

A
  • most common
  • use for elevators but not luxator as could break it
  • instrument goes in horizontal
  • wedge it in so tip is engaging CEJ or as deep as you can go
  • rotated on an axle
  • twist wrist and rotate
  • as it twists upwards it elevates the tooth
25
Q

what is lever movement

A
  • use more force
  • dangerous if not don’t properly
  • only occasionally done
26
Q

what is wedge movement

A
  • with luxators
  • tip pushed into pdl and as it works its way in it can push tooth out
  • only time a luxator could be used to elevate a tooth
27
Q

how are the 3 actions used

A
  • all 3 actions can be used in combination with each other

- must avoid excessive force

28
Q

what are the various points of application for the elevators

A
  • mesial
  • distal
  • buccal
  • superior = not really done
  • inferior = not really done
29
Q

what force of application is used first

A
  • mesial then rotation

- as it rotates, put force up and back to tooth which is good

30
Q

what other movement is needed for lower molar along with mesial

A
  • need buccal movement as well otherwise mesial would only get it so far
31
Q

why is buccal movement good in lower molars

A
  • lingual bone is quite thin
32
Q

what is superior application of force

A
  • would have to remove all the buccal bone to do this

- not really done

33
Q

what is the most common sequence used for force

A
  • mesial then buccal
34
Q

why don’t we do mesial and distal force at the same time

A
  • going to fracture mandible
  • would have no hand supporting jaw
  • not done
35
Q

how do we change a point of application fro distal to mesial

A
  • use Cryer’s
  • put them down socket and rotate it, will fracture bone and engage root so one component of force is vertical which could be enough to elevate the root
  • use available space as distal root is done
  • vertical force will hopefully dislodge and push root up and possibly back as well
  • eventually have more space at mesial side of mesial root and can get instrument in there and rotate again to get it out
  • root could get fall backward and be loose enough to elevate it
36
Q

what is inferior application of force

A
  • drill away buccal bone
  • pointless
  • not really done
37
Q

is it safe to leave retained roots?

A
  • if apical radiolucency associated with root, then needs removed as it is a problem
  • if ortho can be done without root being removed, then can be left
  • if it will interfere with treatment, then needs removed
  • if more than 1/3 retained then remove it
  • if there is a risk of nerve damage removing it, then better leave it
  • whatever you do with it, need to tell patient and ask them what they want as well

BDS3 - Oral Surgery (7 decks)

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