CHAPTER 3 Flashcards
(14 cards)
FIVE MAJOR MOTIONS IN THE USE OF DENTAL FORCEPS
1) APICAL PRESSURE
- first force that is generated as the tooth socket expands by insertion of beaks down into the periodontal ligament space and gain an apical seat
2) BUCCAL PRESSURE
- produces the expansion of the buccal plate and lingual apical pressure
3) LINGUAL PRESSURE
-produces the expansion the lingual cortical plate and buccal apical pressure
4) ROTATIONAL PRESSURE
- internal expansion of the socket breaks the periodontal fibers which helps tooth movement notfor multi-rooted teeth & only for teeth with single conical roots (not curved or dilacerated)
- usually applied for maxillary incisors, mandibular incisors, & mandibular premolars
5) TRACTIONAL FORCE
- used for delivering the tooth out of the alveolar socket
General steps in tooth extraction for closed technique.
- Loosening of soft tissue attachment from the tooth.
- Luxation of the tooth with an elevator.
- Adaptation of the forceps to the tooth.
- Luxation of the tooth with a forcep.
- Removal of the tooth from the socket.
Procedures for alveolar purchase.
A) detach the labial gingival cuff using a small, sharp curette
B) labial beak of the forcep is placed under the tissue on the labial plate of the alveolar bone
C) pressure of sharp forceps will grasp the root along the labial alveolar bone
D) tooth or root can be delivered with the labial alveolar bone easily
well-planned sequence of tooth removal during the transition from the primary dentition to the secondary dentition
SERIAL TOOTH EXTRACTION
BASIC SURGICAL FLAPS USED IN THE ORAL SURGERY
- Trapezoiodal flap
- Triangular flap
- Envelope flap
- Semilunar flap
- Pedicle flap/Attached flap
a. Buccal flap
b. Palatal flap
c. Pedicle bridge flap - Other types of flaps
a. Y-SHAPED FLAP
b. X-SHAPED FLAP
TWO MAIN OPEN TECHNIQUES USED TO REMOVE ROOT TIPS
a. Extension of a technique used for single-rooted teeth
b. Open window technique
3 CONDITIONS TO CONSIDER LEAVING A FRACTURED ROOT W/IN THE SOCKET:
l
1) fractures root is only a small root fragment: not exceeding 4-5mm in length
2) root is not superficial and is deeply embedded in the bone
3)
tooth involved is not be infected & there with no radiolucency around the apex as seen on a radiograph
3 CONDITIONS WHEN RISK IS GREATER IF THE ROOT IS REMOVED:
1) removal will cause excessive destruction of the surrounding tissues or excessive amount of bone must be removed to retrieve the root
2) removal endangers important structures such as the inferior alveolar nerve (IAN)
3) attempts at removing the root tip has a high risk of displacing the root tip into the tissue spaces or the maxillary sinus
COMPLICATIONS OF TOOTH EXTRACTION
LOCAL
IMMEDIATE
- failure of local anesthesia
- failure to remove the tooth
- fracture of the tooth, alveolus, mandible and/or maxila
- oro-antral communication
- displacement into the soft tissues
- hemorrhage
- temporomandibular joint (TMJ) dislocation
- nerve injury and damage to the ophthalmic (V1), maxillary division (V2), and the mandibular division (V3) of the trigeminal nerve
DELAYED
- excessive pain, swelling, and trismus
- bleeding
- dry socket / alveolar osteitis
- mechanical dislodgement of the clot
- acute osteomyelitis (acute infection of the bone & bone marrow)
- infection
- oro-antral fistula
-failure of the socket to heal normally
- nerve damage
LATE
- chronic osteomyelitis (chronic infection of the bone & bone marrow)
- osteoradionecrosis/ORN(condition of non-vital bone after radiation therapy)
- chronic pain
- nerve damage
COMPLICATIONS OF TOOTH EXTRACTION
SYSTEMIC
- syncope / fainting (transient loss of consciousness due to cerebral ischemia)
- hypoglycemia (low blood glucose)
- hyperventilation (panic attack)
- fits / tantrums
- myocardial infarction (heart attack)
- addisonian crisis (extremely low levels of cortisol)
- respiratory obstruction
DRY SOCKET / ALVEOLAR OSTEITIS
- refers to localized osteitis involving either whole or part of the condensed bone lining of a tooth socket
- one of the most common & most painful complication from tooth extractions
CAUSES OF DRY SOCKET/ALVEOLAR OSTEITIS
- undue trauma during extraction
- pre-existing infection
- disturbance of the blood clot during vigorous mouthwash use or by curettage
- increased fibrolytic activity
- localized impaired vascular supply
- smoking
- use of oral conceptive pills
CLINICAL FEATURES
- recent extraction (48-72 hours)
- unpleasant or foul odor (halitosis)
- continuous throbbing and excruciating pain
- alveolar socket is covered with grayish necrotic tissue
- denuded alveolar bone
POSTOPERATIVE INSTRUCTIONS FOR THE PATIENT
- Rest
- Side-effects
- Edema
- Bleeding
- Diet
- Oral Hygiene
- Habits
- Activity
- Removal of sutures
- Medications
