Flashcards in Introduction To Extractions Deck (24):
Distinguish luxators and elevators in appearance
Luxators -thinner working ends with a sharper blade
Elevators - more rounded at the end, blade is slightly more spoon shaped.
What are winged elevators?
Working end well adapted to tooth shape, narrow shaft better for visualisation
How should you hold an elevator or luxators?
With a palm grasp
What should you ensure with extraction forceps?
Ensure beaks meet
What can you use to retrieve root fragments? 3
Root tip picks, root tip elevators, root tip extraction forceps
What holds the tooth root in the alveolar socket? 2
Gingiva and periodontal ligament
What are the broad steps of direct extractions?
1cut gingival attachment
2 insert luxators into periodontal ligament space
3 use elevator for rotation around long axis until wedged and hold under tension
4 repeat step 3 at different locations
5 use extraction forceps on apical crown, rotate and then apply traction then in opposite direction
What should you check an extracted root for?
Check the apex for roundness and completeness, suspect root fragmentation of sharp edges
What should you use to cut gingival attachment?
Scalpel blade no. 11 or 15 or luxator
What angle should you hold the luxator to the tooth?
Why should you avoid holding the luxator parallel to the tooth?
Risk of slipping onto alveolar bone
How should you use the elevator?
Insert where luxator was then rotate slowly, avoid tilting or quick digging movements, count to 10 while holding instrument under tension.
Anatomical term for direction towards the point between the central incisors
Define distal in the context of dentistry
Anatomical term for direction away from the point between the central incisors
How do you operate a dental drill?
Always ensure water spray functions, activate foot pedal fully for full speed rotations before touching tooth, alternate 2seconds of pressure and drilling with one second of easing off.
Outline the broad steps required for the direct extraction of a multi rooted tooth.
1 cut gingival attachments
2 transect tooth at furcation
3 confirm independent mobility of the segments
What should you use to cut the gingival attachment and how should you hold it?
Tapered fissure cutting bar with the modified pen grasp
How do you transect the tooth at the furcation?
Point tip of the 702 bur towards the furcation and hold it at a slight angle to the crown. The preferred shape is a slight v shape as is makes it easier to insert the elevator later.
How do you confirm independent mobility of the tooth segments?
Insert a small elevator at a 90 degree angle then very gently rotate it around its long axis. Do the two sections move independently of are they still connected?
What should you bear in mind with teeth 108 and 208 when sectioning them?
They are three rooted and the furcation is mesial to the centre of the crown. It helps to reduce the crown height first if the tooth is very big e.g. In a very large dog.
How should you section 109 or 209?
The first cut should section between the palatial and the two buccal roots. This way the second cut between the two buccal roots will find a natural stop.
What should you consider when removing maxillary PM4 distal root?
Use a tapered fissure to cut bur size 701 to remove the distal overhang of the crown to create space for the elevator. Take care not to cut into the crown of molar 1!
What are some possible complications of extractions?4
Root fragmentation, jaw bone necrosis (especially if dental drill hasn't been adequately cooled), iatrogenic jaw fracture and oronasal fistula