L3- Exodontia Flashcards
(88 cards)
instead of ‘getting a clearance’ you talk to physcian about
is the patient optimized?
*important to determine the severity and stability of the medical condition vs clearance– you make the final call with the information you are given
if implants are done you need
socket preservation
patient factors in terms of race
race - may affect the density of bone
what makes retraction and visibility more difficult
think cheeks and large tongues
teeth with minimal PDL space and need extraction?
with minimal PDL space – the roots are close to adjacent teeth
tooth factors that can cause adverse affects
- endo treated teeth
- minimal PDL space - roots of adjacent are closer
- long, divergent roots
- status of the neighboring teeth
- tooth is adjacent to a large crown or restoration
orthodontic reasons for extraction
pre-molars
- most common wrong teeth extracted as well
absolute contraindications for exrttactions
severe uncontrolled metabolic diseases - diabetes, or end stage renal/ liver failure
uncontrolled leukemias, lymphomas,
due to risk of infection and bleeding
UNSTABLE ANGINA
severe hypertension, hyperthyroidism
severe bleeding disorders
patients on chemotherapy, immunosuppressants, bisphosponates
patients on high dose corticosteroids
if patient is unable to give consent or not sure about the plan
rule of thumb for pregnant pateints
postpone ELECTIVE extractions otherwirse 2nd tri-mester is safe
if patient is in pain then extractions can be done in any trimester
x- rays are safe
teeth in region of recent radiotherapy?
this is considered a local contraindication
- at risk of osteonecorsis
acute pericoronitis around a lower third molar? note what
this can be considered a local contraindication
- consider
extracting the OPPOSING tooth if it is hiting the operculum, antibiotics or irrigation
acute abscess significance if present and need extraction?
extracting the cause is preferable but anethesia, access may be a challenge
- draining abscess, antibiotics, then extraction in 2-3 days
principle #1
know the patient
principle #2
you have to see it to do it
4 main tools to use for examining the oral cavity
- tongue blades
- seldin retractor
- minnesota retractor
- mirror,explorer, probe
went encompeses the consent
discussion of risks, complications, and alternatives
like make them aware that there is a large restoration adjacent and there is a chance that it comes out with the extraction of the adjacent one
concept of Time Out
list of the protocol and a checklist that basically goes through everything
principle #3
if a patient is not comfortable you will never be
LA suggested with local anesthesia
lidocaine 2% with 1:100000 epi is the most commonly used local anesthetic and suggested with NERVE BLOCKS
suggested use for nerve blocks
lidocaine 2 with 1:100000 epi
suggest use what for infiltrationns
articaine 4% with 1:100000 epi (often used)
use what if epi is not advised
use mepivicaine 3%
due to cardiac conditions
long acting LA and its use
bupivicaine 0.5% solution is used when long acting anesthesia is required like after third molar surgeries
what does raising a flap allow for
allows you to hold the tooth beyond the coronal structure
allows you to access to bone should its removal be necessary
