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True or false.. you use the same instruments to extract primary teeth as you do to extract permanent teeth



What are some differences between primary and permanent teeth?

Smaller teeth

Crowns are more bulbous

Root furcations are more cervical

Roots are thinner and flare more

Roots of primary teeth naturally resorb

The alveolus is much more elastic


What are the differences in the types of forceps you use to extract primary teeth in comparison to permanent teeth?

Beaks and handles are smaller to accommodate a more bulbous crown

Beaks are more curved in forceps


What do you have to do to compensate for the wide splaying of primary molar roots?

More expansion of the socket

Strong apical pressure!


What are some modifications to extraction technique that you use in children?

Don't plunge deeply with beaks around primary molars because the bifurcation is very cervical (dont want to hit underlying tooth)

Avoid blind investigation of primary socket (avoid hitting underlying tooth)

Because of physiological resorption it is often preferable to leave small fragments in situ if root fractures


Why dont you typically section primary teeth for extraction?

Don't want to risk hitting the permanent tooth. You're not going to cause problems if you leave some tooth behind. The primary root tips behind wil either be resorbed or erupted.


True or false.. you should NEVER leave a primary root tip behind

False. It is preferable to leave the tips in to avoid damage to underlying tooth


What are the indication for extraction of deciduous teeth?

Badly carious teeth

Preventing eruption of permanent teeth

Periapical infection

For Orthodontics purposes

Supernumerary teeth

Vertical fracture

Ankylosed primary teeth

Impacted teeth

Ectopically positioned teeth


Why cant you extract a tooth of a 17 yo if they come in alone?

Any one under the age of 18 is considered a minor and requires parental consent before procedure


What are the five steps to extract a pediactric tooth?

Parental consent before the procedure

Instruct the parent not to discuss with the child what the dentist will do

Armamentarium should be kept out of site of child

Before giving the LA, explain to the child sensation of pinching or an ant biting feeling

Extraction with controlled force in a deliberate fashion


What is the most common tooth extraction?

Third molars


True or false... the younger you are the higher the risks of extracting third molars

False.. the older you get the higher the risks are


True or false... ALL third molars need to be removed.



True or false.. third molars must be removed for orthodontic purposes.

Maybe maybe not. The literature isn't consistent


Why is the extraction of third molars the most common surgical procedure in dentistry?

Limit progression of periodontal disease (perio pathology initiates in the 3rd molar region. Perio disease associated with systemic disase)

Absence of symptoms does not indicate absence of diseases or pathology

Dental crowding

Removal prior to 25 minimizes risk


True or false.. abscess of symptoms does not indicate absence of diseases or pathology



What is the most reliable thing to examine when determining if the third molar is ready to be extracted, age or root development?

Root development


What are the 2 main risks when extracting third molars?

Sinus perforation

Damage to IA


What are some possible complications of third molar extraction?

Lingual nerve injury

IAN injury (temporary or permanent (typically from not performing the surgery correctly)

Damage to adjacent teeth

Alveolar osteitis (dry socket)

Subperiosteal injection

Mandibular fracture


What are the 5 treatment options for impacted canine?



Surgical exposure and assisted eruption

Surgical uprighting



What is the third most commonly impacted tooth after maxillary and mandibular 3rds?

Maxillary canine


What is the ideal age to extract maxillary impacted canines?


(18 or older is high risk)


Name 7 factors to consider when determining whether or not to extract an impacted maxillary canine.


Past medical hx

Potential pathology

Location to adjacent teeth


Risk of surgery


Surgical exposure of an impacted maxillary canine requires coordination between ___ and ___. There needs to be ___. And the orthodontic appliances are placed __ to exposure.

Surgeon and orthodontist

Adequate space



What is a risk when the impacted canines are angled?

It can burn the roots out of adjacent teeth when you pull the canine down.

If the pt is over 12 surgical assisted eruption is NOT recommended. Better to extract them


75% of the time, maxillary canine teeth are impacted towards the ___


Not labial


Canines are impacted labially __% of the time. In this case, it is critical to....


Critical to maintain the cervical margin of attached mucosa on the erupted impacted tooth


What are the treatment options of a labially impacted canine?

Apical positioned flap

Closed technique


What is the apical flap? How is it used in treating a labially impacted canine?

Attach gingiva to CEJ, then pulll the tooth down.


What is the most frequently occurring odontogenic tumor in pediatric pts?