Pontillas, Kyla Ma a. S dation by th inhalation of nitrous oxid is
fr qu ntly th t chniqu of choic for anxious
aMa 5y1-1
pati nts and may b th only t chniqu
r quir d for many pati nts who hav mild to
mod rat anxi ty. An xtr m ly anxious pati nt
CHAPTER 7: Principl s of Routin Exodontia who is to hav s v ral uncomplicat d
xtractions may r quir d p r s dation,
Extraction of a tooth is a proc dur that
usually by th intrav nous (IV) rout .
combin s th principl s of surg ry and
l m ntary physical t chniqu s INaICATIONS FOR REMOVAL OF TEETH
PRE-SURGICAL MEaICAL ASSESSMENT 1. Cari s
2. Pulpal n crosis
Pati nts can hav a vari ty of h alth probl ms
3. P riodontal dis as
that r quir tr atm nt modifcation or m dical
4. Orthodontic r asons
manag m nt b for surg ry can b p rform d.
5. Malpos d t th
PAIN ANa ANXIETY CONTROL 6. Crack d t th
7. Impact d t th
Profound local an sth sia is n d d if th tooth 8. Sup rnum rary t th
to b r mov d without a sharp pain for th 9. T th associat d with pathologic l sions
pati nt; th r for it is ss ntial that th 10. Radiation th rapy
surg on r m mb r th pr cis inn rvations of 11. T th involv d in jaw fractur s
all t th and surrounding sof tissu , as w ll as 12. Financial issu s
th kinds of inj ction n c ssary to an sth tii
thos n rv s compl t ly. CONTRAINaICATIONS FOR REMOVAL OF TEETH
Syst mic contraindications
1. S v r uncontroll d m tabolic dis as s
lik britl diab t s and nd stag r nal
dis as
2. L uk mia and lymphoma
3. S v r myocardial isch mia such as
unstabl angina p ctoris
4. Myocardial infarction
5. Malignant hyp rt nsion
6. Pr gnancy
7. S v r bl ding (h mophilia)/S v r
plat l t disord rs
Local contraindications
1. In an ar a of radiation that may r sult
to ost oradion crosis
2. T th within an ar a of tumor
3. T th with s v r p ricoronitis
4. Acut d ntoalv olar absc ss
SEaATION
, CLINICAL EVALUATION OF TEETH FOR REMOVAL Caus bony xpansion
C nt r of rotation of tooth is displac d
1. Acc ss to th tooth
apically
2. Mobility of th tooth
Buccal pr ssur
3. Condition of th crown
Lingual or palatal pr ssur
RAaIOGRAPHIC EXAMINATION OF THE TOOTH FOR Rotational pr ssur
REMOVAL Tractional forc s
1. R lationship to vital structur s OPEN TECHNIQUE
2. Confguration of roots
3. Condition of surrounding bon Wh n clinician b li v s xc ssiv forc would
b n c ssary to r mov th tooth wh n a
PATIENT ANa SURGEON PREPARATION substantial amount of th crown is missing or
cov r d by tissu . Wh n acc ss to th root of a
POSITIONING:
tooth is difficult (fragil crown)
Th corr ct position allows th surg on to k p
THREE FUNaAMENTAL REQUIREMENTS FOR A GOOa
th arms clos to th body and provid s
EXTRACTION
stability and support; it also allows th surg on
to k p th wrists straight nough to d liv r th 1. ad quat acc ss and visualiiation
forc with th arm and should r, and not with
th fng rs or hand. 2. unimp d d pathway for r moval of th tooth
Th forc d liv r d can, thus, b controll d in
th fac of sudd n loss of r sistanc from a root 3. Us of controll d forc to luxat and r mov
or fractur of th bon . th tooth
REMOVAL OF TEETH REQUIRES USE OF WHAT 3 STEPS OF THE CLOSEa EXTRACTION PROCEaURE
MECHANICAL PRINCIPLES ANa SIMPLE MACHINES
1. . loos n sof tissu from around tooth with
1. L v r sharp instrum nt (scalp l blad ) or sharp nd of
2. Wh l and axl No. 9 p riost al l vator
3. W dg
*allows surg on to nsur an sth sia has b n
GOAL OF FORCEPS achi v d
Expansion of bony sock t by us of w dg - *allows l vator and forc ps to b position d mor
shap d b aks apically
R moval of th tooth from th sock t
BLAaE VARIATION ON ELEVATOR
2. . Luxation of th tooth with a d ntal l vator
Triangular (cri r) (usually straight)
Curv d (pots)
Point d (cran )
3. . Adaptation of forc ps to th tooth and s at d
FORCEPS CAN APPLY 5 MAJOR MOTIONS TO LUXATE (s at lingual and th n buccal)
TEETH ANa EXPANa SOCKET
Apical pr ssur
- 2 goals
fr qu ntly th t chniqu of choic for anxious
aMa 5y1-1
pati nts and may b th only t chniqu
r quir d for many pati nts who hav mild to
mod rat anxi ty. An xtr m ly anxious pati nt
CHAPTER 7: Principl s of Routin Exodontia who is to hav s v ral uncomplicat d
xtractions may r quir d p r s dation,
Extraction of a tooth is a proc dur that
usually by th intrav nous (IV) rout .
combin s th principl s of surg ry and
l m ntary physical t chniqu s INaICATIONS FOR REMOVAL OF TEETH
PRE-SURGICAL MEaICAL ASSESSMENT 1. Cari s
2. Pulpal n crosis
Pati nts can hav a vari ty of h alth probl ms
3. P riodontal dis as
that r quir tr atm nt modifcation or m dical
4. Orthodontic r asons
manag m nt b for surg ry can b p rform d.
5. Malpos d t th
PAIN ANa ANXIETY CONTROL 6. Crack d t th
7. Impact d t th
Profound local an sth sia is n d d if th tooth 8. Sup rnum rary t th
to b r mov d without a sharp pain for th 9. T th associat d with pathologic l sions
pati nt; th r for it is ss ntial that th 10. Radiation th rapy
surg on r m mb r th pr cis inn rvations of 11. T th involv d in jaw fractur s
all t th and surrounding sof tissu , as w ll as 12. Financial issu s
th kinds of inj ction n c ssary to an sth tii
thos n rv s compl t ly. CONTRAINaICATIONS FOR REMOVAL OF TEETH
Syst mic contraindications
1. S v r uncontroll d m tabolic dis as s
lik britl diab t s and nd stag r nal
dis as
2. L uk mia and lymphoma
3. S v r myocardial isch mia such as
unstabl angina p ctoris
4. Myocardial infarction
5. Malignant hyp rt nsion
6. Pr gnancy
7. S v r bl ding (h mophilia)/S v r
plat l t disord rs
Local contraindications
1. In an ar a of radiation that may r sult
to ost oradion crosis
2. T th within an ar a of tumor
3. T th with s v r p ricoronitis
4. Acut d ntoalv olar absc ss
SEaATION
, CLINICAL EVALUATION OF TEETH FOR REMOVAL Caus bony xpansion
C nt r of rotation of tooth is displac d
1. Acc ss to th tooth
apically
2. Mobility of th tooth
Buccal pr ssur
3. Condition of th crown
Lingual or palatal pr ssur
RAaIOGRAPHIC EXAMINATION OF THE TOOTH FOR Rotational pr ssur
REMOVAL Tractional forc s
1. R lationship to vital structur s OPEN TECHNIQUE
2. Confguration of roots
3. Condition of surrounding bon Wh n clinician b li v s xc ssiv forc would
b n c ssary to r mov th tooth wh n a
PATIENT ANa SURGEON PREPARATION substantial amount of th crown is missing or
cov r d by tissu . Wh n acc ss to th root of a
POSITIONING:
tooth is difficult (fragil crown)
Th corr ct position allows th surg on to k p
THREE FUNaAMENTAL REQUIREMENTS FOR A GOOa
th arms clos to th body and provid s
EXTRACTION
stability and support; it also allows th surg on
to k p th wrists straight nough to d liv r th 1. ad quat acc ss and visualiiation
forc with th arm and should r, and not with
th fng rs or hand. 2. unimp d d pathway for r moval of th tooth
Th forc d liv r d can, thus, b controll d in
th fac of sudd n loss of r sistanc from a root 3. Us of controll d forc to luxat and r mov
or fractur of th bon . th tooth
REMOVAL OF TEETH REQUIRES USE OF WHAT 3 STEPS OF THE CLOSEa EXTRACTION PROCEaURE
MECHANICAL PRINCIPLES ANa SIMPLE MACHINES
1. . loos n sof tissu from around tooth with
1. L v r sharp instrum nt (scalp l blad ) or sharp nd of
2. Wh l and axl No. 9 p riost al l vator
3. W dg
*allows surg on to nsur an sth sia has b n
GOAL OF FORCEPS achi v d
Expansion of bony sock t by us of w dg - *allows l vator and forc ps to b position d mor
shap d b aks apically
R moval of th tooth from th sock t
BLAaE VARIATION ON ELEVATOR
2. . Luxation of th tooth with a d ntal l vator
Triangular (cri r) (usually straight)
Curv d (pots)
Point d (cran )
3. . Adaptation of forc ps to th tooth and s at d
FORCEPS CAN APPLY 5 MAJOR MOTIONS TO LUXATE (s at lingual and th n buccal)
TEETH ANa EXPANa SOCKET
Apical pr ssur
- 2 goals
