Dental Extractions 1

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Author:
kris10leejmu
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177794
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Dental Extractions 1
Updated:
2012-10-15 13:29:00
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Clinical Practice ll
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Clinical Practice ll
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  1. What is the importance of extracting teeth?
    provides relief from pain and infection for teeth that cannot be saved
  2. What does the Virginia Board of Veterinary Medicine state about teeth extractions for LVTs?
    surgery does not include routine dental extractions
  3. Which dental extractions are LVTs not allowed to perform?
    • sectioning teeth
    • surgical extractions
  4. What are the different categories of dental extractions?
    • simple extractions (1 root)
    • sectioned extractions
    • surgical extractions
  5. What are surgical extractions?
    alveolar bone is removed to get to the tooth roots
  6. What are simple extractions?
    single rooted tooth
  7. How do we remove simple extractions?
    with a dental elevator and maybe extraction forceps
  8. What are sectioned extractions?
    • multi-rooted tooth is cut into one section for each root
    • cut between roots to the surface of the crown because roots diverge
  9. Can LVTs removed multi-rooted tooth after the veterinarian has sectioned them into single rooted sections?
    yes
  10. What kind of pain management do we use for dental extractions?
    • medical management - pre and post extraction medications
    • nerve blocks (regional or local)
  11. The top 1/3 of the alveolar bone surrounding the tooth has _____ of the holding power.
    2/3
  12. What can not withstand slow, continuous torque?
    periodontal fibers
  13. What must be preserved when extracting teeth?
    gingiva
  14. How do we confirm a complete extraction of a root?
    take a radiograph
  15. Why do we close the alveolus after extracting a tooth?
    maintain the blood clot
  16. What are some indications for dental extractions?
    • end-stage periodontal disease
    • end-stage endodontic disease (abscessation)
    • retained deciduous teeth
    • pulp exposure when endodontic treatment is not elected due to cost or animals habits (keeps on chewing on things, breaking teeth)
    • malocclusions
    • crowding
    • plaque intolerant animals
    • feline odontoclastic resorptive lesion
    • disarming
    • trauma
  17. What is the labial?
    surface of tooth facing lips
  18. Define buccal.
    surface of tooth facing check - caudal to commissure of lips
  19. Define facial.
    includes labial and buccal
  20. Define palatal.
    surface of tooth facing palate - upper arcade
  21. Define lingual.
    surface of tooth facing tongue - lower arcade
  22. Define mesial.
    surface between teeth facing toward midline
  23. Define distal.
    surface between teeth, facing away from the midline
  24. Define occlusal.
    surface of upper and lower teeth that contact each other (chewing surface)
  25. Define cervically.
    on the crown, towards the neck of the tooth
  26. Define occlusally.
    on the crown, toward the occlusal surface
  27. Defin coronally.
    on the root, toward the crown
  28. Define apically.
    on the root, toward the apex, or tip of the root
  29. When should dental radiography be performed?
    before and after extraction
  30. Why should we perform dental radiographies before extracting teeth?
    to know...how many roots, abscesses, fractures, widened periodontal ligament space
  31. Why do we take dental radiographs after extracting teeth?
    to make sure the entire tooth was removed - no tips left in
  32. Which teeth in dogs are suitable for simple extractions?
    • incisors (upper and lower)
    • first premolars (upper and lower)
  33. Which teeth in cats are suitable for simple extractions?
    • incisors (upper and lower)
    • canines (upper and maybe lower if loose)
    • premolars (upper second premolars and no upper first premolars)
    • molars (upper first)
  34. What kind of equipment do we need for dental extractions?
    • dental elevators
    • luxators (not as common)
    • extraction forceps
    • suturing material
    • mouth gags
    • gauze sponges
    • air/water syringe
    • chlorhexidine flush
    • analgesic syringe
  35. Do dental elevators come in different sizes?
    yes
  36. How do we know what size dental elevator to use?
    should be narrower than the root, sharp at tip
  37. What are luxators?
    like elevators, but slimmer - for cutting periodontal ligament
  38. Which uses harder steel, dental elevators or luxators?
    dental elevators
  39. What are extraction forceps?
    like pliers
  40. Do extraction forceps come in different sizes and styles?
    yes
  41. When do we use the extraction forceps?
    use last, after tooth is significanly loosened
  42. What can happen if we use the extraction forceps too soon?
    if used alone or too soon, can fracture the tooth
  43. What kind of equipment do we need for suturing after extracting a tooth?
    • needle holders
    • thumb forceps
    • scissors
    • suture material (absorbable)
  44. Why do we need to support the jaw when extracting teeth?
    to prevent fractures
  45. Describe the procedure for a simple extraction.
    • sever attachment of gingiva to CEJ
    • loosen gingiva from bone
    • place elevator tightly to neck of tooth, as far mesially or distally as possible (between teeth)
    • press elevator into periodontal ligament space
    • use short, rotating movements and leverage to break down the periodontal ligament
  46. The elevator acts as a _____ for extractions.
    wedge
  47. What happens when the elevator is pushed down into the periodontal ligament space?
    it tends to force the root out of the alveolus
  48. How do we press the elevator into the periodontal ligament space?
    • pointing toward the tip
    • extend your index finger along the blade of the elevator
    • this acts as a stop if the instrument should slip
  49. Why do we use short, rotating movements?
    this breaks some ligaments, so you can push the elevator deeper
  50. How do we use a leverage motion to remove the tooth?
    • keep elevator still in socket, twist slightly
    • hold in this poistion for at least 5 - 10 seconds until the fibers fatigue and break
  51. After extracting the tooth, what do we need to curette out?
    curette out (debride) any infected or necrotic tissue from alveolus
  52. What should the alveolus always be filled with after an extraction?
    a clot
  53. If there is no clot in the alveolus after an extraction what should we do?
    curette until it bleeds and clots
  54. After we have removed the tooth, what do we do?
    • lavage with disinfectant solution (chlorhexidine)
    • suture extraction site if necessary
  55. How do we extract deciduous teeth?
    • take care not to damage the emerging adult tooth
    • gradually work with elevator, with the tip against the deciduous root
    • do not lever against the adult tooth - its root is not very subtantial yet

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