oralsurgery week2

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emm64
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213865
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oralsurgery week2
Updated:
2013-04-16 10:40:23
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oralsurgery week2
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oralsurgery week2
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  1. Clinical assessment of extraction
    • access: opening, location
    • mobility: perio disease, hypercementosis, ankylosis(primary molars)
    • crown condition: caries, restoration
  2. radiographic requirements
    • exposure
    • position
    • processing
    • recent
    • visible during procedure
    • relationship to vital structures
    • root configuration
  3. What effect does endo have on roots as it relates to extraction?
    • brittle: internally weakened through shaping
    • ankylosis
  4. maxillary extraction positioning
    • occlusal plane 60 degree angle with floor
    • height: operator elbow
    • pt head straight for anteriors
    • toward operator for posterior
  5. mandibular extraction position
    • more upright when open occlusal plane parallel to floor
    • use bite block
    • 120 degree angle at operator elbow
  6. elevator
    • primarily lever (long lever arm, short effector arm)
    • transmit modest force into small movement against greater resistance
    • purchase point (crane pick)
  7. wedge
    • beaks of forceps
    • straight elevator into PDL
  8. wheel & axel
    • triangular, pennant elevator
    • multirooted tooth
  9. forceps
    • wedge beaks: expand bony socket
    • remove tooth
    • 1. apical pressure: bony expansion, displace center of rotation apically (decrease fracture risk)
    • 2. buccal force: expand buccal plate, does cause lingual apical pressure
    • 3. lingual force: expand linguocrestal bone
    • 4. rotational pressure: usually for single conical rooted teeth
    • 5. fractional forces: deliver tooth after adquately expanded.
  10. which teeth are typically weaker lingually?
    mandibular molars
  11. extraction requirements for success
    • 1. access and visualization
    • 2. unimpeded removal pathway
    • 3. contolled force
  12. closed extraction steps
    • 1. loosen soft tissue (woodson elevator, no 9 periosteal elevator)
    • a. confirm anesthesia
    • b. allow proper forcep positioning
    • 2. luxation w/ dental elevator
    • 3. adapt forceps to tooth
    • 4. luxation with forceps
    • a. apically seat
    • b. buccal lingual slow deliberate force
    • c. hold force for several seconds
    • 5. removal from socket
  13. when is a tooth removed
    • after:
    • 1. bone is expanded
    • 2. PDL is disrupted
  14. Maxillary forceps
    • anterior & premolars: 150, 150A
    • molars: 53R, 53L, 89, 90(aka upper cowhorn)
  15. mandibular forceps
    • anteriors & premolars:151, 151A, english ashe
    • molars: 17, 23(squeeze into bifurcation), 222 (erupted 3rds)
  16. primary forceps
    150S, 151S
  17. Should extraction socket be debrided or curretaged?
    NO, unless periapical lesion and granuloma or debris
  18. what complication does granulation tissue in socket pose?
    excessive bleeding
  19. post op care
    • 1. remove granuloma cyst or debris
    • 2. compress buccolingual plates
    • 3. remove bony projections

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