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عبد الرحمن خالد الزميلي Assighment Of Dental Surgery /Principle of routine exodontia
عبد الرحمن خالد الزميلي Assighment Of Dental Surgery /Principle of routine exodontia
: Supervised
Dr . Emad Majdalawy
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بسم هللا الرحمن الرحيم
عبد الرحمن خالد فهمي الزميلي/ اسم الطالب جامعة األزهر غزة
20170475 /الرقم الجامعي كلية طب االسنان
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There are two techniques involved in the extraction:
1. Simple extraction (also called closed method, forceps technique,
intra-alveolar technique): which involve using forceps and/or
elevator to luxate the tooth and extract it.
Indications Of Extraction:
advocated for dental extraction:
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12 -Economical reason ; Unaffording patient.
options.
Contraindications Of Extraction:
Systemic Local
1-Local contraindications
1- Irradiated jaw which may lead to osteoradionerosis due to
endarteritis obliterans
Cause: metastasis.
4-Acute cellulites
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2-Systemic contraindications
1. Uncontrolled diabetes mellitus
6. Addison’s disease
chemotherapeutic agents).
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PRE OPERATIVE ASSESSMENT
A. History Taking
1. Medical History :
2. Dental History
B: . Clinical Examination
(i)Accessibility (mouth opening)
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Relation To Vital Structure (Maxillary Sinus, Inferior Dental
Nerve)
SURGEON PREPARATION
1. Wear of Hand gloves
2. Mask 3.
4. Surgical Gown
PATIENTS PREPARATION
1. Prophylactic Antibiotics
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(i) Scaling
(ii) Polishing
(iii) Brushing
Surgeon Positon
For all maxillary teeth , anterior mandibular teeth & teeth of the 3rd
quadrant : Right front position.
For teeth of the 4th quadrant : Right back position
illumination
Good illumination of the operator field is an absolute essential for
successful extraction of teeth.
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Requirements of Ideal Extraction
1. Satisfactory access and visualization of the field of surgery.
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• Excess motion of root apex caused by high
center of rotation results in fracture of root
apex.
• Buccal or labial pressure applied to tooth will
expand the buccal cortical plate toward the
crestal bone with some lingual expansion at
apical end of the root.
• Lingual or palatal pressure will expand lingual
cortical plate at crestal area and slightly expand
buccal bone at apical area.
• The initial linguo-buccal movement for
extraction of lower second mandibular molar.
• Initial rotational forces It is useful for removal of
teeth with conical roots; such as maxillary
central.
• Tractional forces are useful for final removal of
tooth from socket. They should always be small
forces, because teeth are not "pulled."
• The Final withdrawal movement for Most of the
upper and lower teeth is an outward- occlusal
direction. Except the lower third molar which
should be in a lingual- occlusal way and
maxillary 3rd molar should be disto-buccal.
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The proper use of forceps
in luxation and removal of teeth
1. The extraction movements are essentially three movements
which are outward, inward, and rotatory movements.
7. The force should be held for several seconds to allow the bone time to
expand.
8. Once the alveolar bone has expanded sufficiently and the tooth has been
luxated, a slight traction force, usually directed buccally, can be used.
9. Final movement is the movement by which the tooth is removed from its
bony socket. It should be always directed outward and occlusally to avoid
traumatizing the opposing tooth,
10. The extraction forceps blade should be applied to the carious side first,
and the first movement made toward the caries.
Insertion of wedge
• The wedge principle is useful for the extraction of
teeth in several different ways.
1. By using the beaks of the extraction forceps as a
wedge.
2. When a straight elevator is used to luxate a tooth
from its socket.
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Procedure for closed extraction:
Requirements for extraction
• Adequate access and visibility
• Unimpeded pathway of removal
• Use of controlled force.
Role of assistant
Helps to visualize and gain access, by
reflecting soft tissues and tongue
Suction away blood, saliva, irrigating
solution
Stabilize mandible
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Maxillary Incisor Teeth:
. Left index finger reflects the soft tissue & thumb rests on
alveolar process.
Maxillary Canine
• Longests tooth in the mouth.
• Bone over labial part is quite thin.
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• Universal no:150 forceps is used.
• Initial movement is buccaly.
• Small amount of lingual force is applied.
Maxillary Molars:
• It has 3 large and relatively strong roots.
• Paired forceps no.53R and 53L are used.
• Luxation begins with a strong buccal force.
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• Lingual pressure are used moderately.
• Teeth is delivered in buccolingual direction.
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• Tooth is delivered in labial incisal direction.
Mandibular Premolars:
• They are easiest teeth to remove.
• The overlying bone is thin on the buccal aspect and
somewhat heavier on lingual side.
• Lower universal no 151 forceps is used.
• Buccal force followed by slight lingual pressure is used for
luxation. Mandibular Molars:
• No 17 forceps is used.
• If tooth roots are closely bi furcated no:23 or cow horn
forceps can be used.
• No 17 forceps is seated as far apically as possible.Luxation
of molar begin with a strong buccal movement.Strong lingual
pressure is used to continue luxation.
AFTER CARE
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TANK YOU