Part3.Extraction Of Teeth

Extraction of Teeth

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Wang YinStomatology Department ,

General Hospital affiliated to Tianjin Medical University

Indication (1)

• foci of infections

• nonvital pulps or pulpitis• severe periodontoclasia#4. Severe Periodontoclasia

• not treatble by apioectomy

• interfering with the placement of restorative appliances

• not restorable by operative dentistry• impacted teeth #5. Impacted Teeth

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Severe Periodontoclasia

Impacted Teeth

• A tooth is spoken of as being impacted when its eruption is partially or wholly obstructed by bone or some other teeth.

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Impacted Teeth

• Mesialclination impaction

• Distalclination impaction

• Vertical impaction

• Horizontal impaction

• Inverted impaction

• Buccalclination impaction

• Lingualclination impaction

Etiology of Impacted Teeth

• Acute infectious fevers of childhood

• Inflammation of the peridental membrane

• Severe traumatism to the jaws

• Ankylosis of the mandibular joint

• Early extraction of deciduous teeth

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Local Effects of Impacted Teeth

• decay of the front tooth #9. Decay of Front Tooth

• absorption of the root of the front molar

• neuralgia• pericoronal infection #10. 幻灯片 10

• pericoronal abscess

• cellulitis #11. Submasseteric Space Cellulitis • Osteomyelitis #12. Diagnosis of Impacted Teeth

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Decay of Front Tooth#8. Local Effects of Impacted Teeth

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Pericoronal Infection #8. Local Effects of Impacted Teeth

Submasseteric Space Cellulitis #8. Local Effects o

f Impacted Teeth

Diagnosis of Impacted Teeth

• Pantomogram

• Dental film

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Pantomogram

Pantomogram

Indication (2)

• supernumerary teeth #16. Supernumerary Teeth

• retained deciduous teeth #22. Retained Deciduous Teeth #15. Indication (2)

• fractured crown• malposed teeth #23. Malposed Teeth #15. Indication (2)

• roots #24. 幻灯片 24

• traumatizing soft tissues #26. Contraindications of the Extraction of Teeth

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Supernumerary Teeth

Supernumerary Teeth

Supernumerary Teeth

Supernumerary Teeth

Supernumerary Teeth

Supernumerary Teeth #15. Indication (2)

Retained Deciduous Teeth #15. Indication (2)

Malposed Teeth #15. Indication (2)

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Roots

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Roots #15. Indication (2)

Contraindications of the Extraction of Teeth

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Local Contraindication

• Acute infection with an uncontrolled cellulitis

• acute pericoronitis

• acute infectious stomatitis

• malignant disease

• radio therapy (osteoradionecrosis)

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Systemic Contraindication• diabetes• cardiac disease• blood dyscrasias• debility disease• steroid deficiency• fever of unexplained origin• nephritis• pregnancy or menstruation• senility

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Complication• loosening of adjacent teeth • fracture of adjacent teeth and restorations• fracture of the buccal or labial plate• teeth or roots into the maxillary sinus• injury to the inferior alveolar nerve• postoperative hemorrhage• postoperative pain• dry soket• ecchymosis

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Postoperative Hemorrhage’ leading cause

• patient’s manipulation of the wound

• foreign body in the socket

• sharp bone margins and fractured soket walls

• excessive granulation tissue

• hypertension

• clotting deficiency or vascular disorder

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Instrument

• Forceps

• Elevator

• Chisel

• Mallet

• Bur

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