TEETH EXTRACTION EXTRACTING TEETH (EXODONTIA) Reasons - indications ➢ Caries ➢ Trauma ➢ Periodontitis ➢ Endodontic reasons ➢ Retention, semiretention if it causes heavy inflammation and pain ➢ Supernumerary tooth CONTRAINDICATIONS • Serious systemic diseases e.g. leukeaemia, agranulocytosis, disease with ulcerative changes esp. in oral cavity Acute infection diseases and other diseases when extraction would be a risk for the patient. Relative and absolute contraindications – see clinical part od the study. PRINCIPLES OF EXTRACTION Interruption, rupture of preiodontal Ligaments and extraction - the tooth is pulled out. Extraction – extraction wound INSTRUMENTS • Elevators Interruption of periodontal ligaments, dilatation of the socket Elevators for special situations • Forceps Realeasing of the tooth – pulling out STRAIGHT ELEVATOR EXTRACTION ELEVATORS Source www.Pocket dentistry.com SPECIAL ELEVATORS Acc. To Schlemmer Barry- Winter For extraction of roots in lower jaw Through the septum EXTRACTION FORCEPS Source: www. Pocket dentistry.com EXTRACTION FORCEPS Beaks The beaks of extraction forceps are designed to fit around the curve of the tooth’s crown Universal forceps have a beak that can be used in any quadrant of the mouth Forceps designed for multi-rooted teeth have beaks with a point that is adapted to grip the tooth furcation Forceps designed for single-rooted teeth usually have smooth beaks EXTRACTION FORCEPS Handle • A serrated handle allows the operator to have a better grip • A palm grasp is used with the handle of extraction forceps • Handles of maxillary forceps are often curved upwards, or straight, the beak in line with the handle • Mandibular forceps tend to have a straight handle with the beak at a 90° angle to the handle • EXTRACTION FORCEPS Hinge • Extraction forceps have hinges (can be screw or pin type) allowing the beak and handle to be opened and grasped Forceps For crown – open For roots - closed For upper jaw – Straight or s-shaped hndle Lower jaw – beaks and handle In 90°angle Beaks Hinge Handle BEAKS ARE ALWAYS IN LONG AXIS OF THE CROWN TYPES OF EXTRACTIONS • Simple – single,multiple • Complicated • Surgical SURGICAL EXTRACTION FORCEPS FOR UPPER INCISORS FORCEPS FOR UPPER PREMOLARS Horní kleště premolárové, liší se od řezákových esovitým vyhnutím držadla FORCEPS FOR UPPER ROOTS – BEAKS ARE CLOSED Kleště dovírají ! FORCEPS FOR UPPER MOLARS – POINTED PART GOES INTO FURCATION. THIS FORCEPS IS PAIRED – LEFT AND RIGHT FORCEPS FOR UPPER THIRD MOLARS Special curvature beaks can reach the area of third molars. FORCPES FOR LOWER INCISORS, CANINES AND PREMOLARS FORCEPS FOR LOWER ROOTS For incisors are open For roots are closed FORCEPS FOR LOWER MOLARS Beaks are pointed – go into furcation FORCEPS FOR LOWER THIRS MOLARS HAEMOSTATIC PLIERS • Pean • Cochr FORCEPS FOR PRIMARY TEETH - MOLARS TISSUE RETRACTORS TISSUE RETRACTORS RAISING THE FLAP (MUCOSA AND PERIOSTEUM) RONGUERS SUTURE Instruments: Needles: bent Straight Various size Needleholder: Without fixation Autofix Tweerezs anatomical Tweezers – surgical SURGICAL KNIFE Interchangeable blades