The method of tooth extraction depends on several factors, the main one being the degree of destruction of the tooth being removed. Thus, teeth with a retained crown are often removed using forceps; when removing roots, the technique is completely different - elevators are used.
Tooth extraction can be: simple, complex or atypical.
- In a simple tooth extraction, only one instrument is used.
- If the doctor uses two or more instruments, then this is a complex removal (gouging out, sawing out the tooth with a drill, etc.).
- In case of atypical removal, an incision is made in the mucous membrane and a mucoperiosteal flap is cut out.
When removing a tooth with a retained crown, the doctor must sequentially perform the following steps:
- Detachment of the circular ligament of the tooth is carried out with a trowel from the vestibular and oral sides, which subsequently facilitates the application of forceps. Also, with this manipulation, the doctor checks how well the local anesthesia worked.
- Applying the cheeks with forceps - the doctor spreads the cheeks so that the crown of the tooth to be removed fits between them. The forceps must be applied in such a way that their axis coincides with the axis of the tooth.
- Advancement of the forceps - you need to move the cheeks under the gum until you feel a tight grip on the tooth.
- Closing (fixation) - the handles of the forceps are then compressed, thereby fixing the tooth with the cheeks. If the forceps are closed weakly, it is impossible to loosen the tooth; if the forceps are squeezed too tightly, the crown of the tooth can be broken.
- Tooth luxation – the doctor may rotate the tooth (rotation) or wobble it (luxation). Such movements are carried out with a gradual increase in their amplitude. Rotation can be applied to single-rooted teeth (incisors, canines and premolars) lower jaw) and free-standing roots of multi-rooted teeth. Luxation is indicated for teeth with multiple roots, but it can also be used for single-rooted teeth. Important point– the direction of the first movement when removing a tooth, which should be directed towards the least resistance. So, when removing teeth upper jaw the tooth begins to dislocate outward (with the exception of the first molars, when the first movement should be carried out in the palatal direction). On the lower jaw, the seventh and eighth teeth begin to loosen lingually, the rest - buccally.
- Tooth extraction - after the tooth being removed is completely separated from the retaining ligaments, it is carefully removed from the socket. The direction of movement is outward and up or down (depending on which jaw tooth is being removed).
The technique of removing teeth using elevators requires the doctor to have experience working with them. The most important thing is to find a fulcrum for the working part of the tool.
So, with a thick alveolar wall, they try to pass the elevator between the root of the tooth and the wall of the socket, after which they carry out rotational movements tool, gradually loosening the tooth.
When deleting lower molars It is often possible to penetrate the root furcation area with a narrow elevator, after which the tooth is lifted (like a lever), removing it from the socket. Sometimes a molar breaks along the line of root connection, after which such roots are removed with forceps or an elevator.
After tooth extraction, the socket is inspected, granulations and bone fragments are removed from it, sterile swabs are applied and the patient is asked to press them tightly with his teeth or jaws. They give recommendations: keep the tampons for 20 minutes, do not heat the wound site, do not rinse the mouth during the day.
Difficult removal
Removal is considered difficult if the doctor uses more than one instrument. However, this does not mean that the tooth is technically difficult to remove. It is more convenient to dislocate the roots with an elevator and then remove them from the hole with forceps.
Also a complex technique includes tooth extraction using a chisel or drill, when the surrounding bone tissue is removed or the tooth is sawed into several parts.
Atypical removal technique
If during the removal process it becomes necessary to make an incision and cut out a mucoperiosteal flap, then this is an atypical removal. This technique is used to remove impacted (non-erupted) or supernumerary teeth, as well as to fracture the root tips.
First, an incision (usually trapezoidal) is made in the projection of the tooth to be removed, after which the flap is separated from the bone using a smoother or rasp. Then they begin to remove the bone plate using burs (always with cooling!). If deleted impacted tooth, all the bone around its crown is cut out, after which it is dislocated with an elevator. If the broken root tip is removed, it is cut down most of the walls of the alveoli, after which the apex is removed with an excavator or a narrow elevator.
After removal, the hole is washed with antiseptic solutions, hemostatic sponges or the drug “Alveogyl” are left in it, sutures are applied and recommendations are given to the patient.
For students
You can use this article as part or basis of your essay or even thesis or your website
Save the result in MS Word format, share with friends, Thank you:)
Article categories
- Students of dental faculties of medical universities
Minimally invasive tooth extraction technique
Auxiliary tool: Luxator ® tooth extraction instrument
Author: Dr. Mikael Zimmerman Associate Professor, Royal Carolina University, Stockholm, Sweden.
The reasons for tooth extraction may be not only extensive caries or a structure that is so destroyed that the tooth cannot be restored, but also other considerations (positional or structural). In addition, patients sometimes choose tooth extraction as a cheaper alternative to filling or crowning a tooth that is too damaged. Unfortunately, all over the world, tooth extraction is considered the most common measure of emergency dental care for patients. Therefore, it is very important to find a method that will make the tooth extraction procedure as less invasive and safer as possible.
Luxation (displacement) is the separation of a tooth from the dental socket by destruction of the fibers of the periodontal ligament.
Luxator ® tool is used by easy rocking action to gently move the tip of the instrument inside the tooth socket. Using a thin and sharp tip of the instrument, cut off the fibers of the periodontal ligament, press on the alveolar bone and carefully remove the tooth from the dental socket.
Displacement or elevation?
Tooth extraction can hardly be called a simple procedure. A tooth extraction is considered successful when the entire tooth is removed, rather than its fragments, and when the traumatic damage to the remaining surrounding tissues is minimal. Successful tooth extraction requires knowledge of the morphology of the tooth, the correct choice of method for its removal and the use of suitable tools and equipment.
The routine method of removal is considered to be luxation (displacement, separation from the socket) and extraction (raising) of the questionable tooth. Luxation is the separation of the tooth from the socket by destruction of the fibers of the periodontal ligament. Then the remaining fibers of the periodontal ligament are destroyed by lightly twisting the tooth root in the dental socket, carried out using dental forceps. The root should be grasped as low as possible to reduce the effect of torque on the tooth and the risk of crushing the latter.
The Luxator ® instrument has a thin, sharp blade of an anatomical design that allows it to precisely adhere to different root surfaces.
The invention of Luxator ® instruments allows the doctor to remove teeth in a way that minimizes trauma to the surrounding tissue.
New thin instruments for tooth extraction
Luxator ® is a new extraction instrument that has proven its clinical value for cutting periodontal ligament fibers. The Luxator ® is an instrument used to extract teeth in a new way that is different from traditional extraction procedures. The shape of the Luxator ® tool is similar to that of existing dental elevators, but its distinguishing feature is the very thin end of the blade, which is also very rigid. Thus, the instrument resembles a knife for cutting periodontal ligament fibers, which can be used to remove a tooth (Toschimichi Moris et al., 2004).
The blade of the Luxator® tool is made of solid stainless steel and is extremely thin. The ergonomic handle design provides optimal tactility and control. Place your index finger on the point corresponding to the maximum depth of insertion of the instrument into the tooth socket. Forefinger serves as an emphasis on the occlusion surface adjacent tooth.
Precise and tangible
Although traditional type elevators can be used to some extent to cut periodontal membrane, this procedure will not be effective due to the large thickness of the blade. The blade of the Luxator® tool is made of very thin and very hard metal, and, unlike traditional elevators, using the Luxator® when extracting a tooth, you can feel the cutting of the fibers by touch.
Minimally invasive procedures and patient satisfaction
When tooth extraction is carried out in a short time, thanks to the unexpectedly rapid luxation, this will also mean that the patient will feel satisfied. Studies have been conducted showing that delayed clinical healing leads to delayed relief from pain and other clinical symptoms, delayed restoration of normal oral function and delayed return to the patient’s usual lifestyle (Ruvo A. T. et al., 2005 ). One of the complications of tooth extraction is dry socket. This complication is associated with the loss blood clot from the tooth socket and exposing the surface of the alveolar bone. It is believed that it occurs in cases where the doctor used excessive force when removing a tooth.
The minimally invasive procedure preserves the most important bone structures.
Pounding movements can lead to the development of bacteremia.
Cutting the fibers of the periodontal ligament with the Luxator ® instrument is carried out with minimal penetration
penetration into the bone structures of the periodontium, therefore the healing of the extraction socket will be accelerated. In one of the studies conducted by Swedish scientists, it was shown that after tooth extraction, bacteria were present in the blood of 100% of patients (Heimdahl A. et al., 1990). Bacteremia is not associated with the extent of the surgical operation, since when one tooth is removed, the level of bacteria in the blood may be higher than when wisdom teeth are removed or bilateral tonsil removal. It turned out that tooth extraction is associated with anaerobic and aerobic bacteremia much more often than other procedures. The reasons for this phenomenon are not fully understood, but it is possible that the role is played by the intensive colonization of anaerobes and aerobes on the surface of the tooth in combination with the driving movements of the instrument performed during the surgical procedure.
Along with a reduction in postoperative pain and swelling, a good postoperative prognosis for minimal instrument invasion into the extraction hole, Luxator ® allows for good preservation of the surrounding bone tissue. In cases of immediate installation of implants into the alveolar sockets, good preservation of the alveolar bone has great importance for implant survival. Short-term studies in animals and humans have shown that the effectiveness of immediate implant placement in an extraction socket is comparable to the results of inserting implants into healed alveolar bone. The advantage of immediate installation of implants is a reduction in the number of visits to the surgeon by the patient, elimination of the period of waiting for complete healing of the wound after tooth extraction, reduction in the period of absence of teeth in the patient, reduction total cost treatment, as well as maintaining the height and width of the alveolar bone. The advantages of instant implantation make this procedure very attractive for those patients who need to remove several teeth and install several implants (Barzilay I., 1993).
When removing lower teeth, hold the lower jaw with your free hand to prevent excess pressure on the temporomandibular joint.
The tip of the Luxator ® instrument is placed into the periodontal space symmetrically to the tooth axis.
Difference between Luxator ® tool and elevators
Luxator ® instruments have thin sharp blades, anatomically adjacent to different surfaces of the roots of the teeth. When extracting a tooth, the Luxator® instrument makes a rocking motion around the tooth (luxation) to cut the epithelial attachment and periodontal ligament. Unlike conventional dental elevators, which are used to lift and extract a tooth, Luxator® instruments allow tooth extraction by cutting the attachment and displacing the tooth. Luxator® instruments eliminate the need for pressure on adjacent teeth.
Typically, the thickness of the compact bone on the buccal side is greatest. Therefore, the first luxation is performed on the palatal/lingual side. This allows the subsequent insertion of the instrument from the buccal side to press on the alveolar bone and create space for moving the root in the palatal/lingual direction.
To minimize trauma and avoid bone damage, examine the radiograph to determine the orientation of the tooth in relation to the patient's bony structures. In particular, the localization of the upper maxillary sinus in relation to the tooth, the position of the second and third molars of the upper jaw and the risk of fracture of the maxillary tuberosity, as well as the location of the nerves and blood vessels in the lower jaw.
Invented and designed by a dentist
Luxator ® instruments are specifically designed for cutting the periodontal ligament; they are knives with thin tapering blades that apply pressure to the alveolar bone, cut the periodontal membrane and carefully remove the tooth from the socket. Luxator® instruments were invented and designed by Swedish dentist Dr. Eriksson to make tooth extraction as painless as possible. The entire operation is performed with minimal tissue damage, which means healing is faster and the procedure itself will be less tiring for both the patient and the surgical team.
3.2. TEETH REMOVAL TECHNIQUE
♦ Preparing for tooth extraction surgery
After the doctor has established the indications for tooth extraction, the issue of preparing the patient for surgery, the method of pain relief, choosing the necessary instruments, and the method of tooth extraction.
First they carry out inspection tooth that needs to be removed. The strength of the crown is established, allowing the use of crown forceps when removing a tooth. If there is a significantly damaged tooth crown that does not allow the use of crown forceps and prevents the use of root forceps or a direct elevator, it is advisable to bite it first.
The degree of tooth mobility and the presence of inflammation are determined. Using an x-ray, we establish the features of the bone tissue surrounding the roots of the tooth, the location of the roots, their number, size and shape, which can significantly complicate the operation, as well as their relationship with the nasal cavity, maxillary sinus, and mandibular canal. On an x-ray we can detect impacted, dystopic and supernumerary teeth.
The patient, adult or child, must be warned about the need for tooth extraction, about the expected duration of the intervention, about the possible development of complications during its implementation. It is necessary to talk about the sensations that the patient will experience during the operation. With timely and correct warning, patients react more calmly to medical procedures. Persons with a labile nervous system should undergo sedative preparation using tranquilizers and sedatives.
You need to wear gloves when performing surgery. The treatment of the surgeon's hands is carried out according to generally accepted surgical techniques.
Preparation surgical field consists of mechanical removal of food debris and plaque from the mucous membrane and teeth. To do this, rinse the mouth antiseptic solutions or wiping the surgical field with gauze balls soaked in these solutions. It is advisable to remove tartar in advance.
Rice. 3.2.1. Forceps for removing teeth on the upper jaw.
♦ Tools for tooth extraction
Used to remove teeth forceps various designs and elevators.Forceps . The forceps are distinguished:
1) cheeks - part of the forceps that serve to grasp the crowns of teeth or roots, i.e. provide fixation of the forceps on the tooth;
2) handles (jaws, handles) - areas for which the doctor fixes the forceps in his hands, i.e. place of application of the doctor’s efforts;
3) lock - the area connecting both halves of the forceps.
Forceps are distinguished depending on the group of teeth for which they are intended to remove (Fig. 3.2.1-3.2.5):
Forceps for removing upper and lower teeth;
Forceps for removing incisors, canines, premolars and molars;
Forceps for a specific side (right or left) or for removing teeth on both sides.
Rice. 3.2.2. Crown forceps for Rice. 3.2.3. Tooth extraction forceps
removal of molars on the upper jaw. lower jaw.
Rice. 3.2.4. Incisor removal forceps Rice. 3.2.5. Molar Extraction Forceps
and premolars on the lower jaw. and wisdom teeth on the lower jaw.
Forceps are distinguished by the following characteristics:
1) angle sign;
2) bending of tongs and handles;
3) sign of the party;
4) width of the cheeks.
Angle sign . Forceps for removing upper teeth are designed so that the axis of the cheeks coincides with the axis of the handles (forming a straight line) or the angle between them is obtuse (more than 90°). In some forceps for removing upper teeth, the axes of the cheeks and handles are parallel or almost parallel.
In contrast to what was said earlier, with forceps for removing lower teeth, the angle between the axis of the cheeks and handles approaches a straight line.
Bend sign . Straight forceps are used to remove the upper incisors and canines, and forceps with an S-shaped bend are used to remove the upper premolars and molars. Thanks to the latter, the cheeks of these forceps can be correctly applied to the upper small and large molars, i.e. without resting on the lower teeth. To remove the upper wisdom teeth, forceps are used that have a significant bend, or bayonet-shaped (bayonet) forceps.
When extracting lower teeth, the forceps may be curved along the plane(designed to remove lower large molars with poor mouth opening) or curved along rib (beak-shaped) - When applying forceps to a tooth, the handles are located one above the other (designed for removing incisors, canines, premolars and molars).
Side sign . Relates to the removal of large molars in the upper jaw. In forceps intended for removing upper molars, the cheek on the outer side (cheek) ends with a protrusion - a spike located between two notches, and on the other cheek there is a semicircular groove. The cheek, which has a tenon, moves into the space between the two buccal roots of the large molars, and in the recesses (located in front and behind the tenon) the mesial and distal buccal roots of the molar are tightly held. The other cheek covers the palatine root.
Thus, right and left side forceps are used to remove large molars in the upper jaw.
If there is a spike on both cheeks of the forceps, then they are intended for removing lower molars. When they are applied, the spike moves into the space between the mesial and distal roots of the lower molar.
P 
Cheek width indicator
.
To remove tooth roots, forceps are designed that have the narrowest cheeks. To remove incisors, canines and premolars, narrower cheeks of forceps are used than to remove large molars. The cheeks for removing incisors are narrower than those for removing canines and premolars. In addition, the cheeks can close together and not close.
Elevators . They consist of three parts: the working part, the handle and the connecting rod (Fig. 3.2.6).
Rice. 3.2.6. Lateral and direct elevators.
There are straight, angular and bayonet-shaped elevators.
Straight elevator . The working part is convex (semicircular) on one side, and concave (has a grooved shape) on the other. The end of the working part is thinned and rounded (can be pointed on one side).
The working part of a direct elevator can be spear-shaped, one side is smooth, the other is convex. Elevators with a spear-shaped working end are called bayonet-shaped .
And if the handle of the tool is located perpendicular to the working part and the connecting rod, then it is called " Lecluse elevator " and is designed to remove lower wisdom teeth.
Corner (side) elevator . The working part is curved along the edge and located at an angle of about 120° to the longitudinal axis of the elevator. One surface of the elevator cheek is convex, the second is slightly concave with longitudinal notches. The end of the working part is thinned and rounded (may be pointed or jagged). During tooth root removal, the convex part of the working end of the elevator faces the wall of the socket, and the concave part faces the root being removed. The concave surface of the elevator cheek can be turned to the left (towards you) or to the right (away from you).
♦ Position of the doctor and the patient
When teeth are removed, the patient is in a dental chair in a sitting or semi-sitting position, and on the operating table in a lying position.
Depending on the location of the tooth being removed, the position of the patient and the doctor changes. When deleting upper teeth the patient sits in a dental chair with the back and headrest slightly reclined. The chair is raised to such a height that the tooth to be removed is approximately at the level shoulder joint doctor The doctor is right and front from a patient.
Deleting lower teeth the chair is lowered as low as possible. The back of the chair and the headrest are moved so that the patient's torso and head are in an upright position or the head is tilted slightly forward. The lower jaw is located at the level elbow joint the doctor's lowered hand. At tall If the patient is sick and the doctor is short, the back of the chair should be tilted back and the patient should be placed in a semi-sitting position. Using a headrest, the patient's head is raised to a vertical position.
When removing the lower right large and small molars, the doctor is to the right and slightly posterior from a patient.
When deleting lower frontal teeth, the position of the doctor changes - he stands to the right and slightly ahead from a patient.
When removing the lower left large and small molars, the doctor is located to the left and slightly ahead from a patient.
The correct position of the patient and the doctor during tooth extraction creates the most favorable conditions for viewing the surgical field, fixing the jaws and removing teeth or roots. An incorrect choice of position for the patient and the doctor can lead to mistakes that result in various complications (incomplete tooth extraction, dislocation of the lower jaw, etc.).
♦ Methods for fixing forceps in the doctor's hand
First way. The tongs are held so that the thumb is located on one side below the lock and covers one handle, and all other fingers are located on the opposite side of the tongs, of which the second and third fingers clasp the tongs from the outside, and the fourth and fifth are in the space between the handles (Fig. 3.2.7).
The first finger holds the forceps motionless, the second and third fingers squeeze and fix them. The other handle of the forceps can be moved away by extending the fourth and fifth fingers. Subsequently, when squeezing (fixing) the tongs, the fourth and fifth fingers are removed from the space between the handles (Fig. 3.2.8) and used to grasp the handle from the outside (i.e. with four fingers).
Second way. The thumb clasps one handle, the second and third are between the handles, and the fourth and fifth clasp the other handle from the outside. Straightening the third finger, we move the forceps apart, and bending the fourth and fifth fingers, we squeeze them. After applying the forceps to the tooth, the third finger is removed from the space between the handles and placed on the outside of one of the handles, i.e. where the fourth and fifth fingers are located (Fig. 3.2.9-3.2.10).
Rice. 3.2.7. Method of fixing the forceps, Rice. 3.2.8. Method of fixing the forceps,
curved along the edge (position 1). curved along the edge (position 2).
Rice. 3.2.9. Method of fixing the forceps, Rice. 3.2.10. Method of fixing the forceps,
curved along the plane (position 1). curved along the plane (position 2).
Rice. 3.2.11, 3.2.12. Methods for fixing forceps curved along a plane (when using forceps to remove lower wisdom teeth).
Rice. 3.2.13, 3.2.14. Methods for fixing forceps.
Third way. The thumb is on top of the lock of the pliers, and the rest (in different versions) clasp the handles from below, from the outside and from the inside (Fig. 3.2.1 1-3.2.14).
Improper holding of the forceps during tooth extraction leads to slipping of the forceps, pushing or slipping of the tooth being removed, damage to antagonist teeth and other complications.
♦ Techniques for removing teeth with forceps
The removal operation begins with the separation of the circular ligament from the neck of the tooth. It is convenient to separate the gums using a smoothing iron or a narrow rasp. When the teeth to be removed are severely damaged, it is necessary to separate the gum from the edge of the alveolus ( syndesmotonia- peeling of the circular ligament of the tooth). This makes it easier to apply the cheeks of the forceps and makes it possible to more accurately navigate in relation to the transverse size of the root, and also preserves the integrity of the mucous membrane when extracting the tooth.
Tooth extraction is carried out using forceps and consists of several sequential techniques:
1) application of forceps;
2) advancement of the cheeks of the forceps;
3) closing the forceps (fixation);
4) tooth dislocation (luxation or rotation);
5) extraction of the tooth from the socket (traction).
Forceps delivery . Holding the forceps in your hand using one of the previously mentioned methods, open their cheeks so that the crown of the tooth or root can fit between them. One cheek of the forceps is applied on the lingual (palatal) side, the other on the buccal side of the tooth. The axis of the pliers must coincide with the axis of the tooth. A mismatch between the axis of the forceps and the tooth leads to a root fracture or injury to the adjacent tooth.
Advancing the cheeks of the forceps . Pressure right hand The cheeks are moved under the gum using forceps. On the lower jaw, this is ensured by pressure with the thumb of the left hand on the locking area of the forceps; on the upper jaw, by pressure on the handles of the forceps. The cheeks are advanced until you feel a tight grip around the tooth. If the crown of the tooth is destroyed, then the cheeks of the forceps are advanced so that they grasp the edges of the wall of the socket (alveoli). When a tooth is removed, these sections of the alveolar edge break off, i.e. is happening subperiosteal resection edges of the hole.
Closing the forceps . The first two steps are performed with the forceps not fully closed. Then their handles are squeezed tightly to firmly fix the tooth or its root being removed. The forceps should be squeezed with such force as not to crush the crown or root of the tooth.
The tight closure of the forceps seems to unite the tooth and forceps into one whole. When the forceps move, the tooth moves. Weak fixation of the forceps does not allow tooth removal, and strong fixation leads to crushing of the crown or root of the tooth.
Tooth dislocation . When a tooth is dislocated, the periodontium, which connects the tooth to the alveolar wall, is torn. During a dislocation, the doctor rocks (luxury) tooth in the buccal and lingual (palatal) sides or carries out rotation (rotation) the tooth around the axis by 25-30°, either in one direction or the other. These movements should be carried out gradually increasing the amplitude of vibrations. With such movements, the walls of the socket shift and break, i.e. The walls of the alveoli move apart.
The first swinging movement is made in the direction of least resistance. The first movement is made on the upper jaw outward, and then ininside. Except for the case when they delete sixth tooth. The outer wall in the area of the sixth upper tooth is thickened due to the zygomatic-alveolar ridge, therefore, when removing this tooth, the first movement is made ininside.
On lower jaw the outer side of the walls of the holes in the area second and third molars thicker. Therefore, the first dislocation movement is made in lingual side.
When deleting first molar, premolars, canine and incisors on the lower jaw make the first swinging movement outward.
Rotational movements can be carried out in the area of teeth that have one root approximating a cone in shape. These movements are useful when removing incisors, canines and premolars on both jaws and when removing separated roots of upper multi-rooted teeth. Caution must be exercised when performing rotational movements when removing the lower incisors, because their roots are flattened on the sides.
However, using only rotational movements it is not always possible to remove a tooth or root. Therefore, rotational movements should be combined with rocking movements (i.e. rotation with luxation).
Extracting a tooth from the socket (traction) It is the final stage in the tooth extraction operation. After complete separation of the tooth root from the retaining ligaments, it is extracted. The tooth is extracted smoothly, without jerking, often outward, less often inward. Up or down, depending on the location of the tooth in the lower or upper jaw.
If the doctor uses excessive force when extracting a tooth, the forceps can forcefully hit the teeth of the opposite jaw, damaging them or the mucous membrane.
Tooth extraction is completed by bringing the edges of the postoperative wound together by squeezing them with the fingers of the right hand, i.e. the doctor produces reposition of fractured edges alveolar process of the jaw. This helps to reduce the degree of gaping of the postoperative wound and has a beneficial effect on its healing, because the size of the connection between the wound and the oral cavity decreases.
Many people are afraid of tooth extraction, and not without reason. This procedure has always been one of the most traumatic and dangerous in dentistry: during removal, you can easily damage the jaw, cause infection or cause heavy bleeding. Even if everything went well, after the tooth is removed, a real wound remains - a hole that will take quite a long time to heal.
Unfortunately, dentistry cannot yet completely do without this procedure. It is shown, for example, when running purulent inflammations: In some cases, tooth extraction is the only way to save the jaw from destruction. Planned treatment (for example, orthopedic), as well as prosthetics, is impossible without tooth extraction.
So what happens - we treat one thing and cripple the other? Dentists see only one way out of this situation - to improve the technique to make tooth extraction as safe and painless as possible. Medicine clearly does not stand still, and this procedure develops along with it.
For example, dental offices are now using the third “generation” of instruments for tooth extraction. In general, such equipment dates back to the 14th century: its ancestor is considered to be the medieval dental pelican, which was replaced by the dental key in the 18th century. It, in turn, was replaced by modern dental forceps in the 20th century.
Modern instruments for tooth extraction are very clearly differentiated by function. Thus, forceps with non-converging cheeks are intended for removing entire teeth, forceps with convergent cheeks are intended for removing individual roots. Such instruments also differ in shape: straight forceps are intended for removing incisors and canines from the upper jaw, curved at right angles - for removing incisors of the lower jaw, S-shaped - for premolars and molars of the lower jaw.
The extraction techniques themselves vary depending on the type of tooth. On single-rooted teeth, rotation is carried out (rotation of the tooth around its axis), on multi-rooted teeth - luxation (rocking, loosening). The goal of both of these procedures is to loosen the bond between the tooth and the socket so that the removal does not damage the jaw.
By the way, sometimes a multi-rooted tooth cannot be extracted even after thorough loosening. Then the dentist cuts it with a drill, separating the roots, and removes it in stages. Tooth extraction turns into almost a surgical operation.
Don't miss the chance! Sign up for free consultation in July!
Sign up
It is even more difficult to remove teeth that are atypically located or have not fully erupted. They are usually covered by mucous membrane or bone; To access them, the dentist may cut soft fabrics and even remove a piece of the jaw. Only careful planning can help minimize damage during such an operation - in difficult cases Before removing teeth, the doctor takes an x-ray to study the topography of the roots.
A separate issue is the use of antibiotics, wound healing and painkillers. It is worth noting that tooth extraction is not currently carried out without anesthesia and antiseptics. There is also a remedy designed to speed up wound healing: platelet mass is planted into the hole after tooth extraction - a dense clot rich in platelets and collagen. This mass is obtained from the patient’s own blood, taken immediately before tooth extraction and processed in a centrifuge.
So, are you still afraid of having your teeth removed? In vain. Of course, the risk of complications during this operation is high, but modern dentists have everything to reduce it to a minimum.
