Dentaltown April 2016 - (Page 82)
oral surgery
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Any More Tips on This Extraction?
A Townie seeks advice on an upcoming complicated extraction.
Dentaltown.com > Message Boards > Cosmetic Dentistry > Oral & Maxillofacial Surgery > Oral & Maxillofacial Surgery > Any More Tips ...
nickdentist
Member Since: 08/13/08
Post: 1 of 51
Related Message Boards
Extraction Needed
Extraction Needed
#30 Extraction-Mesial Root
Remaining
Root Remaining
I am taking out this #32 on a middle aged AA lady on Friday. I know that it is probably
going to be a little difficult. My plan is Luxator, then using the 301 all around the tooth and
also in the straight buccal. If no movement from that, make a trough through some buccal bone
without laying a flap. Then try to elevate again.
I don't see much of a furcation on this tooth, so I don't think a cowhorn will do me any
good. Was going to try my 151 APR forceps and rotate and buccal
lingual movements on the tooth. Hopefully it will come out after
that. Just really hope those roots don't shear off halfway down
into the socket.
Does this sound like a good plan for it? Anything else I should
be looking out for? ■
FEB 17 2016
roadrunnercc
Member Since: 01/31/12
Post: 3 of 51
Also not present is much of a PDL. Your plan sounds good, by the way. I'd reconsider not
laying a flap if you're going to trough bone. And be prepared if it does shatter. Root tip picks,
patience, sutures, etc. Good luck! ■
FEB 17 2016
davidpalmer
Member Since: 04/14/00
Post: 4 of 51
It's often a good idea to start with (and use often during the extraction) a spade proximator,
one of the best instruments in dentistry. Keep trying to wiggle the instrument between tooth
and bone, especially mesial and distal. Luxate, elevate, and then carefully remove with forcep.
Grabbing it too quickly with the forcep will break a tooth like this nearly every time. ■
FEB 17 2016
nickdentist
Member Since: 08/13/08
Post: 5 of 51
This patient has no plans for any kind of implants in the future. If the bottom half or so
of those roots break and they are locked in there-is there anything wrong with laying a big
envelope flap and taking away buccal bone until I can see them and elevate and pop them out
to the buccal? ■
FEB 17 2016
denovo
I think you will elevate this out and have no issues. ■
Member Since: 12/01/14
Post: 6 of 51
strugglin
Member Since: 11/13/10
Post: 7 of 51
82
FEB 17 2016
As was mentioned, spade proximator on tooth and then Luxator or elevator, especially at
the mesial.
Should be able to work it down there good. Then with a forcep, seat it and then try to rotate
the tooth to the distal to roll it out. Should take about three times of reseating it and rotating it
distally to get it out. I personally have the 217 Hu-Friedy forceps, which gets a good hold of the
tooth and it will rotate out distally.
Buccal and lingual will do very little on dense bone. Bone looks way less dense on distal. Try
this with the forcep before you lay flap and remove bone. I will be very surprised if you need to
remove any bone.
APRIL 2016 // dentaltown.com
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Table of Contents for the Digital Edition of Dentaltown April 2016
On Dentaltown.com
HOWARD SPEAKS: Lessons from Asia
PROFESSIONAL COURTESY: Today’s Active Topics
Continuing Education Update
Industry News
Love It!
Poll
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OFFICE VISIT: Family Ties
Breaking the Cookie Cutter: Finding Our Way Back to Individuality with Shape, Form and Texture
Choose Your Weapon: Finding the Best Fluoride Option for Your Patient
(Your Own) Practice, Made Perfect
Braces vs. Aligners: The Science of Picking the Best Appliance
You Be the Judge: The Case of the Lazy X-Rays
Product Profile: Premier
Principles of Flap Design and Closure
Any More Tips on This Extraction?
Dentistry’s Great Marketing Untruths
Product Profile: CreoDent Prosthetics
Product Profile: Ivoclar Vivadent
You Should Know: Dental Planet
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Bio-Minimalism: Trends and Transitions in Endodontics
Material Classifi cation and Shade Selection Protocol for All-Ceramic Restorations
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