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Surgical extractions (Proceedings)

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Aug 01, 2011

Indications for extraction

Teeth are extracted for a number of reasons. These include periodontal disease, caries, advanced feline dental resorptive lesions apical abscesses, traumatic malocclusion, tooth root fracture, tooth crown fracture, retained deciduous, teeth, root tips, supernumerary teeth and client preference.

There are many alternatives to extraction for the treatment of many of these conditions as described in other modules. Financial and other pressures may lead the client to request extraction.

Teeth with periodontal lesions are easier to extract than those which having normal bony support. The alveolar bone and periodontal ligament are weakened and progressively destroyed by the periodontal disease process. Rendering affected teeth more easily extracted.

Extraction techniques

There are three extraction techniques for most carnivores and omnivores. Herbivores require a surgical extra oral approach for the extraction of' most of their teeth. Number of tooth roots, the amount of tooth retention, and the instrumentation requirements determine the exact technique.

Small single rooted teeth indicated for extraction are deciduous teeth or periodontal involved permanent incisors.

Deciduous teeth often seem to be the easiest to extract, but their small size, long delicate roots, and roots that are partially resorbed by the erupting permanent tooth make them more difficult too extract without root fracture. Patience and the delicate use of fine sharp instruments are preferable to the use of force, which usually results in root fracture. Fractured root tips are far more difficult to extract than intact teeth.

Four possibilities exist with fractured retained root tips. 1, if the root tip was fractured at the time of acute dental infection, such as advanced periodontal disease or Periapical involvement, the root tip will most likely serve as a source of continued infection. All efforts should be taken to remove root tips that at left when extracting these diseased teeth. 2, the root tip can simply resorb. 3, the root tip can become encapsulated in bone, and 4, the root tip can migrate out of the extraction site. As you can see, the last three possibilities suggest leaving these non diseased root tip fragments in place rather than induce unneeded trauma to the patient trying to remove these retained root tips.