6/18/2020
Dental Extractions Techniques & Complications
Lenin Villamizar-Martinez, DVM, MS, Ph.D, Dipl. AVDC Assistant Professor of Veterinary Dentistry & Oral Surgery [email protected]
Definitions
1) Closed extraction Not requiring vertical releasing incisions (flaps), bone removal and/or tooth sectioning – Incisors, first premolar and third molar teeth
2) Open extraction Requires vertical releasing incisions (flaps), bone removal and/or tooth sectioning – Canine tooth, and teeth with more than one root
Indications for Extraction Persistent Deciduous Teeth Periodontitis Unerupted Teeth
Dental fractures Tooth resorption Maxillary/mandibular trauma
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Indications for Extraction Malocclusion Pulp Necrosis Chronic Gingivostomatitis
Contraindications
Dental extractions must be deferred in patients with congestive heart failure, uremia, uncontrolled endocrine disorders, severe coagulopathies, or untreated leukemia or lymphoma
Extraction of teeth in the field of previous radiation treatment may lead to osteoradionecrosis and should be avoided.
Equipment
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Tooth Root Forceps
Dental Burs (Carbide & Diamond)
Do not forget !!
Dental radiographs Nerve blocks
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Surgical Technique
Elevator vs. Luxator
Closed Extraction
Intrasulcular incision with a # 15 scalpel blade
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Luxation and Elevation
The luxator/elevator is always used slightly oblique to the root surface of the tooth. The blade of the instrument is inserted into the periodontal ligament space and pushed apically, severing the collagen fibers and acting as a wedge
Proper grasp of a luxator/elevator. The index finger is extended along the shaft towards the tip of the blade in order to minimize trauma to the patient if the instrument slip during extraction.
Avulsion
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Alveolar curettage
Open extraction
Flap design Oral and maxillofacial surgery in dogs and cats, 2012
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Be gentle with the flap!
Alveolectomy
Modified pen grasp
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Avulsion and Alveoloplasty
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Extraction of a resistant deciduous Canine Tooth
12 months old dog
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Multirooted teeth
307 308
Alveolectomy Tooth sectioning
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Reiter; Soltero-Rivera, 2014
Complications
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Root Fracture
Flap Failure and wound infection
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Flap Dehiscence
Oronasal Fistula
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Mandibular Fractures
Upper jaw
Oral and maxillofacial surgery in dogs and cats, 2012
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Roots or teeth into….
Oral and maxillofacial surgery in dogs and cats, 2012
Questions?
Thanks!
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