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 Maxillary/mandibular trauma

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Indications for Extraction Malocclusion 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 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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