7 topics with concise reviews: definitions, key facts, and class questions.
Tooth extraction (exodontia) is one of the most common procedures in dentistry. In this chapter, we discuss the strict indications and contraindications for the procedure so that you clearly understand when a tooth can still be saved and when surgery is the only justified option.
This section details the instruments and step-by-step stages of tooth extraction on the upper and lower jaws. You will study the biomechanics of using forceps and elevators, taking into account the anatomical features of the alveoli and roots of each tooth group.
In practical classes and examinations, instructors most frequently ask for the algorithm of instrument selection for a specific tooth, as well as clinical management in unforeseen situations. Carefully review the topics dedicated to intraoperative complications (root fractures, sinus perforation) and postoperative complications (alveolar hemorrhage, alveolar osteitis) — this is crucial material that protects the physician from critical errors.
Why does throbbing pain occur during inflammation?
The throbbing nature of the pain is associated with the phenomenon of prestasis, when a pendulum-like movement of blood occurs in the microvessels: during systole, it moves toward the veins, and during diastole, it flows back.
In which cases is tooth extraction performed for emergency indications?
Emergency extraction is indicated for progressive purulent periodontitis, acute odontogenic infections (osteomyelitis, phlegmon), and severe dental trauma that cannot be restored.
In which direction is the initial luxation movement directed in the maxilla?
Toward the path of least resistance of the bone tissue. In most cases, this is the external (buccal) wall of the alveolus, as it is thinner than the palatal wall. The main exception is the first molar, where the buccal bone is thickened.
Why are mandibular molar roots rarely extracted with forceps?
Due to the significant thickness of the alveolar process bone tissue. It is impossible to advance the forceps blades beneath the gingiva as they will slip, which is why surgeons prefer to use elevators.
Is it mandatory to remove a fractured root tip?
Yes, leaving a root fragment leads to the development of an inflammatory process. If it cannot be removed immediately, a revision surgery is scheduled in 7–10 days once the inflammation subsides.
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