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Extractions and Impactions
Ratra´s Dental offers best sterilization (centres with one of the best sterilization protocols like instrument sterilization systems like autoclaves ( temperature of 121 deg centigrade at 20 lbs pressure ) + chemical sterilization by immersoltm ( glutaldehyde + 1,6 dihydroxy + 2,5 dioxahexane solution ). Air sterilization system by fumispraytm ( ethanol + propanol mixture ). floor disinfection system by hospaltm solution.) & team of oral surgeons for painless oral surgical procedures. Our digital radiography systems decreases the radiographic exposure to minimal levels & rvg system from csn italy helps patient to see the procedure on the screen, our painless anesthesia delivery system like sprays, laser analgesia & microfine needle delivery systems make your dental experience painless & comfortable.
An ideal extraction of tooth is defined as painless removal of tooth or root of tooth from its bony attachments with minimal injuries to surrounding investing structures such that there will be minimum post operative complications.
INDICATIONS :
INDICATION FOR EXTRACTION OF PERMANENT TEETH
:
- Grossly decayed teeth which cannot be saved by conservative procedures.
- Teeth that are foci of infection.
- Teeth with non-vital pulp, where root canal is not possible.
- In case of severe periodontoclasia in which excessive bony support of the teeth is destroyed.
- Teeth in line of radiation therapy.
- Teeth mechanically interfering with placement of restorative appliances.
- Impacted or unerupted teeth.
- Supernumerary teeth.
- Retained deciduous teeth.
- Tooth with fractured roots.
- Malposed teeth not amenable to Orthodontic treatment.
- Roots and fragments.
- Teeth traumatizing soft tissues.
- Teeth associated with cysts and other pathologies.
INDICATION FOR EXTRACTION OF DECIDUOUS TEETH :
- Extensive decay resulting in death of the dental pulp.
- Extensive decay which makes pulpotomy and pulpectomy impossible.
- When the deciduous teeth interfere with the normal eruption and alignment of their permanent successor.
- When there is sinus opening through mucoperiosteal membrane.
- When roentgenogram reveals evidence of periapical infection.
- When the root is fractured as a result of subsequent infection.
- Supernumerary teeth.
CONTRAINDICATIONS :
Absolute :
Central Haemangioma. May cause uncontrolled bleeding.
A-V malformation.
Relative :
When some precautions have to be taken.
Local
- Acute cellulitis.
- ANUG.
Systemic
- Uncontrolled Diabetes Mellitus, Hypertension.
- Bleeding disorders
Cardiovascular diseases
Liver disorders
Patients on long-term steroid therapy
Teeth that have undergone radiation [6 months - 1 yr ]
CONTRAINDICATIONS :
IMPACTION
A tooth which fails to erupt in normal anatomical position either due to lack of space or due to obstruction from tooth, bone or soft tissue.
CAUSES OF IMPACTIONS
:Local
- Irregularity in the position and pressure of an adjacent tooth.
- Density of the overlying or surrounding bone.
- Chronic inflammation with resultant fibrosis of the overlying mucosa.
- Lock of space due to under developed jaws.
- Unduly over retention of the deciduous teeth.
- Premature loss of deciduous teeth.
- Acquired disease such as necrosis due to infection.
- Inflammatory changes in the bone due to exanthematous diseases in children, like, Chicken pox, Parotitis
SYSTEMIC
Prenatal
- Heredity
- Miscegenation
- Syphilis
- Tuberculosis
- Malnutrition
Post Natal
- Rickets
- Anemia
- Endocrine dysfunctions.
- Diseases of jaw and surrounding tissue
Rare Conditions
- Cleidocranial dysostosis
- Oxycephaly
- Progeria
- Achondroplasia
- Cleft palate
COMPLICATIONS FROM RETAINED IMPACTED TEETH
- Infection
- Pericoronal infections.
- Acute or chronic alveolar abscess
- Chronic suppurative osteitis
- Necrosis
- Osteomyelitis
- Pain
- Pain may be reflected not only to the areas of distribution of the nerve but the associated areas too.
- Pain may be slight and localized
- Severe and excruciating involving the entire upper and lower teeth.
- Intermittent, constant or periodical
- Fractures
FACTORS COMPLICATING THE IMPACTION OPERATIVE PROCEDURE
- Abnormal root curvature.
- Hypercementosis
- Proximity of mandibular canal
- Extreme bone density especially in elderly patients
- Follicular space filled with cementum or bone
- Ankylosis
- Small orbicular oris
- Inability to open the mouth
- Large and uncontrollable tongue
POST OPERATIVE INSTRUCTIONS :
- Keep the sponge held firmly between your jaw and over the operative site for full half an hour.
- Do not use mouthwash for six hours after oral surgery; vigorous use of mouthwash may stimulate bleeding.
- In case of mild bleeding place cold water in the mouth. In case of severe bleeding place a cotton pellet soaked in cold water over the bleeding and cover it with gauze biting firmly and call your dentist.
- In case of swelling and followed by discoloration, patient need not worry because it´s an absolutely normal event.
- Pain in case or afterwards of surgical procedure is a normal phenomenon. Post operative pain can be controlled by taking medicine. If severe pain develops accompanied by bad taste then return to your dentist for this treatment.
- To control swelling which develops post operatively apply ice pack or towels wrung out of ice water. Day after operation, apply heat to your face.
- Rigid cleanliness is necessary of the remaining teeth. Mouth wash in a glass of lukewarm water. This promotes healing.
- Avoid meat and food difficult to masticate for a few days. Eat plenty of fruits and drink eight to ten glasses of water, fruit juice and other fluids daily.
OST OPERATIVE VITAMIN THERAPY :
- After oral surgery there is diminished in take of vitamin therapy i.e. Vitamin C & B complex.
- Drugs especially analgesics decrease the level of vitamin C in the body.
- Ascorbic acid is essential for the maintenance of normal cellular material of connective tissues, bone, teeth and blood vessels. If vitamin C level falls, healing is retarded, capillary fragility is increased.
