Oral Surgery

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Oral Surgery

• 02/22/08

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Function of an elevator

• Tooth removal
• Minimize breakage of teeth
• Minimize trauma in area of tooth to be ext.
• Reduction of forces felt by patient during
  subsequent traction
• MOST IMPORTANT Facilitate broken root tip
  removal if tooth
• In other words, if you use an elevator first
  (like you should), if the crown breaks you can
  get the root out easier if you used an elevator
  first!!!

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Broken Crown You didnt use an elevator first
what to do?

• Do not use a root tip pick youll break the
  instrument because the PDL is still mostly
  attached
• Use an elevator instead.
• The next time, use an elevator in the first place!

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Elevator functions

• Wedge
• 2.5x mechanical advantage
• Use it like a shoe-horn to displace the root
• Residual root tips
• Supernumberary teeth his spelling
• Mesiodens
• Displacement
• As you press apically, the tooth displaces
  occlusally
• Lever
• You can break instruments using this motion
• Place the lever under the height of contour, and
  then lever off of the interseptal bone
• So use the crestal (buccal) bone as the fulcrum
• Wheel and Axle
• Rotation
• 5x
• T-bar instruments, typically

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Define mechanical advantage

• Resistance / effort

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What Defines Surgical EXT?

• Mucoperisoteal flap reflection (full thickness)
• AND one of the below
• Buccal bone removal
• Division of crown / roots

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Indications for Surgical

• When elevator and forceps technique fails
• Teeth possessing divergent roots
• Teeth with curved roots
• Devitalized teeth
• Dont listen to endodontists they LIE
• Hypercementosis
• Adults with submerged retained deciduous teeth
• Etc you get the idea.

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What to do about root tips?

• Loose
• Irrigate with saline
• Suction
• Apex elevator
• Attached
• Loosen with explorer or elevator
• Extend bone removal from alveolar crest
• Curved flap

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If you have to leave a root tip

• Place patient on antibiotics for one week
• Take 3MO PA
• Take 6MO PA