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Oral Surgery

Oral Surgery. 02/22/08. 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

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Oral Surgery

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  1. Oral Surgery 02/22/08

  2. 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!!!

  3. Broken Crown – You didn’t use an elevator first… what to do? • Do not use a root tip pick… you’ll break the instrument because the PDL is still mostly attached • Use an elevator instead. • The next time, use an elevator in the first place!

  4. 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

  5. Define mechanical advantage: • Resistance / effort

  6. What Defines Surgical EXT? • Mucoperisoteal flap reflection (full thickness) • AND one of the below • Buccal bone removal • Division of crown / roots

  7. Indications for Surgical • When elevator and forceps technique fails • Teeth possessing divergent roots • Teeth with curved roots • Devitalized teeth • Don’t listen to endodontists… they LIE • Hypercementosis • Adults with submerged retained deciduous teeth • Etc… you get the idea.

  8. 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

  9. If you have to leave a root tip: • Place patient on antibiotics for one week • Take 3MO PA • Take 6MO PA

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