Extraction case selection for General Dentists for Surgical Extractions.
1) recognize red flags and refer cases if necessary, or 2) deal with these issues after learning more surgery in our courses.
Red Flags
- You think greater force is OK? It’s not. Learn other ways to do it.
- Patient age: over 35 will be harder.
- Handicap alert:
- You can’t use an elevator if there is a prosthetic crown, weak restoration, or extensive decay on an adjacent tooth. Or flat bone (tooth missing).
- You can’t engage a forcep if a tooth is bombed out or fractured to the bone level. (Can possibly still use 23 or 88.)
- Can’t use a Luxator or skinny bur into the PDL if interseptal bone is less than 1 mm wide.
- Usually need to section if a molar or 1st premolar roots are wider than the cervical width.
- Expect difficulty with unusually wide or hypercementotic roots, or:
- Dilacerated roots
- No observable PDL
- Unusually long roots, even to the mandibular canal or overlapping the maxillary sinus.
- On a maxillary 1st premolar, look for a 2nd root and treat accordingly.
- If erupted third molars do not budge after two minutes of moderate force, then a tuberosity fracture is emminent. Learn what to do to avoid it.
Recognize red flags and refer or learn the steps required to handle the situations. Each situation has a solution.
Continuum 1 (models – in person or Zoom) or Continuum 3 (patient treatment).
