Surgical extraction (also known "open extraction") is a teeth removal process in which surgical access is needed to completely remove a teeth. Even if the teeth is visible in the mouth without surgically exposing it, surgical techniques may be essential to remove the teeth. This includes sectioning the teeth into two or more pieces, whether or not a soft tissue incision is made. Surgical extraction includes removal of impacted wisdom teeth (third molars), but this does not mean that all wisdom teeth requiring removal are needed to be removed surgically. Removal (extraction) of a teeth is prescribed if the teeth is too extensively damaged from decay or trauma to be fixable, or if it is infected and the patient is not a candidate for endodontic (root canal) treatment. Wisdom teeth removal is frequently recommended, and ideally prescribed in the late teens to early twenties, if it is apparent that these teeth will not fit in the jaws in a normal bite relationship with normal gum tissue design. Extensively damaged teeth, and teeth with multiple curved roots frequently required extraction by surgical technique when removal is necessary. Teeth which have been endodontically treated and later required to be removed for some reason, frequently require surgical technique as their roots tend to be more brittle.
is necessary. Teeth which have been endodontically treated and later need to be removed for some reason, frequently require surgical technique as their roots tend to be more brittle.
Steps invlved in Surgical Tooth Extraction
When you have invasive dental process like teeth extractions done, the dentist will review your health history. If you have replacement joints (e.g. total knee, hip, etc.), you may be pre-medicated with antibiotics for the process. If you have certain kinds of heart murmurs or replacement heart valves, you may also required to take an antibiotic pre-medication prior to the process. If you take blood thinning medications like warfarin (the generic name for Coumadin® and others), or drugs that inhibit platelet aggregation like clopidogrel (the generic name for Plavix®), particularly if you take either with aspirin, your dentist or physician may need you to suspend those medications temporarily to have any oral surgical process, including simple teeth extraction. This is due to the possibility for prolonged bleeding from teeth extraction sites. The following describes the typical generally teeth extraction process in detail. Your process may vary from the process mentioned.
The teeth to be removed is usually anesthetized by injecting local anesthetic around the nerve(s) that supply sensation to the tooth. Discomfort from the injection can be reduce by use of a topical numbing gel for a minute or two prior to the injection..
Incision and flap elevation to expose tooth
If the teeth is not visible, or is only partly visible in the mouth, it will be essential to gently expose the tooth by elevating a surgical flap. An incision is made, and the gum tissues are slow reflected to expose the tooth.
Release periodontal ligament fibers
Teeth are not normally fused to bone. Instead, they have a shock-absorbing ligament that suspends them from the bony teeth socket. The ligament is known as "periodontal ligament", and the first step in removing a teeth is to release it. This can be done very automatically with a thin-bladed instrument known a periotome. It may be essential to remove enough bone from around the teeth to allow its removal (full- and partial-bony impactions). This is simply done with a surgical handpiece that is specially designed for the removal of bone..
Sectioning of the tooth
Whether or not a surgical access flap is required to expose the tooth, it may be necessary to section it into individual pieces to remove it safely and atraumatically. That step would usually be accomplished next. How many pieces the tooth is divided into depends on many factors, including the number and shape of the roots, as well as any nearby anatomical features that may be of concern..
Luxation and elevation of the tooth
The tooth is (or individual pieces are) loosened (the dental term is "luxated") within the socket by applying leverage with an instrument called an lift. There are several kinds of elevators, depending on the shape and size of tooth to be removed, and its location in the mouth. When the teeth has been sectioned, the socket generally isn't raised much, if any. The tooth snipped are removed in an ordered sequence that usually involves curved roots being removed last..
Ridge preservation via socket graft (optional)
If the teeth being removed is going to be replaced, the dentist may adviced placing bone graft material in the teeth socket to significantly decelerate the bone resorption procedure and protect the height and width of the bony ridge at its pre-extraction level. If ridge preservation is not done, the height and width of the bony ridge will instantly begin to deteriorate with the healing procedure.
Placement of an immediate dental implant (optional)
Certain tooth may be candidates for immediate replacement with dental implants. If no acute infection is present (i.e. one that has drainage and swelling), and the bony socket is intact, you and your dentist may plan for instant placement of the dental implant upon removal of the teeth. A bone graft may be need simultaneously..
Post-operative instructions and care
Your dentist will give you distinguished post-operative instructions, taking into account your comical medical and dental situation. Although they may seem generally at the time of your , assignation, query frequently come up later.
Benefits of Surgical Tooth Extraction
1). Removal of infected tooth eliminates the source of the infection, and generally brings fairly rapid relief from pain and swelling..
2). ). Removal of tooth from severely crowded dental arches provides more space in which to move the remaining teeth to straighten and better align the dental arches.
3). Removal of tooth having a questionable long-term prognosis can lead to a much more successful treatment outcome.
4). Removal of wisdom tooth can prevent the start of periodontal disease, avoid damage to the adjacent molars, and promote a more "stable" dentition that is easier to maintain.
5). Surgical removal of tooth is generally less traumatic to the jaw bone than intact removal of the teeth. In some cases surgical removal can importantly less risk of surgical tangles like nerve injuries and development of an oroantral fistula (i.e. an initial between the mouth and maxillary sinus caused by removal of an upper back tooth)