Extraction of tooth

Description:

Extraction of teeth — operation of an exodontia.

Indications to an exodontia: the inflammation at a top of a root, especially multi-rooted teeth which is not giving in to treatment; dontogenous osteomyelitis of a jaw (causal tooth is subject to removal); destruction of a crown of tooth if it is impossible to use a root for prosthetics; mobility of teeth of the III degree at periodontosis; the wrong arrangement of the third painters (wisdom teeth) which is followed by frequent inflammatory processes of surrounding fabrics (pericoronitis); incorrectly located accessory teeth. In some cases extract tooth according to the recommendation of the stomatologist-orthopedist for production of a full-fledged denture.

The milk teeth even destroyed should be kept before eruption of constants. Removal of milk teeth is shown only at chronic recurrent dontogenous inflammatory processes and also if milk teeth prevent eruption of constants.

Contraindications to an exodontia are relative. It diseases of a nervous system, the lowered coagulability of blood, hemophilia. In these cases the exodontia should be carried out in stationary conditions with preliminary training of the patient for operation.

For an exodontia use special tool kit, for each group of teeth upper and a mandible there are special nippers, elevators.

Operation of an exodontia consists of the following stages: 1) rinsing of a mouth solution of potassium permanganate and greasing of a gingiva about tooth of 1 — 2% spirit solution of iodine; 2) carrying out anesthesia (see below), anesthesia comes, as a rule, in 15 — 20 min.; 3) separation of a gingiva from a tooth neck gladilka; 4) application of forceps, pro-moving of their cheeks to the brim holes and their fixing; 5) a tooth vyvikhivaniye slowly, the kachatelny or rotational movements depending on a structure of roots; 6) extraction of tooth from a hole (traction); 7) processing of a wound, its audit and a scraping an acute spoon for removal of splinters of a bone, granulyatsionny fabric.
Before an exodontia it is reasonable to make a x-ray film for definition of a structure of roots, especially wisdom teeth and accessory which removal usually presents considerable difficulties.
Milk teeth are extracted special nippers, observing extra care, without deep advance of nippers not to damage  rudiments of second  teeth.

Anesthesia. At an exodontia usually apply intra oral ways of infiltration and conduction anesthesia of 1 — 2% novocaine solution with addition of one drop of adrenaline (1: 1000) on 2 ml of solution. The infiltration anesthesia is applied on an upper jaw to all teeth, and on lower — to cutters, canines and premolar tooths. Eagle should stick at an angle 30 — 40 ° in a mucous membrane of a threshold of an oral cavity about tops of teeth that the bevel of a needle was turned to a bone; in addition enter novocaine into a mucous membrane according to palatal the parties or from lingual. Conduction anesthesia is applied at extensive  interventions on jaws, and also at an exodontia on a mandible (painters).
On an upper jaw apply the following types of anesthesia: 1) tuberalny anesthesia anesthetizes three painters, a mucous membrane, and also outside and back walls of a genyantrum. To Eagle stick in a transitional fold of a threshold of an oral cavity over the second upper painter, advance knutr and up on 1,5 — 2 cm up to a bone, continuously entering solution in order to avoid wound of a pterygopalatine veniplex; 2) infraorbital anesthesia anesthetizes area of cutters, canines, premolar tooths; a needle stick in a mucous membrane of a transitional fold between the first and second cutter; gradually entering novocaine solution, advance to an entrance to an infraorbital foramen, then enter into the canal and produce 0,5 ml of solution; 3) palatine anesthesia anesthetizes soft tissues of a half of a hard palate to canine level; a needle stick in a mucous membrane of a hard palate about the second painter, grope an entrance to a big palatal opening and enter 0,5 ml of solution of novocaine; 4) incisal anesthesia anesthetizes front department of a hard palate; a needle stick vertically in the area of an incisal nipple and advance to the incisal canal.

On a mandible apply mandibular anesthesia at which on the corresponding half the mucous membrane, a half of a mouth floor, a part of language, an alveolar shoot and all teeth is anesthetized. To Eagle stick in an outside part of an alate and maxillary  fold  1 cm higher than a chewing surface of the lower painters (the syringe is located across a mouth); at a depth of 0,7 cm enter 0,5 ml of solution of novocaine for switching off of a lingual nerve, and at a depth of 2 — 2,5 cm 2 more ml for switching off of a nizhnealveolyarny nerve; in addition enter solution into a transitional fold of a mucous membrane from an oral cavity threshold in the extracted tooth.
The wound after an exodontia at a normal current is epithelized in 12-14 days.