This document provides an overview of exodontia (tooth extraction). It defines exodontia and ideal tooth extraction. It discusses types of extraction including closed and open extractions. It outlines indications, contraindications, instruments used, and complications of extraction. Post-extraction care is also summarized, including inspection of the socket, medication, and follow-up care.

1. EXODONTIA
Presented by
Dr Pavan. R. Rathod
(MDS I)

2. 1. Definition
2. Ideal tooth extraction
3. Types of extraction
4. Indication
5. Contraindication
6. Evaluation of tooth removal
7. Instruments
8. Dental forceps
9. Dental elevators

3. 10. Types of elevators
11. Principles of elevators
12.Complication of exodontia
13.Post extraction care

4. EXODONTIA
It is the branch of Oral surgery which deals with
the Extraction of Tooth.

5. ( GEOFFREY L HOWE)
The painless removal of whole tooth or
root with minimal trauma to the
investing tissue, so that wound heals
uneventfully and no post operative
complication created.

6. • Intra alveolar (closed) extraction-
1. Expansion of bony socket
2. By using lever ,wedge and wheel principle
• Trans alveolar (open)extraction-
1. Impacted unerupted teeth
2. By using surgical flap

7. • Closed method extraction
• Beak of the forceps are forced into the periodontal space to gain
the sufficient grip to the forceps
• By using tooth extraction forceps
 ARMAMENTARIUM-
• Diagnostic tray + surgical tray
• Lab investigation
• Radiographs
• Anesthesia

8. • SEVERE CARIES
• SEVERE PERIODONTAL DISEASES
• ORTHODONTIC PURPOSE
• PROSTHODONTIC PURPOSE
• TEETH FROM FRACRURE LINE
• ECONOMIC FAILURE TO PRESERVE TOOTH.
• SUPERNUMERARY TOOTH
• TEETH ASSOCIATED WITH PATHOLOGICAL LESION
• ESTHETICS

10. 1. LUXATION OF TOOTH
2. REFLECTION OF MUCOPERIOSTEAL FLAP
3. ADAPTATION OF FORCEPS
4. FORCED APPLIED TO THE TOOTH WITH TIOOTH EXTRACTION
FORCEP
5. REMOVAL OF TOOTH FROM SOCKET
6. COMRESS THE SOCKET
7. TO ACHIIEVE THE HAEMOSTASIS

11. 8. Inspection of socket
9. Smoothing of Hard/socket margine
10. Pressure pack
11. Suturing of the socket (if require)
12. Post operative instruction/care/medication
13. Follow up

12.  Acute infection
 Acute pericoronitis
 Malignant disease
 Irradiated jaw
 Vascular abnormalities
 Tooth with severe tenderness
 SEVERE INFECTION AT EXTRACTION SITE

13. Uncontrolled Diabetics
Cardiac Disease
Blood Dyscrasias
Renal Disease
Pregnancy And Manstruation
Jaundice
Hyperthyroidism

14. 1. CLINICAL EVALUATION.
• Accesss to the tooth
• Mobility of tooth.
• Condition of crown.
• Condition of adjacent teeth
• Genaral condition of Patient

15. • Associated vital structure
• Configuration of root/roots
• Condition of surrounding Bone and Structure

16. INSTRUMENTS

18. • COMPONENTS:
1. Handle
2. Hinge
3. Beak
• GOALS:
1. Expansion of Bony socket.
2. Removal of tooth From the socket.

19. • The correct forceps should be use
• Do not grasp the forceps near the Beak
• Handle should almost covered by palm and hand
• Long axis of forceps beak should be parallel to the long axis of the
tooth root
• Beaks should be placed on sound root

20. Forceps help in-
• Dilation of alveolar socket
• Luxation of the tooth
• Removal of the tooth

21. • The Physics Forceps are a unique type
of extraction system that provides:
Predictable and efficient extractions
in less than four minutes
• Atraumatic extractions where you
preserve the bone
• Elimination of root tip fractures
• No need for elevating or laying a flap
• Very little operator movement (or
strength) necessary

22. • The dental elevators:
-To Luxate /elevate the teeth from the socket prior to
application of the forceps
- It expand the bony socket facilitating tooth extraction
-To remove root remnants from the extraction socket

23. • Handle
• Shank
• Blade

24. • Depend on the condition of the tooth and its mobility
• How much tooth structure remaining
• Availability and position of solid fulcrum
• Direction of the movement required
• Space available foe elevation.

25. • TO REFLECT MUCOPERIOSTEUM
• WIDEN THE PERIODONTAL LIGAMENT
• TO LUXATE AND REMOVAL THE TOOTH
• TO REMOVE FRACTURE OR CARIES TOOTH
• TO REMOVE INTRARADICULAR BONE
• TO REMOVR FRACTURED ROOT

26. • No joint
• Need a fulcrum to work
• Has to be wedged between the interdentally bone and the tooth
• BLADES- Straight type.
Triangular type.
Pick type.

27. • Straight Elevators
• Apexo Elevators
• Cryers Elevators
• Winters Elevators

28. • Periosteal elevators • Crossbar elevators • Apexo elevators

29. • Lever Principle
• Wedge Principle
• Wheel and axel Principle

30. • Most commonly used principle
• Elevators is a lever of the first order
• Fulcrum is located between the input effort and the output load.
• Effort arm must be longer the resistance arm
• Effort represented by handles of the forceps
• Resistance represented by beaks

31. • Fulcrum
• Effort
• load

35. • Modified form of lever principle
• Light force applied to a crank handle on to the side of wheel
creates a torque about the axle centerline to lift a heavy load.
• The efforts is applied to circumference of a wheel which turn
the axle so as to raise weight.
• Greater the diameter of the wheel, more is mechanical
advantage.

36. ELEVATORS WOEKED ON WHEEL ANS AXLE
PRINCIPLE
• WINTWR CROSS BAR ELEVATORS
• HOCKEY STICK ELEVATORS

38. • WORKING BLADE 0F THE ELEVATOR IS OF THE SHAPE THAT BROADENTS
POSTERIORLY
TIP OF THE ELEVATORS IS FORCED BETWEEN THE BONY SOCKET AND THE
ROOT
THE TOOTH GRADUALLY DISPLACED OUT OF THE SOCKET SEVERING
PERIODONTAL ATTACHMENT
ELEVATORS - PERIOSTEAL ELEVATOR
STRAIGHT APEXOI ELEVATOR
ANGULATED APEXO ELEVATOR
Mechanical Advantages =Length / Height

39. Mechanical Advantage = Rw/ra

40. • INTRAOPERATIVE COMPLICATION
1. Failure to luxate /Remove tooth
2. Fracture of tooth .,alveolus ,Mandible, Maxillary tuberosity
3. Mucosal laceration on gums, lips ,Tongue ,Flour of the mouth
4. Luxation/Removal of Adjacent tooth
5. Displacement of tooth in Facial space ,Maxillary sinus
6. Nerve injury
7. Tempaoromandibular Joint Dislocation Subluxation

41. Haemorrhage: Reactionary ,Secondary
Pain
Dry socket: Alveolar osteitis
Postoperative edema
Hematoma
Infection
Truisms
Oro antral fistula
Nerve damage

42. Chronic osteomelitis
Osteoredionecrosis
Nerve damage: Anaesthesia / paresthesia
Chronic pain
 Syncope, Respiratory Complication
 Hyperventilation
 Mycordial infarction
 Hypo glycaemia
 Respiratory obstruction

43. Inspect the socket: Remove the Debris, Bone, tooth fragments
Irrigate the site with saline
Compress the alveolar bone with firm finger pressure
Curette out the granulation tissue from the socket and excess
granulation tissue around gingival cuff.

44.  Moist pressure pack to be held with gentle pressure at least 30 min.
 Do not split at least one hour
 Ice fomentation ideally first 24 hours
 If no infection from on third day hot saline gargle can be advisable
 No spitting/ gargling/ smoking
 Avoid hot food/ Alcohol for at least 24 hours
 Liquid/semisolid/soft Diet

45. • Antibiotics
• Analgesic/anti inflametory
• Multi vitamine
• Anti pyretics
• Mouth wash for local application

46. • Open method of extraction
• Extraction ehich can not be performed by application of tooth or
root from its bony socket
• Surgical removal of toth
• Raising of overlying soft tissue, direct vision of root and alveolar
bone

47. a) Removal of teeth lying in difficult position
b) The fracture of bone are avoided
c) Less danger of creating an oro natural communication
d) Less chances of tearing of soft tissue
e) Less chances of fracture of large section of alveolar bone

48. • Any tooth that resists extraction by closed method
• Unerupted tooth
• Fracture root at low level
• Teeth with fused, dilacerated root
• Teeth with unfavourable curvature
• Ankylosed root
• Danger of fracture of maxillary tuberosity