Tooth extraction, also called exodontia, is the removal of teeth from their socket in the jawbone. There are two main methods: intra-alveolar extraction using forceps to remove the tooth through the socket, and trans-alveolar extraction which requires raising a bone flap and removing bone around the roots before extracting. Tooth extraction is indicated for severe dental caries, periodontal disease, pulp or bone pathology, orthodontic reasons like crowding, prosthetic needs, impacted teeth causing issues, supernumerary teeth, teeth fractured with jaw fractures, or aesthetic reasons. Contraindications include uncontrolled local or systemic infections, previous radiation therapy, or uncontrolled medical conditions.

1. Definition
is a painless removal of teeth from their bony alveolar socket.
Methods
1- Intra-alveolar (forceps or simple) extractin: removing the tooth or
root by the use of forceps or elevators or both.
2- Trans-alveolar (surgical) extractin:
rising a flap and by removal some of the bone surrounding the
roots, then removed by the use of elevators and/or forceps.
Exodontia (Extraction)
simple
extractin
surgical
extractin

2. Indications
1- Sever caries (Badly carious teeth).
2- Sever periodontal disease.
3- Pulp pathology: If endodontic therapy wasn't possible.
4- Apical pathology (P.A. abscess, granuloma and cyst…): If the teeth
failed to respond to all conservative treatment.
5- Orthodontic reason
a) Therapeutic extraction: provide space for teeth alignment.
b) Malposed teeth : teeth which erupted out of arch line.
c) Preventive exaction: extract few deciduous teeth to prevent future
malocclusion.
6- Prosthetic considerations
a) To provide better design and success of partial denture.
b) To enable the patient to have complete denture.
7- Impacted teeth:
are indicated for extraction when they responsible for:
a) Vagus facial pain.
b) Periodontal problems of the adjoining teeth.
c) TMJ problems
d) Bony pathology eg cyst & tumor.
e) May predispose, to anterior teeth crowding.
f) Significant infection (pericoronitis) e.g. partially erupted third
molar.
8- Supernumerary tooth (Extra tooth).
9- Tooth in the line of fracture of the jaws
a) It is a source of infection at the site of the fracture
b) The tooth itself is fractured.
c) Interfere with fracture reduction.
d) Interfere with healing of fracture
10- Teeth in relation to bony pathology: Cyst formation, Neoplasm
(tumor) and Osteomyelitis( infection of bone)
11- Root fragments (Retained root)
12- Teeth prior to irradiation (before radiotherapy )
13- Aesthetic considerations: due to severe staining (tetracydine,
flourosis) or hypoplasia of enamel or dentine and they cannot be
restored.

3. Contraindications
Local
Contraindications
• 1- Acute and uncontrolled infections.
• 2- Previous radiotherapy
• 3- Teeth located within area of tumor
Systemic
Contraindications
• 1-Sever uncontrolled metabolic disease, eg,
uncontrolled diabetes, end stage renal disease.
• 2- Uncontrolled leukemias and lymphomas.
• 3- Sever uncontrolled cardiac disease. eg,
myocardial infarction, unstable angina pectoris,
dysrhythmias.
• 4- Sever uncontrolled hypertension.
• 5-Pregnancy (some cases).
• 6- Uncontrolled bleeding disorder eg;
hemophilia, platelet disorder, patient on
anticoagulants.
• 7- Patients who take a variety of medications
eg: patient on steroid and immunosuppressive
drugs, cancer and chemotherapy.
• 8- Uncontrolled epilepsy.