This document summarizes Dr. Firas Kassab's lecture on extracting mandibular teeth. It discusses the extraction movements for different types of mandibular teeth, including anterior teeth, premolars, and molars. It also covers the role of the opposite hand in providing support and stabilization during extraction. Finally, it provides guidance on post-extraction care, such as using pressure packs and advising soft diets and analgesics for pain management.

1. Dr. Firas Kassab
Simple
Extraction of
Mandibular
Teeth

2. 2Dr. Firas Kassab

3. 1. Quick Revision of previous lecture
2. Extraction movements
3. Extraction of Mandibular Anterior
4. Extraction of Mandibular Premolar
5. Extraction of Mandibular Molar
6. Role Of The Opposite Hand
7. Post extraction Care
8. Postoperative Instructions
9. Sequence of Extraction
3Dr. Firas Kassab

4. 4Dr. Firas Kassab

5. 5Dr. Firas Kassab

6. 6Dr. Firas Kassab

7. • Primary movement: Along longitudinal axis of
root
• Secondary movement: Main extracting movement
• Rotatory
• Buccolingual or labiolingual
• Mesodistal
• Lifting the tooth
7Dr. Firas Kassab

8. 8Dr. Firas Kassab
Root :
single ,
straight
Root of
mandibular
canine is shorter
and weaker than
its maxillary
counterpart
Labio-lingual
movement

9. 9Dr. Firas Kassab
Root :
single ,
bifurcation is possible.
Primary rotational
movement
Bucco-lingual
movement with
second premolar more
towards lingual

10. 10Dr. Firas Kassab
Two designs of forceps used –
1.lower molar forceps
2.forcep of cowhorn design:
Lower molar forcep have two
pointed beaks which are applied
in the
Region of bifurcation buccally &
lingually.
Applied the forceps & move the
tooth in buccal direction to
expand
the buccal cortical plate.
When buccal expansion is not
sufficient to deliver the tooth
then the
forceps should be moved In a
figure –of –eight fashion to
expand the
Socket lingually as well as
buccally.

11. 11Dr. Firas Kassab
Two roots ; mesial and
distal
Bucco-lingual
movement with second
molar more towards
lingual
Extraction of Mandibular Molar

12. • Wide anatomy variation
• Thinner lingual plate and much thicker
buccal plate
• Relation : IAN ,lingual nerve
• Linguo-buccal movement
12Dr. Firas Kassab

13. • Reflection and protection of soft
tissues
• Support and stabilization of the
patient’s head or jaw
• Support of alveolar process and
transmission of tactile information
13Dr. Firas Kassab

14. Retraction Tissues and Support of Mandible
14Dr. Firas Kassab

15. 15Dr. Firas Kassab
ALWAYS SUPPORT THE MANDIBLE
IN
MANDIBULAR EXTRACTIONS

16. • Inspection of the tooth
• Inspection of the socket
&debridement only if
necessary
• Squeezing the socket walls
• -assist in hemostasis
• -better form of the ridge
(U shaped) after healing
• Pressure pack
16Dr. Firas Kassab

17. • Granuloma attached to extracted rootFailure of Socket Inspection
Deciduous teeth may be extracted using smaller pattern
forceps, but the essential difference is that with the
primary molars the forceps should grip one root to avoid
the permanent successor.
Great care must be taken that the secondary teeth are
not damaged. Small root fragments are better left than
removed and the use of the curette after extracting
deciduous teeth should be avoided
17Dr. Firas Kassab

18. Dr. Firas Kassab 18

19. • Pressure pack for at least 30 minutes
• Soft and cool diet
• No hot beverages
• Not to spit
• Not to smoke
• Ice packs on and off
• Warm saline washes after 24 hours
• Prescription of analgesics(NSAIDS)
19Dr. Firas Kassab

20. • Maxillary before mandibular
extractions
• Posterior before anterior extractions
• Eight, seven ,five ,six ,four ,two
,three , one
• Ideally, extractions should be
completed in a quadrant at a time.
20Dr. Firas Kassab

21. 1.Contemporary Oral and Maxillofacial Surgery. 5TH
Editon By Hupp Ellis and Tucker
2.Text Book of Oral Surgery by G.Kruger
3.Google.com for Images
References:
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22. Dr. Firas Kassab 22
Thank you