3 Roots Molar
2021年4月22日Register here: http://gg.gg/p4wuw
*3 Roots In Molar
*3 Roots Molar Volume
*3 Root Molar Native AmericanImportant pages –
A molar root canal may take a couple of hours. X-rays are taken of the infected tooth to establish how many canals are present and where the work will be done. Molars can have two to four canals and may require multiple visits. In some cases antibiotics may be given prior to, during, or after the molar root canal procedure. Usually the maxillary second molars have 3 roots with 3 or 4 root canals 9, 10. Demonstrated that 3.1% of maxillary second molars had 1 root and 1 canal, 2-rooted maxillary molars range from 0 to 12% 6, 10. The prevalence of maxillary second molars with 4 roots (2 buccal and 2 palatal) is rare; it is only 0.4%. Apr 30, 2013 Studies of the tooth anatomy have shown that anatomical variations can occur in each group of teeth, in each person and they should be considered as frequent possibilities.3-4 Diagnosis and identification of the shape and number of roots of teeth are a critical factor in their restorative and endodontic treatment or extraction procedures if needed. The molars or molar teeth are large, flat teeth at the back of the mouth.They are more developed in mammals.They are used primarily to grind food during chewing.The name molar derives from Latin, molaris dens, meaning ’millstone tooth’, from mola, millstone and dens, tooth.All Topics »Tooth Extraction Pages »“Surgical” extractions.
Indications for this procedure – Broken or cracked teeth, Impacted wisdom teeth, Curved roots, Root tip removal. | Techniques used: Tooth sectioning, Bone removal.What is a surgical extraction?
The term Surgical tooth extraction refers to the process used to remove teeth that includes additional “surgical” steps that aren’t performed during routine extractions.Routine/”Simple” extraction protocol. These added steps may include:
*Creating a gum tissue flap. – With this procedure, an incision outlining a section of gum tissue is made. The area of tissue is then reflected (peeled) back, thus providing your dentist with access to the bone tissue and/or tooth that lies underneath.
*Removing bone (ostectomy) – Trimming away bone tissue may be needed to give your dentist better access to, or a better view of, your tooth. Or it may be required to create an opening through which your tooth is taken out.
*Tooth sectioning – This is a process where your tooth is cut into pieces (“sectioned”), so it can be removed more easily.When does a tooth extraction qualify as a surgical extraction?
When one or more of the above techniques are used, the procedure is formally categorized as a “surgical” extraction. Procedures that don’t require any of these steps are termed “simple” extractions.Surgical vs Simple example.When are surgical extractions needed?Indications / Applications
There can be a number of situations where the nature of a tooth’s extraction is expected or discovered to be more complicated or challenging than with routine cases. And as such requires the inclusion of one or more of the above surgical techniques as a means of helping to lessen the complexity, difficulty or risk of the procedure.
A decision to include these additional techniques might be planned, anticipated or even an impromptu event. Situations can include:
*Severely broken or fragile teeth.
*Teeth that have extreme root morphology. (For example, especially curved or exceptionally long roots.)
*Impacted teeth. (Wisdom teeth are a common example.)
*Dense or inelastic bone tissue surrounding the tooth.
Our next section discusses the difficulties and challenges that the above situations can pose for a dentist and then explains what surgical steps (gum tissue flap, bone removal, tooth sectioning) are used to overcome them. (Jump to a specific section using the links above.)
If instead you’d rather learn more about the process itself, use this link: Surgical tooth extraction procedure details.Problem situations and their surgical solutions –1) Broken teeth.
Many teeth are slated for extraction because much of their crown (the portion of a tooth that lies above the gum line) has been lost (fractured, broken) or severely damaged (like by decay), and now the tooth is beyond repair.
Or it’s possible that during its extraction procedure, a tooth has broken (for example, the crown of a weakened tooth might break off at the gum line), therefore leaving little of the tooth visible or accessible to the dentist.
The difficulty this causes – In cases where significant portions of a tooth are missing, the shape of the piece(s) that remains may be difficult for the dentist to grasp or manipulate with their extraction instruments.
And since these are the tools the dentist will use to remove the tooth, the dentist now has a dilemma.Solutions for this situation.
One remedy is for the dentist to remove bone from around the pieces of the broken tooth that remain, so they’re more accessible and visible. Then, once this process has been completed, the tooth can be worked and removed using conventional extraction instruments.How it’s done.
*In some cases, the procedure that’s used to remove the bone may be as simple as the dentist using their drill to create a trough around the tooth, thus exposing more of it.
If so, the whole process may be completed in just a minute or two, with little extra attention required for the wound because this technique has been used.
*With other cases, the dentist may find that they need more of the tooth exposed, or a greater extent of bone removed to reach where the broken bit lies. If so, a gum tissue flap will be raised, then the bone underneath trimmed away.
This scenario is a more involved surgical process than the first one. And afterward, stitches will be needed to hold the flap in place as it heals.
(See below to learn more about both of these procedures.)2) Fragile or cracked teeth.
Beyond just having missing parts, what remains of a broken tooth may be fragile. And traumatized teeth that may still appear substantially intact, may have cracks that suggest to the dentist that they’ll fracture during the extraction process.
The difficulty this causes – Teeth are extracted by way of applying forces to them. And these same forces might be enough to break a fragile tooth. If so, the portion that remains in the tooth’s socket may be difficult to access and manipulate, thus adding greatly to the degree of difficulty of the procedure.(A study by Ahel determined that the level of force that results in tooth fracture is often only slightly greater than that required for the extraction process. This suggests that the potential for fracture of structurally compromised teeth is very real.)
▲Section references – AhelSolutions for this situation.
With these types of situations, the dentist may decide that approaching the tooth’s procedure as a surgical one right from the start makes the best plan because it minimizes the chances of complications associated with the unpredictability of the tooth fracturing.
Here’s how performing a surgical extraction can help.
*Removing some of the bone that encases the tooth’s root(s) can make it so it can be loosened up and removed with less force, thus reducing its chances for fracture.
*The dentist may decide to section the tooth. “Sectioning” means cutting a tooth into pieces and taking them out individually.
As an example, a two-rooted molar might be cut in half. That way each piece, each having one of the roots attached, can be removed separately.
(See below for more details about these procedures.)3) Teeth with long or curved roots.
An extraction’s level of difficulty often hinges on the configuration of its roots. (This is one reason why dentists typically recommend that wisdom teeth should be removed before full root development has occurred.Rationale / Example.)
Here are some of the root-related challenges that a tooth may pose that a dentist can manage by performing its extraction surgically:
a) Curved roots – Removing multi-rooted teeth (like molars) that have especially curved, hooked or crooked roots can prove to be stubborn extractions. Beyond just being difficult procedures, the act of pulling these teeth may require the use of excessive forces that may cause bone or tooth breakage.Solutions for this situation.
Molars (including wisdom teeth) are frequently sectioned when pulled. Cutting the tooth into parts, each having its own individual root, means that each piece will take less force to remove than if the tooth were whole.
The dentist will also have the luxury of removing especially curved roots each on their own, instead of locked together as an unmanageable unit.
(See below for more details about sectioning teeth.)
b) Long, large roots – Teeth (like eyeteeth, canines) that have relatively larger, longer roots will take more force to extract than those that have comparatively shorter, smaller ones (such as lower incisors).
And when having to extract a tooth with a longer root, the dentist doesn’t want to be placed in the position where they must apply excessive forces. Doing so puts the tooth, surrounding bone and even the jawbone at risk of fracture.Solutions for this situation.
By removing some of the bone that encases the roots of stubborn teeth, or sectioning them into parts if multi-rooted, the dentist can lower the level of force they must use, thus lowering the risk of procedure complications.
(See below for more details about these procedures.)
c) Thin, fragile roots – Comparatively longer, thinner roots will be more likely to break during a tooth’s extraction process. And this concern doesn’t just exist with small teeth. Some of the roots of multi-rooted teeth (molars, premolars) can be small, fragile and easily broken too.Solutions for this situation.
In cases where a dentist fully expects that a tooth’s root(s) will break, a surgical extraction (bone removal, sectioning) may be indicated. That’s because at the time of surgery, broken root tip retrieval can be routine but isn’t always.
For example, the layer of bone that encases the tips of the roots of upper molars can be paper-thin. So in the case where a root does break, an attempt to retrieve the piece that remains may result in it being pushed through this fragile bone and into the nasal sinus. If this occurs, this is a major complication.
(See below for more details about these procedures.)4) Impacted teeth.
Tooth “impaction” involves the situation where a tooth has not been able to come into its normal position in the mouth. And as a result, it still lies buried by gum tissue and possibly bone tissue too.
The type of tooth that’s most likely to be impacted is the 3rd molar (wisdom tooth).
[Use this link for a graphic illustrating the different impaction typesPictures / Diagrams discussed below.]
With impacted teeth, a surgical extraction will be required. It’s only a question of which added surgical steps will be needed.
a) Soft tissue impactions. – This is the case where the tooth is only buried by a layer of gum tissue.Solutions for this situation.
The dentist will need to make an incision in the overlying gum tissue and then reflect it back as a flap.
Now that the tooth has been exposed it can be removed, possibly just using routine extraction techniques. The flap is then positioned back and tacked into place using stitches.
(See below for more information about tissue flaps.)
b) Partial-bony impactions. – This classification involves teeth whose upper portion is both buried underneath the gums and partially encased by bone.Solutions for this situation.
Just as above, the gum tissue must be flapped back so the tooth is exposed. Whatever bone stands in the way of removing the tooth is trimmed. The tooth is then removed and the tissue flap repositioned and stitched into place.
(See below for more information about how these procedures are performed.)
c) Full-bony impactions. – With this situation, the impacted tooth is fully encased in the jawbone. (The most difficult types of wisdom teeth to remove are full-bony impactions.)Solutions for this situation.
The same general steps taken with partial-bony impactions are performed here also, although much more bone tissue is trimmed away. And while any of the cases discussed above may, this one frequently involves the use of tooth sectioning technique to cut the tooth into smaller pieces that can then be removed individually.
(See below for more information about tooth sectioning.)
5) Dense, inelastic bone.
The underlying difficulty – Conditions may exist that have affected the bone that encases the roots of a tooth. This can include increased bone density (often a result of excessive tooth clenching and grinding) and age-related bone inelasticity.
Other patients may have added deposits of bone on their jaws (termed exostoses) whose presence complicates the extraction process.Solutions for this situation.
With these cases, the use of bone removal or tooth sectioning techniques can help to reduce the level of force that’s needed for the extraction, thus making it a more controlled and predictable process.
(See below for more information about these procedures.)
Some bone removal may be needed to retrieve this root tip.6) Root tip removal.The underlying difficulty – The outcome of a tooth’s extraction process may be such that the fractured tip of one of its roots has either been inadvertently, or possibly purposely, left behind.
Over time, the broken piece may remain in its original location, or possibly migrate toward the jaw’s surface.Why they move. But either way, if at some point a decision is made to retrieve the root tip, a surgical extraction will likely be needed.Solutions for this situation.
The type of procedure needed will simply depend on the tip’s current position.
*If it now lies close to the surface of the gums, a minor incision through the overlying tissue may create enough access to flick it out.
*If the broken tip still remains encased in bone, a tissue flap and bone removal will be required to retrieve it.▼Primary reference sources for the surgical tooth extraction procedure. – Fragiskos, Koerner, WraySurgical extractions – Procedure details.
There are 3 basic surgical techniques that might be utilized during a tooth’s extraction. They are:
*a)Raising a gum tissue flap.
*b)Trimming bone from around the tooth.
*c)Sectioning the tooth.
Creating a flap allows access to the jawbone surrounding the tooth.a) Tissue flaps.A gum tissue flap is created and raised (peeled back) when the tooth or bone lying underneath needs to be accessed during the extraction procedure.Then, once the tooth has been removed, it’s positioned back into place and stitches are used to hold it there during the initial phases of its healing process.
Use this page “Gum tissue flaps procedure”The steps. for information about how they’re designed and made, as well as information about types of, placing and removing stitches.b) Trimming bone.Trimming bone tissue from around a tooth can serve two, often overlapping, purposes:
*Changing the nature of the extraction – By removing some of the bone that encases a tooth’s root, the dentist can change (reduce) the level of force that’s needed to loosen and remove it.
This is a positive thing because it helps to make the extraction process more controlled and predictable. When excessive forces must be used, tooth or bone fracture or jaw joint aggravation may occur.
*Access –When extracting broken teeth, surrounding bone is often removed so more of the tooth is exposed. This makes it easier for the dentist to grasp and manipulate what’s left of the tooth, thus making the extraction process more like a conventional one.
In the case of impacted teeth (like wisdom teeth), the purpose of removing bone may be as fundamental as being what’s needed to even access the tooth.
Whatever the purpose, as the dentist makes their plans one of their prime considerations will be how to keep the amount of bone they remove as limited as possible.Trimming away bone – The process.The method a dentist uses to trim bone tissue from around a tooth will depend on the access they have to it.a) Removing bone immediately adjacent to and within the tooth’s socket.
In cases where much of the tooth is missing and what is left is its root portion in its socket, the dentist may already have the direct access they need to remove bone.
This type of situation might exist when pulling teeth that have already fractured, or those that during their extraction procedure have broken or been sectioned into pieces (see below).
What the dentist will do.
Since they already have the access they need, a dentist will often just go ahead and trim away bone tissue from around the tooth using their dental drill. Doing so can be a quick and simple way of exposing more of the tooth without making a big production out of the process.
Deeper within the socket, this same method might be used as a way of removing bone from in between individual roots, or simply creating whatever additional space is needed for better instrument access.Issues.
One advantage of this method is that no secondary wound is created (like when a gum tissue flap is raised, see below). The trimming is primarily accomplished within the wound that would have generally existed anyway. This is favorable for the healing process.What you’ll experience.
If your dentist does things this way, it won’t be much of an issue for you. You’ll hear the noise and feel the vibrations of the drill as it’s being used. Other than that, it should be a non-issue.
Trimming bone in this manner may take very little time. And as opposed to a separate step, it’s often just incorporated into the flow of the procedure.
Since they don’t want to remove more bone than is necessary, a dentist will frequently drill an initial amount, then try to remove the tooth. If it doesn’t come out as expected, and after evaluating why, they’ll make adjustments in their plan and trim some more.
b) Removing bone external to the tooth’s socket.
In situations where the bone that needs to be removed lies in an area covered by gum tissue, a flap will need to be raised.
This type of scenario would apply to cases such as removing impacted wisdom teeth (where a layer of bone lies over the tooth) or removing the bone alongside of a tooth (so to expose a portion of its roots, so it’s easier to remove).
What the dentist will do.
*The dentist will first need to plan and then make the incision(s) needed to create the gum tissue flap (see above). They’ll then reflect (peel) it back.
*Once exposed, the bone can then be removed (either via the use of a drill or hand instruments).
*Once the extraction has been completed, the flap is closed and tacked back into place with stitches.Issues.
The fact that along with bone removal a gum tissue flap is raised too makes this a more involved procedure than that described above.
And because a flap is created, a higher level of surgical trauma is experienced than w
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*3 Roots In Molar
*3 Roots Molar Volume
*3 Root Molar Native AmericanImportant pages –
A molar root canal may take a couple of hours. X-rays are taken of the infected tooth to establish how many canals are present and where the work will be done. Molars can have two to four canals and may require multiple visits. In some cases antibiotics may be given prior to, during, or after the molar root canal procedure. Usually the maxillary second molars have 3 roots with 3 or 4 root canals 9, 10. Demonstrated that 3.1% of maxillary second molars had 1 root and 1 canal, 2-rooted maxillary molars range from 0 to 12% 6, 10. The prevalence of maxillary second molars with 4 roots (2 buccal and 2 palatal) is rare; it is only 0.4%. Apr 30, 2013 Studies of the tooth anatomy have shown that anatomical variations can occur in each group of teeth, in each person and they should be considered as frequent possibilities.3-4 Diagnosis and identification of the shape and number of roots of teeth are a critical factor in their restorative and endodontic treatment or extraction procedures if needed. The molars or molar teeth are large, flat teeth at the back of the mouth.They are more developed in mammals.They are used primarily to grind food during chewing.The name molar derives from Latin, molaris dens, meaning ’millstone tooth’, from mola, millstone and dens, tooth.All Topics »Tooth Extraction Pages »“Surgical” extractions.
Indications for this procedure – Broken or cracked teeth, Impacted wisdom teeth, Curved roots, Root tip removal. | Techniques used: Tooth sectioning, Bone removal.What is a surgical extraction?
The term Surgical tooth extraction refers to the process used to remove teeth that includes additional “surgical” steps that aren’t performed during routine extractions.Routine/”Simple” extraction protocol. These added steps may include:
*Creating a gum tissue flap. – With this procedure, an incision outlining a section of gum tissue is made. The area of tissue is then reflected (peeled) back, thus providing your dentist with access to the bone tissue and/or tooth that lies underneath.
*Removing bone (ostectomy) – Trimming away bone tissue may be needed to give your dentist better access to, or a better view of, your tooth. Or it may be required to create an opening through which your tooth is taken out.
*Tooth sectioning – This is a process where your tooth is cut into pieces (“sectioned”), so it can be removed more easily.When does a tooth extraction qualify as a surgical extraction?
When one or more of the above techniques are used, the procedure is formally categorized as a “surgical” extraction. Procedures that don’t require any of these steps are termed “simple” extractions.Surgical vs Simple example.When are surgical extractions needed?Indications / Applications
There can be a number of situations where the nature of a tooth’s extraction is expected or discovered to be more complicated or challenging than with routine cases. And as such requires the inclusion of one or more of the above surgical techniques as a means of helping to lessen the complexity, difficulty or risk of the procedure.
A decision to include these additional techniques might be planned, anticipated or even an impromptu event. Situations can include:
*Severely broken or fragile teeth.
*Teeth that have extreme root morphology. (For example, especially curved or exceptionally long roots.)
*Impacted teeth. (Wisdom teeth are a common example.)
*Dense or inelastic bone tissue surrounding the tooth.
Our next section discusses the difficulties and challenges that the above situations can pose for a dentist and then explains what surgical steps (gum tissue flap, bone removal, tooth sectioning) are used to overcome them. (Jump to a specific section using the links above.)
If instead you’d rather learn more about the process itself, use this link: Surgical tooth extraction procedure details.Problem situations and their surgical solutions –1) Broken teeth.
Many teeth are slated for extraction because much of their crown (the portion of a tooth that lies above the gum line) has been lost (fractured, broken) or severely damaged (like by decay), and now the tooth is beyond repair.
Or it’s possible that during its extraction procedure, a tooth has broken (for example, the crown of a weakened tooth might break off at the gum line), therefore leaving little of the tooth visible or accessible to the dentist.
The difficulty this causes – In cases where significant portions of a tooth are missing, the shape of the piece(s) that remains may be difficult for the dentist to grasp or manipulate with their extraction instruments.
And since these are the tools the dentist will use to remove the tooth, the dentist now has a dilemma.Solutions for this situation.
One remedy is for the dentist to remove bone from around the pieces of the broken tooth that remain, so they’re more accessible and visible. Then, once this process has been completed, the tooth can be worked and removed using conventional extraction instruments.How it’s done.
*In some cases, the procedure that’s used to remove the bone may be as simple as the dentist using their drill to create a trough around the tooth, thus exposing more of it.
If so, the whole process may be completed in just a minute or two, with little extra attention required for the wound because this technique has been used.
*With other cases, the dentist may find that they need more of the tooth exposed, or a greater extent of bone removed to reach where the broken bit lies. If so, a gum tissue flap will be raised, then the bone underneath trimmed away.
This scenario is a more involved surgical process than the first one. And afterward, stitches will be needed to hold the flap in place as it heals.
(See below to learn more about both of these procedures.)2) Fragile or cracked teeth.
Beyond just having missing parts, what remains of a broken tooth may be fragile. And traumatized teeth that may still appear substantially intact, may have cracks that suggest to the dentist that they’ll fracture during the extraction process.
The difficulty this causes – Teeth are extracted by way of applying forces to them. And these same forces might be enough to break a fragile tooth. If so, the portion that remains in the tooth’s socket may be difficult to access and manipulate, thus adding greatly to the degree of difficulty of the procedure.(A study by Ahel determined that the level of force that results in tooth fracture is often only slightly greater than that required for the extraction process. This suggests that the potential for fracture of structurally compromised teeth is very real.)
▲Section references – AhelSolutions for this situation.
With these types of situations, the dentist may decide that approaching the tooth’s procedure as a surgical one right from the start makes the best plan because it minimizes the chances of complications associated with the unpredictability of the tooth fracturing.
Here’s how performing a surgical extraction can help.
*Removing some of the bone that encases the tooth’s root(s) can make it so it can be loosened up and removed with less force, thus reducing its chances for fracture.
*The dentist may decide to section the tooth. “Sectioning” means cutting a tooth into pieces and taking them out individually.
As an example, a two-rooted molar might be cut in half. That way each piece, each having one of the roots attached, can be removed separately.
(See below for more details about these procedures.)3) Teeth with long or curved roots.
An extraction’s level of difficulty often hinges on the configuration of its roots. (This is one reason why dentists typically recommend that wisdom teeth should be removed before full root development has occurred.Rationale / Example.)
Here are some of the root-related challenges that a tooth may pose that a dentist can manage by performing its extraction surgically:
a) Curved roots – Removing multi-rooted teeth (like molars) that have especially curved, hooked or crooked roots can prove to be stubborn extractions. Beyond just being difficult procedures, the act of pulling these teeth may require the use of excessive forces that may cause bone or tooth breakage.Solutions for this situation.
Molars (including wisdom teeth) are frequently sectioned when pulled. Cutting the tooth into parts, each having its own individual root, means that each piece will take less force to remove than if the tooth were whole.
The dentist will also have the luxury of removing especially curved roots each on their own, instead of locked together as an unmanageable unit.
(See below for more details about sectioning teeth.)
b) Long, large roots – Teeth (like eyeteeth, canines) that have relatively larger, longer roots will take more force to extract than those that have comparatively shorter, smaller ones (such as lower incisors).
And when having to extract a tooth with a longer root, the dentist doesn’t want to be placed in the position where they must apply excessive forces. Doing so puts the tooth, surrounding bone and even the jawbone at risk of fracture.Solutions for this situation.
By removing some of the bone that encases the roots of stubborn teeth, or sectioning them into parts if multi-rooted, the dentist can lower the level of force they must use, thus lowering the risk of procedure complications.
(See below for more details about these procedures.)
c) Thin, fragile roots – Comparatively longer, thinner roots will be more likely to break during a tooth’s extraction process. And this concern doesn’t just exist with small teeth. Some of the roots of multi-rooted teeth (molars, premolars) can be small, fragile and easily broken too.Solutions for this situation.
In cases where a dentist fully expects that a tooth’s root(s) will break, a surgical extraction (bone removal, sectioning) may be indicated. That’s because at the time of surgery, broken root tip retrieval can be routine but isn’t always.
For example, the layer of bone that encases the tips of the roots of upper molars can be paper-thin. So in the case where a root does break, an attempt to retrieve the piece that remains may result in it being pushed through this fragile bone and into the nasal sinus. If this occurs, this is a major complication.
(See below for more details about these procedures.)4) Impacted teeth.
Tooth “impaction” involves the situation where a tooth has not been able to come into its normal position in the mouth. And as a result, it still lies buried by gum tissue and possibly bone tissue too.
The type of tooth that’s most likely to be impacted is the 3rd molar (wisdom tooth).
[Use this link for a graphic illustrating the different impaction typesPictures / Diagrams discussed below.]
With impacted teeth, a surgical extraction will be required. It’s only a question of which added surgical steps will be needed.
a) Soft tissue impactions. – This is the case where the tooth is only buried by a layer of gum tissue.Solutions for this situation.
The dentist will need to make an incision in the overlying gum tissue and then reflect it back as a flap.
Now that the tooth has been exposed it can be removed, possibly just using routine extraction techniques. The flap is then positioned back and tacked into place using stitches.
(See below for more information about tissue flaps.)
b) Partial-bony impactions. – This classification involves teeth whose upper portion is both buried underneath the gums and partially encased by bone.Solutions for this situation.
Just as above, the gum tissue must be flapped back so the tooth is exposed. Whatever bone stands in the way of removing the tooth is trimmed. The tooth is then removed and the tissue flap repositioned and stitched into place.
(See below for more information about how these procedures are performed.)
c) Full-bony impactions. – With this situation, the impacted tooth is fully encased in the jawbone. (The most difficult types of wisdom teeth to remove are full-bony impactions.)Solutions for this situation.
The same general steps taken with partial-bony impactions are performed here also, although much more bone tissue is trimmed away. And while any of the cases discussed above may, this one frequently involves the use of tooth sectioning technique to cut the tooth into smaller pieces that can then be removed individually.
(See below for more information about tooth sectioning.)
5) Dense, inelastic bone.
The underlying difficulty – Conditions may exist that have affected the bone that encases the roots of a tooth. This can include increased bone density (often a result of excessive tooth clenching and grinding) and age-related bone inelasticity.
Other patients may have added deposits of bone on their jaws (termed exostoses) whose presence complicates the extraction process.Solutions for this situation.
With these cases, the use of bone removal or tooth sectioning techniques can help to reduce the level of force that’s needed for the extraction, thus making it a more controlled and predictable process.
(See below for more information about these procedures.)
Some bone removal may be needed to retrieve this root tip.6) Root tip removal.The underlying difficulty – The outcome of a tooth’s extraction process may be such that the fractured tip of one of its roots has either been inadvertently, or possibly purposely, left behind.
Over time, the broken piece may remain in its original location, or possibly migrate toward the jaw’s surface.Why they move. But either way, if at some point a decision is made to retrieve the root tip, a surgical extraction will likely be needed.Solutions for this situation.
The type of procedure needed will simply depend on the tip’s current position.
*If it now lies close to the surface of the gums, a minor incision through the overlying tissue may create enough access to flick it out.
*If the broken tip still remains encased in bone, a tissue flap and bone removal will be required to retrieve it.▼Primary reference sources for the surgical tooth extraction procedure. – Fragiskos, Koerner, WraySurgical extractions – Procedure details.
There are 3 basic surgical techniques that might be utilized during a tooth’s extraction. They are:
*a)Raising a gum tissue flap.
*b)Trimming bone from around the tooth.
*c)Sectioning the tooth.
Creating a flap allows access to the jawbone surrounding the tooth.a) Tissue flaps.A gum tissue flap is created and raised (peeled back) when the tooth or bone lying underneath needs to be accessed during the extraction procedure.Then, once the tooth has been removed, it’s positioned back into place and stitches are used to hold it there during the initial phases of its healing process.
Use this page “Gum tissue flaps procedure”The steps. for information about how they’re designed and made, as well as information about types of, placing and removing stitches.b) Trimming bone.Trimming bone tissue from around a tooth can serve two, often overlapping, purposes:
*Changing the nature of the extraction – By removing some of the bone that encases a tooth’s root, the dentist can change (reduce) the level of force that’s needed to loosen and remove it.
This is a positive thing because it helps to make the extraction process more controlled and predictable. When excessive forces must be used, tooth or bone fracture or jaw joint aggravation may occur.
*Access –When extracting broken teeth, surrounding bone is often removed so more of the tooth is exposed. This makes it easier for the dentist to grasp and manipulate what’s left of the tooth, thus making the extraction process more like a conventional one.
In the case of impacted teeth (like wisdom teeth), the purpose of removing bone may be as fundamental as being what’s needed to even access the tooth.
Whatever the purpose, as the dentist makes their plans one of their prime considerations will be how to keep the amount of bone they remove as limited as possible.Trimming away bone – The process.The method a dentist uses to trim bone tissue from around a tooth will depend on the access they have to it.a) Removing bone immediately adjacent to and within the tooth’s socket.
In cases where much of the tooth is missing and what is left is its root portion in its socket, the dentist may already have the direct access they need to remove bone.
This type of situation might exist when pulling teeth that have already fractured, or those that during their extraction procedure have broken or been sectioned into pieces (see below).
What the dentist will do.
Since they already have the access they need, a dentist will often just go ahead and trim away bone tissue from around the tooth using their dental drill. Doing so can be a quick and simple way of exposing more of the tooth without making a big production out of the process.
Deeper within the socket, this same method might be used as a way of removing bone from in between individual roots, or simply creating whatever additional space is needed for better instrument access.Issues.
One advantage of this method is that no secondary wound is created (like when a gum tissue flap is raised, see below). The trimming is primarily accomplished within the wound that would have generally existed anyway. This is favorable for the healing process.What you’ll experience.
If your dentist does things this way, it won’t be much of an issue for you. You’ll hear the noise and feel the vibrations of the drill as it’s being used. Other than that, it should be a non-issue.
Trimming bone in this manner may take very little time. And as opposed to a separate step, it’s often just incorporated into the flow of the procedure.
Since they don’t want to remove more bone than is necessary, a dentist will frequently drill an initial amount, then try to remove the tooth. If it doesn’t come out as expected, and after evaluating why, they’ll make adjustments in their plan and trim some more.
b) Removing bone external to the tooth’s socket.
In situations where the bone that needs to be removed lies in an area covered by gum tissue, a flap will need to be raised.
This type of scenario would apply to cases such as removing impacted wisdom teeth (where a layer of bone lies over the tooth) or removing the bone alongside of a tooth (so to expose a portion of its roots, so it’s easier to remove).
What the dentist will do.
*The dentist will first need to plan and then make the incision(s) needed to create the gum tissue flap (see above). They’ll then reflect (peel) it back.
*Once exposed, the bone can then be removed (either via the use of a drill or hand instruments).
*Once the extraction has been completed, the flap is closed and tacked back into place with stitches.Issues.
The fact that along with bone removal a gum tissue flap is raised too makes this a more involved procedure than that described above.
And because a flap is created, a higher level of surgical trauma is experienced than w
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