Principles of Dentoalveolar Extractions

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Principles of Dentoalveolar Extractions

Seth Delpachitra

Anton Sklavos

Ricky Kumar

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This edition first published 2021 © 2021 John Wiley & Sons Ltd

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Library of Congress Cataloging-in-Publication Data

Names: Delpachitra, Seth Navinda, 1988– author. | Sklavos, Anton William, 1990author. | Kumar, Ricky Ritesh, 1976– author.

Title: Principles of dentoalveolar extractions / Seth Navinda Delpachitra, Anton William Sklavos, Ricky Ritesh Kumar.

Description: Hoboken, NJ : Wiley-Blackwell, 2020. | Includes bibliographical references and index.

Identifiers: LCCN 2020025027 (print) | LCCN 2020025028 (ebook) | ISBN 9781119596400 (cloth) | ISBN 9781119596417 (adobe pdf) | ISBN 9781119596448 (epub)

Subjects: MESH: Tooth Extraction–methods

Classification: LCC RK531 (print) | LCC RK531 (ebook) | NLM WU 605 | DDC 617.6/6–dc23

LC record available at https://lccn.loc.gov/2020025027

LC ebook record available at https://lccn.loc.gov/2020025028

Cover Design: Wiley

Cover Image: Seth Delpachitra

Set in 9.5/12.5pt STIXTwoText by SPi Global, Pondicherry, India

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v

Contents

Foreword  ix

About the Companion Website  xi

1Principles of Surgery  1

1.1Wound Healing  2

1.1.1Haemostasis  2

1.1.2Inflammatory Phase  4

1.1.3Proliferative Phase  4

1.1.4Remodelling and Resolution  4

1.2Patient­ Assessment  4

1.3Radiographic­ Assessment  5

1.4Informed­ Consent  7

1.5Anaesthesia­   7

1.6Preparation­ of Equipment  9

1.7The­ Surgeon’s Preoperative Checklist  10

1.8Operative­ Note  12

2 Local Anaesthesia  15

2.1Principles­ of Anaesthesia  16

2.2Mechanism­ of Action  16

2.3Common­ Local Anaesthetic Preparations  18

2.4.1Local Risks  19

2.4.2Systemic Risks  19

2.5.1Buccal Infiltration Anaesthetic  20

2.5.2Mandibular Teeth  21

2.5.2.1Conventional ‘Open-Mouth’ Technique  22

2.5.2.2Akinosi ‘Closed-Mouth’ Technique  23

2.5.2.3Gow–Gates Technique  23

2.5.2.4Mandibular Long Buccal Block  24

2.5.2.5Mental Nerve Block  25

2.5.3Maxillary Teeth  26

2.5.3.1 Greater Palatine Block  27

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viContents

2.5.3.2Palatal Infiltration  28

2.5.3.3Nasopalatine Nerve Block  29

2.6.1Intraligamentary Injection  30

2.6.2Intrapulpal Injection  31

2.7Troubleshooting­   32

3Basic Surgical Instruments  35

3.1Retractors­   35

3.2Elevators,­ Luxators, and Periotomes  37

3.3Dental­ Extraction Forceps  40

3.5Suturing­ Instruments  47

3.6Surgical­ Suction  49

3.7Surgical­ Handpiece and Bur  50

3.8Surgical­ Irrigation Systems  51

3.9Mouth­ Props  53

4Simple Extraction Techniques  55

4.1Maxillary­ Incisors  55

4.2Maxillary­ Canines  57

4.3Maxillary­ Premolars  58

4.5Mandibular­ Incisors  61

4.6Mandibular­ Canines and Premolars  62

4.7Mandibular­ Molars  64

5Surgical Extraction Techniques  67

5.4Bone­ Removal  73

5.5Tooth­ Sectioning  74

5.6Cleanup­ and Closure  75

6Intraoperative Complications  79

6.1Lip­ Burns and Lacerations  79

6.3Mandible­ Fracture  81

6.5Instrument­ Fracture  82

6.6Intraoperative­ Bleeding  82

6.7Oroantral­ Communication  83

6.8Dentoalveolar­ Fracture  84

7Third Molar Surgery  87

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Contents vii

7.4.1Maxillary Third Molars  91

7.4.1.1Erupted  91

7.4.1.2Unerupted/Partially Erupted  92

7.4.2Mandibular Third Molars  93

7.4.2.1Mesioangular  93

7.4.2.2Distoangular/Vertical  93

7.4.2.3Horizontal  95

7.4.2.4 Full Bony Impaction (Early Root Development)  99

7.4.2.5Buccolingual/Other Impactions  99

8.1Ischaemic­ Cardiovascular Disease  102

8.3Hypertension­   103

8.5Diabetes­ Mellitus  107

8.6Increased­ Bleeding Risk  108

8.6.1Bleeding Diatheses  108

8.6.2Medications  109

8.6.2.3Management of Patients Taking Direct Anticoagulant Agents Prior to Dentoalveolar Surgery  110

8.7Adrenal­ Suppression  110

8.8The­ Irradiated Patient  112

8.9Hepatic­ or Renal Impairment  113

8.10Pregnancy­ and Lactation  114

9Postoperative Care and Late Complications  115

9.1Immediate­ Postoperative Period  115

9.2Postoperative­ Instructions  116

9.3Postoperative­ Medications  116

9.5Management­ of Late Complications  117

9.5.1Alveolar Osteitis  117

9.5.2Acute Facial Abscess  118

9.5.3Postoperative Haemorrhage  119

9.5.4Temporomandibular Joint Disorder  119

9.5.5Epulis Granulomatosa  120

9.5.6Nerve Injury  121

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