SURGICAL EXTRACTION SECTIONING TIPS | OnlineExodontia.com
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This video provides general dentists with helpful tips for sectioning various teeth in the mouth.
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I had a surgical extraction 07210 the other day and was on nitrous oxide. The gas was so relaxing, I could barely keep my eyes open, and I felt so much pressure but didn’t care
Nitrous is a terrific modality for sedation. Glad to hear things went ok! Thanks for watching!
Thank u so much for very useful tips, appreciate your effort
Great video
Very useful tips
Appreciated
your videos are amazing. thank you
Thank you very much! All the best!
Thanks!
Thank you so much! All the best!
Thank you so much
You’re welcome!
Thank you! Keep it up!
Thanks for watching!
Can I repost your video to my APP, I will indicate the author
Plz tell can we use normal air rotar with round bur to cut the roots
No
Which burs do You use for sectioning? Thanks for the video!
Often a surgical length 702 carbide. Thanks for watching and all the best!
Which elevator was that?
This was the 77R from Hu-Friedy. All the best!
Thank you for your great videos, again something amazing i learned from you!
Hope your little bug friend under your left hand is doing well haha!
All the best
Haha! I recall making that video and yes it wouldn’t go away. All the best!
Regarding sectioning the max 2nd molars,
after we cut off the crown.
How do I know which roots are fused?!
What will I see that leads me to the fused roots?!
My Sincere thanks,
Great question! Yes this can be problematic. The first thing is to get a great periapical image of the area to determine what the root structure looks like (this is important for any extraction). Next, once the crown is off, you will see the pulp chamber and from there you can have a pretty good idea of how things are panning out. Does that help?
@@OnlineExodontia I am still not sure. How would I know - for example- the two fused buccal roots from the pulp chamber? should I be directed by the canal orifices or the pulp floor map?
@@ghaithkiblawi7530 In some instances you may see a C shaped canal or adjoining canals for example. Most times you'll have most of your root anatomy hashed out by looking at the periapical film I mentioned and pulp chamber either helps confirm what you're seeing on the PA or may steer you another direction. Does that make more sense? All the best!
@@OnlineExodontia Thank you , I greatly appreciate your help.
Hi doctor, do u have any tips on extracting a grossly decayed upper 3rd molar? Thanks
What are you needing help with Nigel? Let me know and maybe I can shed some light on the situation. All the best!
@@OnlineExodontia I always find difficulty when elevating the tooth as it gets very brittle. Do u straight go in and section the tooth?
@@eggtart7214 When you reflect the gingiva at the start of the extraction you'll get a sense for the depth of the decay that's present. If a tooth is decayed to the bone level I still attempt an elevator (I use a 3mm luxator) and if I can get a solid purchase I use it. If there is little to no sound tooth structure above the bone, then yes I will choose to go straight to a surgical approach. There is no harm with any extraction going elevator --> forceps
--> handpiece. The trick however is to know what to do next when something doesn't work, and don't spend too long trying something that isn't working. For example, if the tooth is turning to mush with an elevator, don't try the elevator for 20 minutes. Try all the angles of the tooth and if you're not making progress pick up your handpiece. When you pick up the handpiece, know what you're going to do with it, don't just start cutting. Cut with a purpose so that when you put the handpiece down, you can deliver the tooth. Hopefully that helps!
All the best and thanks for watching!
@@OnlineExodontia Thank you very much. Yes this helps alot
When sectioning lower molars using a bur, do you stop a little before the lingual plate or do you go all the way through?
Also would it be easy to break off the crown with a forcep to section as opposed to drilling the crown half off?
Never go to the lingual. Always stop about 2/3rds of the way. Also keep in mind that many times these molars are leaning lingually. Make sure the the angulation of bur matches the long axis of the tooth. Certainly in some cases you can break off the crown with a forcep, but you have no control over how the tooth may break and it's not pleasant for the patient if they are awake. All the best!
How deep should we drill before we spilt the tooth with elevator?
Tith - it really depends on the tooth in question and the surrounding anatomy. If you are sectioning a lower first or second molar I will typically cut straight through the furcation. I stop when I see bone/bleeding at the base of the section. The key thing here is to not go fully through the lingual. In an upper molar, if the sinus is not low down in the furcation area I do the same thing. If the sinus is right at the base of the furcation I'll be more careful and split the tooth with the elevator. Likewise in a lower impacted third molar, if the IAN is way beneath the tooth I'll cut right through, if it's close, I don't. I use the drill to split the tooth whenever possible because it is more predictable than using your elevator. Hopefully that helps and makes sense?
Really appreciate your answer dr. and thank you so much.