How to extract a tooth as a professional dentist with minimal trauma in five steps. Firstly 3 fundamentals not to be forgotten during extraction: (1) Adequate access & visualization (2) A clear pathway for the removal (3) Usage of controlled force to luxate and remove the tooth. Step 1 Loosening soft tissue attachment from the cervical portion of the tooth by Molt 9 periosteal elevator, that will give two advantages: a- Allows ensuring profound anesthesia has been achieved b- Allowing the elevator & tooth extraction forceps to be positioned more apically. Step 2 Involves luxation of the tooth with a dental elevator. Elevation should occur at the mesial and distal buccal aspects of the root. No elevation should be attempted along buccal bone because it can easily fractured or the surgeon can lose control & cause soft tissue injury. Step 3 Involves adaptation of the forceps to the tooth. The lingual beak is usually seated first and then the buccal beak. The surgeon grasps the handles of the forceps at the ends to maximize mechanical advantage and control. The forceps are forced apically as far as possible to grasp the root of the tooth as apically as possible, Why? 1-The beaks of the forceps act as wedges to dilate the crestal bone on the buccal and lingual aspects 2- Forcing the beaks apically, the center of rotation (fulcrum). Step 4 Involves luxation of the tooth with forceps. In 3 stages: 1-Forceps apically seated as far as possible 2-Forces applied in the buccal and lingual directions should be slow, deliberate pressures & not jerky wiggle 3-Force held for several sec to allow the bone to expand. Step 5 Removal of the tooth from the socket. Once the alveolar bone has expanded sufficiently and the tooth has been luxated, a slight tractional force, usually directed buccally, can be used.
Dr Ryan: Bending back the bone doesn’t increase the chances of fracture of the plates? Also, isn’t that an old practice? I though we didn’t squeezed bone anymore to preserve as much bone as we can, better seating for removable appliances, more esthetics for bridges, better bone hight to implants, and probably a periodontist dies every time he/she sees someone bending plates after an ext
Thanks for asking this question! Honestly, that is not something that is going to be tested on the board exam, but like I said you definitely do not want to be doing that if orthodontics or an implant are planned for the future because you would compromise ridge width. You are right that it is an old practice, and it's how I was taught. I know several clinicians who are not a fan of the practice themselves!
We always squeezing bone in edentouls patient ..those Who have complete denture.. Bcz not bending bone is not good for retention and support ane difficult to remove appliances
Hi Dr. Ryan first of all I would like to thank you for the wonderful presentations. I have one question, in which cases do you choose to place stitches after the extraction and do you usually put any material inside the socket for anti-bleeding or just leave it as it is? Thank you
I usually only place stitches when multiple adjacent teeth are taken out in the same quadrant and/or a flap is raised. I don’t usually place anything in the socket unless significant bone is removed and then I may put a collagen plug or membrane to help with healing.
in lower molars ext... shouldn't we apply lingual pressure first because it's less resistance than buccal? this how i learned it in my school but you said the opposite
A figure eight movement is a technique that can be used for extracting most teeth, as long as the movements are slow and deliberate with the intention of expanding the alveolus.
"Exciting" I'm only watching this video to learn how to remove my upper Canine ,which is pretty loose already , i just don't want to give myself a dry socket, because i had that once before, and it is pretty sore. Bought the upper Canine extraction forcep already, now i just need the ale and some dutch courage, and a few more video, Not very "Exciting" for me at this point lol.
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How to extract a tooth as a professional dentist with minimal trauma in five steps.
Firstly 3 fundamentals not to be forgotten during extraction:
(1) Adequate access & visualization
(2) A clear pathway for the removal
(3) Usage of controlled force to luxate and remove the tooth.
Step 1
Loosening soft tissue attachment from the cervical portion of the tooth by Molt 9 periosteal elevator, that will give two advantages:
a- Allows ensuring profound anesthesia has been achieved
b- Allowing the elevator & tooth extraction forceps to be positioned more apically.
Step 2
Involves luxation of the tooth with a dental elevator.
Elevation should occur at the mesial and distal buccal aspects of the root.
No elevation should be attempted along buccal bone because it can easily fractured or the surgeon can lose control & cause soft tissue injury.
Step 3
Involves adaptation of the forceps to the tooth.
The lingual beak is usually seated first and then the buccal beak.
The surgeon grasps the handles of the forceps at the ends to maximize mechanical advantage and control.
The forceps are forced apically as far as possible to grasp
the root of the tooth as apically as possible, Why?
1-The beaks of the forceps act as wedges to dilate the
crestal bone on the buccal and lingual aspects
2- Forcing the beaks apically, the center of rotation (fulcrum).
Step 4
Involves luxation of the tooth with forceps.
In 3 stages:
1-Forceps apically seated as far as possible
2-Forces applied in the buccal and lingual directions should be slow, deliberate pressures & not jerky wiggle
3-Force held for several sec to allow the bone to expand.
Step 5
Removal of the tooth from the socket.
Once the alveolar bone has expanded sufficiently and the tooth has been luxated, a slight tractional force, usually directed buccally, can be used.
Thank you 🤎
Why should you elevate from the buccal aspect of the mesial and distal if you don't wanna touch the buccal bone? Why not from the lingual aspect?
@@kvgolfa because thre is lingual nerf lingually
blood vesselles also
I can't stop thanking you enough , nice and simple presentation ! :)
Very Professional presentation.
Thank you kindly! 💯
Nicely explained! Loved it
Very helpful video. I enjoy most of your videos Ryan.
Thanks heaps!
So helpful, thank you for making this
thank you so much, Dr Ryan! 💐
Very informative & nice presentation .thank u so much
You’re very welcome! 😁
شكرا جزيلا ❤
Thank u so much ! Could you make a video on the LA Techniques?
Yes! I have a video on that topic here: ua-cam.com/video/eWXuKFSnkIY/v-deo.html
Gonna do one for the first time tomorrow. Hope it’ll go well..
Best of luck!
@@mentaldental It's done. 28 extraction without any symptom. My instructor hold my hand all the way though..
Thanks a million! 💙
REALLY ...... MILLION LIKE ........
Very helpful, thank you so much
Glad it was helpful!
Dr Ryan:
Bending back the bone doesn’t increase the chances of fracture of the plates? Also, isn’t that an old practice? I though we didn’t squeezed bone anymore to preserve as much bone as we can, better seating for removable appliances, more esthetics for bridges, better bone hight to implants, and probably a periodontist dies every time he/she sees someone bending plates after an ext
Thanks for asking this question! Honestly, that is not something that is going to be tested on the board exam, but like I said you definitely do not want to be doing that if orthodontics or an implant are planned for the future because you would compromise ridge width. You are right that it is an old practice, and it's how I was taught. I know several clinicians who are not a fan of the practice themselves!
We always squeezing bone in edentouls patient ..those Who have complete denture.. Bcz not bending bone is not good for retention and support ane difficult to remove appliances
But not for young people because of the probability of ortho and implant!!
Thank you for sharing your knowledge
thank u so much that was so HELPFUL!
Thank you soooo much 👌
Really like this information
your my g!!!
This was great!
Very good presentation
Plzzz make more videos on oral surgery
Thank u sooo much , it is really useful
Hello thank you so much for your great Videos ، is there a way where I can print out your lectures.?
You can get the video slides one of two ways! For more information, go to our website FAQ at www.mentaldental.com/faq
We want video of chair position for extraction ' doctor and for patients
thanks
good job champ
can u tell what is purchase point
Helpful!
Thank You
Hi Dr. Ryan first of all I would like to thank you for the wonderful presentations. I have one question, in which cases do you choose to place stitches after the extraction and do you usually put any material inside the socket for anti-bleeding or just leave it as it is? Thank you
I usually only place stitches when multiple adjacent teeth are taken out in the same quadrant and/or a flap is raised. I don’t usually place anything in the socket unless significant bone is removed and then I may put a collagen plug or membrane to help with healing.
Thanks very much ♥️♥️♥️♥️
Thank you so much
Good job ryan! =)
in lower molars ext... shouldn't we apply lingual pressure first because it's less resistance than buccal? this how i learned it in my school but you said the opposite
another question dr ryan : squeezing sockets after extraction is still a doable thing? isn't it unfavorable generally now?
Which book have you referred?
thank you😍😍
How i can get these slides to make it paper based?
Thankyou ❤❤❤
When do you use a figure eight movement?
A figure eight movement is a technique that can be used for extracting most teeth, as long as the movements are slow and deliberate with the intention of expanding the alveolus.
u could include wharfe classification for exodontia .
"Exciting" I'm only watching this video to learn how to remove my upper Canine ,which is pretty loose already , i just don't want to give myself a dry socket, because i had that once before, and it is pretty sore. Bought the upper Canine extraction forcep already, now i just need the ale and some dutch courage, and a few more video, Not very "Exciting" for me at this point lol.
I would not do this yourself.
👏👏👏👊👊👊👏👏👏
thanks