MECHANICAL PRINCIPLES OF EXTRACTION.
1-Expansion of the bony socket.
2-Luxation of the tooth from the bony socket using elevator
1- Expansion of the bony socket:
The Most important factor Achieved by using tooth as dilating instrument.
Determined by root pattern and the surrounding bone Dilation is accompanied
by multiple small fractures of buccal plate and inter-radicular sept (microfractures)
[Link] of bony socket:
The Most important factor Achieved by using tooth as dilating instrument.
Determined by root pattern and the surrounding bone Dilation is
accompanied
by multiple small fractures of buccal plate and inter-radicular sept
(microfractures)
PRINCIPLES OF FORCEPS USE:
Primary instrument to remove tooth from alveolar process although
elevators help in luxation of tooth.
The goals of dental forceps use:
1-Expansion of the bony socket
2-Removal of the tooth from the socket
Main Motions (steps)in Forceps Extraction
1- Apical pressure: break the periodontal seal
2- Buccal force: expand the buccal plate
3- Lingual force: expand the lingual crest
4- Rotational force: Overall expansion of tooth socket
5- Tractional force: Removal of the the tooth out of the socket
1-Apical Force: accomplishes two goals
1. Bony expansion:
Tooth socket expanded by the insertion of beaks into the PDL space.
Apical pressure on the tooth causes bony expansion
2. Centre of rotation:
Displaced apically.
Greater movement of expansion forceps at the crest of ridge and less force
moving the apex of tooth lingually.
Decreased root fracture
3-Buccal Force
[Link] of buccal plate, at the crest of ridge.
[Link] causes lingual apical pressure
4-Lingual force (pressure):
Expands the lingual-crestal bone.
Avoids excessive pressure on the buccal apical bone
Step 2: Luxation of the tooth with a dental elevator
Expansion and dilation of the alveolar bone and tearing of the
periodontal ligament requires the tooth luxation.
Straight elevator inserted perpendicular to the tooth into interdental
space.
Elevator is turned so that inferior portion rests on alveolar bone, superior
or
occlusal portion of the blade turned toward the tooth being extracted.
Type of force: Strong, slow, forceful turning.
Step 5: Removal of the tooth from the socket
Once the alveolar bone expanded sufficiently and the tooth luxated-
slight tractional force-buccally used.
Major role of the forceps - not to remove the tooth but rather to
expand the bone so that the tooth can be removed.
ELEVATORS
2. Use of a lever and fulcrum.
Basic factor governing use of elevators is to force the tooth or root out of
socket along the path of least resistance.
Three principles:
1-The lever
2-The wedge
3-The wheel and axle
The Lever
A lever -mechanism for transmitting a modest force-
The mechanical advantages of a long lever arm and a short effector arm—small
movement against great resistance.
Elevators - used primarily as levers.
Crane and pick elevate the tooth or a root -using the purchase point.
Wedge principle
•
Wedge principle -used in straight elevator - to luxate a tooth from its socket.
• A small elevator is forced into the periodontal ligament space- displaces the root
toward the occlusion
Wheel and axle principle
Wheel and axle principle used in triangular, or pennant-
• shaped, elevator.
• One root of a multiple-rooted tooth is left in the alveolar process- pennant-shaped
elevator - used to remove the root
3. Insertion of wedge or wedges.
Used between the tooth-root and bony socket wall causing the tooth to rise
in its socket
Conclusion
• Never use the adjacent tooth as a fulcrum.
• Never use excessive force by carful selection
• Good and sound technique with Proper grip and controlled force
