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    Extraction of the Teeth
    Extraction of the Teeth
    Extraction of the Teeth
    Ebook95 pages45 minutes

    Extraction of the Teeth

    By J. F. Colyer

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    About this ebook

    The General Principles of Extraction of the Teeth
    The Extraction of Individual Teeth
    The Extraction of Misplaced Teeth
    The use of Anæsthetics During Extraction of The Teeth
    Difficulties, Complications, and Sequelæ of Extraction of the Teeth
    LanguageEnglish
    Publisheranboco
    Release dateSep 28, 2016
    ISBN9783736415683
    Extraction of the Teeth

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      Book preview

      Extraction of the Teeth - J. F. Colyer

      TEETH.

      CHAPTER I.

      ———

      The General Principles of Extraction of the Teeth.

      As an operation, extraction of teeth is fortunately becoming more rare, but even now large numbers are needlessly sacrificed, in many cases owing to ignorance on the part of the patient of the value of the teeth, at times to lack of knowledge on the part of both operator and patient of the modern methods of conservative dentistry. With the assistance of antiseptics in the treatment of root-canals, and the increase in knowledge of the methods of filling and crowning teeth, it is now possible to retain many which would in former days have been extracted—indeed it may be said with truth that all teeth and many roots are capable of being saved and rendered useful, with the exception of—

      (1) Those teeth whose roots are much shortened by absorption.

      (2) Those teeth from which the alveolar process has disappeared to such an extent as to leave them quite loose; and

      (3) Those teeth attacked with chronic periodontitis, which, in spite of treatment, tends to become worse.

      Special circumstances naturally alter cases; for instance, with patients the subjects of nervous prostration, or feeble in health, a lengthy operation is often contra-indicated, and under such conditions extraction may be preferable to the lengthy and tedious processes of conservative treatment. Another indication for extraction is in cases of teeth setting up or aggravating ulceration of the tongue, lips, or other soft parts of the mouth. Teeth fractured in a longitudinal direction should generally be removed, and the same rule applies to those which are so misplaced as to be incapable of being brought into the normal arch. In crowded conditions of the teeth extraction is often called for, and under such circumstances is really conservative treatment.

      If extraction be determined upon, a careful examination of the tooth to be removed should be made. This will allow some idea to be formed of the amount of sound tissue present, and also of the force which will be necessary for the dislodgment of the tooth. In the case of roots, the edges must be defined, and for this purpose a blunt probe, similar in pattern to that shown in fig. 1 will be found useful.

      Fig. 1.

      Instruments.—The instruments in general use for the removal of teeth are forceps and elevators. The Forceps is an amplified pair of pincers or pliers. It is made up of three parts, namely, the blades or portions beyond the joint which are applied to the tooth, the joint itself, and the handles. Forceps should be made of fine steel, should be light and yet strong enough to withstand without bending any strain that may be put upon them.[1] The blades should be shaped to fit the tooth they are intended to remove, and they should be clear of the crown when applied. On longitudinal section a blade should present a thin wedge-shaped appearance. Two kinds of joints are met with. In the first variety one half of the forceps passes through a slot in the other, the two being held together by a rivet passing through the centre (fig. 2). In the second variety (fig. 3) the two halves are held together side by side by a screw or pin which takes the entire strain. Most forceps of English manufacture are made on the latter plan, which has the advantage of permitting the instrument to be easily cleaned; it also allows a slight lateral movement of the two halves—a point of some practical importance. It is urged against this style of joint that it is weak; in practice, however, this is not found to be the case.

      Fig. 2.

       

      Fig. 3.

      The handles should be of a size and shape to lie comfortably in the palm of the hand, and should be in such relation to the blades that when the latter are applied in the direction of the long axis of the tooth, the handles clear the lips.

      As a general rule, in forceps designed for the removal of the anterior teeth in the maxilla, the blades and handles are in the same line (fig. 4),

      Fig. 4.

       

      Fig. 5.

      while for the upper back teeth the handles form a curve of greater or less extent with the blades (fig. 5). In forceps for the lower teeth the blades are bent down from the handles to an angle of nearly ninety degrees. In one class, namely, the hawk’s-bill, when the blades are applied to the tooth the handles are at right angles to the line of the arch (fig. 6), while in other classes the handles are in line with the arch (fig. 7).

      Fig. 6.

       

      Fig. 7.

      The manner of holding forceps is shown in figs. 8, 9, 10. The handles should rest comfortably in the palmar

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