Tooth extraction: surgical dentistry

Main indications and contraindications
Complex tooth extraction: features of the procedure
Tools used
Healing process after surgery
Complex tooth extraction in Moscow: reviews of treatment at A-Medic

There are two main types of tooth extraction in dentistry - simple and complex.
The first is used when it is necessary to remove teeth with one root, and the second when the root has a complex structure and several branches. During complex surgical interventions, special instruments are used. Tooth extraction in Moscow is performed by the reliable dental clinic “A-Medic”. The company's employees have high professionalism and extensive experience, which allows surgical intervention with minimal risk of complications. The clinic is equipped with modernized equipment, thanks to which all stages of the procedure are controlled. The cost of a complex tooth extraction in the clinic is only 3,500 rubles.

Main indications and contraindications

Complex removal is required in a number of complex clinical cases when it is not possible to perform surgical intervention using standard techniques and instruments. Very often it is carried out in relation to the last painters (“eights”). As a rule, they do not have enough space, against which they begin to grow incorrectly (for example, erupt towards the cheek, injuring the mucous membrane), slowly erupt, accompanied by painful sensations. The last molars do not participate in the chewing process, so most often the dental surgeon decides to remove them in such situations.

Complex surgical procedures are resorted to in the presence of a chronic inflammatory process, against the background of which the bone tissue and the molar or premolar itself have fused. A complex operation cannot be avoided if the molar has several roots or its area is severely curved. Benign neoplasms (for example, granulomas or cysts) are often an indication for removal if the tooth is destroyed and there is no point in trying to restore it. Sometimes a complex extraction of a previously treated tooth is performed several times. This is due to the fact that it is not durable, its density is weakened, and it is capable of cracking.

As with any surgical intervention, there are a number of absolute and temporary contraindications to complex removal of molars or premolars. Among them:

diseases of viral etiology;
serious deviations from the cardiovascular system;
pregnancy and lactation;
blood diseases (anemia, poor clotting, leukemia);
chronic pathologies during exacerbation;
recent strokes and heart attacks;
serious mental disorders (schizophrenia);
long-term use of medications that affect blood clotting.

Complications

Deterioration during removal rarely develops. But such a situation is still possible; in some cases, the Patient’s condition seriously worsens, especially if the doctor violates the removal technology. In practice, the following complications are noted:

damage to blood vessels, which causes severe bleeding;
removal, serious damage to the primordia of permanent units when removing milk;
puncture wounds of tissue due to puncture of instruments, in this situation there is a high risk of damage to the carotid artery and other large vessels;
development of an infectious lesion, alveolitis (if the instrument is not properly sterilized);
ruptures, dislocations of ligaments;
breakage, part of the elevator getting stuck in the wound;
fractures of hard tissues when the load is exceeded towards the tips of the root part.

Rare cases include the formation of a granuloma in the area where the unit was removed. After eliminating the cyst, part of the nail of the doctor who performed the extraction was found in the tissue. Apparently it was cut off with an instrument during surgery.

Elevators are indicated for use if the coronal part is destroyed or for other reasons it is not possible to use forceps. For the operation, local anesthesia is used, which allows the Patient not to feel pain or discomfort.

Complex tooth extraction: features of the procedure

Before performing a surgical intervention, the specialist prescribes the necessary diagnostic examination (instrumental and laboratory) to the patient. First, he is sent for an X-ray examination. Using this technique, it is possible to assess the general condition of the root system and clearly see the location of the tooth in the jaw. For a more detailed analysis, obtaining images of various dental structures layer by layer, computed tomography is prescribed. It makes it possible to detect in advance the factors complicating the surgical intervention, to establish the approximate time and complexity of the procedure.

Removal of a molar or premolar is always performed under the influence of an anesthetic. To avoid negative consequences, it is recommended to first visit an anesthesiologist to identify a possible allergic reaction to a particular substance. To determine contraindications (for example, exacerbation of a chronic disease), it is recommended to undergo laboratory diagnostics - a general blood test. In the absence of contraindications, they proceed to surgical intervention. The procedure and technique for implementing the removal technique are as follows:

Conducting anesthesia. Depending on the age, neglect of the clinical case and the general physical condition of the patient, local or general anesthesia with a potent drug may be used.
Incision of soft tissues and separation of gums.
Sawing out a small area of bone tissue and the coronal part, sawing the septum (only if necessary).
Gently rocking the tooth using special tools and removing it completely.
Applying sutures to the gum area.

If the wisdom tooth is located next to the mandibular nerve, the procedure becomes a little more complicated. This is because its roots are able to surround the area of the nerve. In such a situation, the roots are divided and removed with extreme caution so as not to touch the nerve. To carry out high-quality surgical intervention, a qualified dental surgeon is required.

Elimination Features

To eliminate a damaged tooth, an elevator is inserted between the wall and the root; for multi-rooted units, between the individual elements of the root. The concave side faces the tooth, the convex side faces the socket. The doctor presses on the handle and forgives the instrument, moving its working part deeper. The success of removal depends on how correctly the dentist chooses the type of instrument and performs the operation. Before starting work, you need to carefully examine the damaged and removed tooth and evaluate the strength of the crown part. If the external crown is in the way, its preliminary removal is indicated.

Elevator usage options:

With slight bending, the root part is deflected, the socket is enlarged, and the unit being removed is dislocated.
For third molars, sectioning and insertion of the cheek from the distal side are necessary. The dental crown is displaced and the units are removed.
If the roots are sufficiently bent, it is necessary to rupture the periodontal ligaments. To do this, the tooth is divided into three separate parts using special tools, which are removed one by one.
In case of buccal as well as lingual curvature, the elevator widens the periodontal gap, after which removal is carried out.
If the alveolar process is of significant thickness or the crown is significantly destroyed, the cheek is inserted between the root part and adjacent units.
The straight type of instrument is used to extract figure eights; the working part is carefully inserted along the surface of the tooth, after which it is removed.

Before starting the procedure, you must thoroughly sterilize the elevator and other instruments. First, they are soaked in an antiseptic solution and washed in clean running water. The next step is immersion in the biolot, heated to 40 degrees. The instruments are dried before use.

Tools used

If a simple elimination requires only two main tools - forceps and an elevator, then in the case of a complex elimination everything is a little different and much more auxiliary devices are required. The instruments are specially developed for dental surgery, which allows all manipulations to be performed without causing severe harm (the level of mechanical damage is minimized).

To extract a molar or premolar, forceps, a bur, an excavator or an elevator are used, and during surgery a scalpel, hammer, scissors, and chisel are used. Let's take a closer look at what the role is and in what situations each of the tools is used.

forceps. They are used in situations where the coronal part has been preserved and the roots are located in such a way that they can be grasped with an instrument. The specialist sets the axis of the crown to align with the axis of the forceps. For each group of teeth, forceps of a certain shape are designed, having a working part - cheeks, handles, lock;
elevator. It is used in relation to molars (particularly the eighth) and premolars in the upper jaw. If necessary, using this instrument, the dental surgeon loosens the tooth (or its remains) along with the root, after which it is dislocated with forceps and removed from the gums;
excavator. According to the principle of operation, it is similar to an elevator; it is used for deep fractures of a molar or premolar. It has an angular working surface, making it easy to penetrate into the hole;
bit. It is used to eliminate the outer wall of the alveolar process. It is often necessary in a situation where a tooth breaks off and it is not possible to get it out using an elevator or excavator;
hammer. Its help is resorted to in cases where a tooth is removed using a chisel. The dentist places the instrument in the area between the root and the hole, and at this time his assistant, using a hammer, makes several blows to this area;
scalpel. Often, complex removal requires making a small incision with minimal trauma. For this purpose, a scalpel is used;
drill. A drill is usually used during separation, removal of multi-rooted teeth, or removal of bone tissue surrounding a molar or premolar. In such situations, the dental tissue is sawed and removed piece by piece. This is not a simple procedure; it requires sufficient qualifications of a specialist. It is more advisable to resort to it if the root canals have already been previously filled or when the last molar is growing incorrectly (in a horizontal position).

A-Medic dentistry practices complex tooth extraction in Moscow. Qualified specialists work here. For high-quality removal during surgical intervention, the above-described instruments are used. Additionally, the clinic provides all necessary manipulations and services: hemostatic sponge, anesthesia (conduction, infiltration, application), preparation, dressing (using Trichopolum or Alvogil), removal and application of sutures. To make an appointment, just call the numbers provided or fill out an application on the clinic’s official website, after which the administrator will contact you.

Piezo device

Along with a laser, a piezoelectric device is another modern device that makes the dental treatment process more comfortable and safe. The device generates ultrasonic waves that replace a traditional drill. It works almost silently; when removing teeth, it allows you to make incisions in the gums, the teeth themselves, and bone tissue. In this case, the cuts are made using ultrasonic vibrations, and the tip of the device does not come into contact with the surface being treated. Due to this, the tissues are practically not injured, the operation is carried out with high precision even in difficult-to-reach areas.

Piezo device

Healing process after surgery

After surgery, the recovery period begins. The duration of its continuation is individual, as a rule, 1-2 days. In particularly advanced clinical situations, negative symptoms may persist for about 5-7 days. After a few hours, the effect of the anesthetic wears off, causing the patient to experience severe discomfort. If the pain is pronounced and does not go away on its own, experts prescribe non-steroidal anti-inflammatory drugs and analgesics.

The day after the operation, redness and slight swelling may occur in the area affected by surgical instruments. It gradually goes away on its own when the blood supply to the area is normalized. Sometimes the patient needs to take antibacterial agents (as prescribed by the attending physician).

Immediately after tooth extraction, bleeding may occur. This is due to the fact that a small bloody clot appears in the formed hole. Most often, it can be stopped in the dental chair, but for some, the hemorrhage continues for another 1-2 days. Prolonged bleeding may be due to a number of factors, such as high blood pressure or a bleeding disorder.

To avoid the appearance of hemorrhagic syndrome, it is important to strictly follow all the instructions of the surgeon. People suffering from hypertension are advised to drink motherwort tincture before tooth extraction. With its help, the functioning of the nervous system is normalized and there will be no surges in blood pressure. To monitor the healing process after surgery, you need to see a dental surgeon on days 5-7. There is usually no need to remove sutures as they dissolve on their own. To avoid complications during the recovery period, the following measures are required:

During the first days, it is recommended to brush your teeth with a soft brush and be especially careful so as not to touch the soft tissues. This will avoid bleeding;
You should not eat food for the first 2-4 hours. Throughout the entire recovery period, only soft foods and drinks at room temperature are recommended. Chewing on the operated side is prohibited;
do not rinse your mouth or take baths for the first 24 hours;
do not undergo strenuous physical activity. Such actions cause an increase in blood pressure, which can lead to hemorrhage.

And it also happens...

... that wisdom teeth block the neighboring teeth and prevent them from erupting normally. In such cases, patients are referred to a surgeon by an orthodontist.

Of course, the germ of the eighth tooth needs to be removed. This is a fairly simple and relatively comfortable operation.

Look at the pictures on the right. There is a difference of three weeks between the top and bottom. It is clearly visible from them that after removing the rudiments of the eights and “unblocking”, the seventh teeth immediately began to grow.

Wisdom tooth removed. The patient is satisfied. But the fun is yet to come. Namely, the postoperative period.

Complex tooth extraction in Moscow: reviews of treatment at A-Medic

Olga, 41 years old. Last month I had an operation to remove a tooth at A-Medic dentistry. I made an appointment with Ziyad Ganiev without any problems. He is a true professional in his field. The procedure was successful, the doctor gave recommendations, followed them completely, and there were no complications.

Pavel, 27 years old. For several years now I have been receiving treatment only at the A-Medic clinic. Recently my wisdom teeth started to erupt and hurt a lot. The doctor advised to remove it. Removal took place quickly and without any discomfort. I recommend A-Medic dentistry to everyone.

Natalya, 32 years old. "A-Medic" is my favorite dentistry. The atmosphere in the room is pleasant, the doctors are experienced, making an appointment is not difficult. The other day I needed to remove the eight. My friends told me that this would be a difficult and painful operation. I signed up for removal with the Blazhentseva Rada. The operation took place in just a few minutes, and the recovery period took only two days.

Semi-retinated tooth

In principle, the method of removing such a tooth is no different from removing a completely impacted tooth. But, as a rule, it is a little easier, because the tooth is not so deep. The main stages are essentially the same: anesthesia, creating access to the tooth (and sometimes you can do without incisions), fragmentation (dividing the tooth into parts) and, in fact, removing the teeth in parts.

After removing the lower semi-impacted tooth, sutures are placed on the socket; in the area of the upper wisdom teeth, sutures are not necessary.