Often the degree of tooth damage is so great that it is necessary to make a difficult choice: to save or remove it. With a timely visit to the dentist, the damage is usually completely recoverable. But not everyone visits the doctor on time. Sometimes the tooth has to be removed so that the infection does not spread further. In the work of a dentist, the surgeon is assisted by tools for tooth extraction. From the correctness of their choice, the effectiveness of the procedure and its outcome sometimes depend. In this article, we will examine the basic tools that dentists use when extracting teeth and their roots.
Indications for a tooth extraction operation
Toothache is one of the most unpleasant. Because of the high sensitivity and natural reluctance to endure unpleasant sensations during dental manipulation, many years postpone a visit to the dentist. And only at the moment when the pain becomes unbearable and is not stopped by analgesics, the average person decides on a "terrible" visit. Typically, this condition indicates that the tooth is struck quite strongly. Treatment in this case often boils down to only one: extraction.
The absolute indications for the operation include:
- abscess and other acute purulent-inflammatory diseases;
- complete or partial tooth decay due to tooth decay;
- periodontal disease.
Numerous cases of tooth extraction are often used for implant placement. In any case, the doctor will try to save the tooth and, if possible, restore it.
Preparing for an operation
Any surgical intervention should be carried out according to the rules of asepsis and antiseptics. Tools for removing the teeth are sterilized, and the oral cavity is prepared according to the following algorithm:
- cleans the tooth deposits from the removed and adjacent teeth;
- offer the patient to rinse the mouth with an antiseptic solution (furatsilin, manganese);
- anesthetize tissues in the area of the tooth to be removed with a solution of lidocaine, novocaine, trimecaine or other anesthetics.
After complete lack of sensitivity is achieved, the doctor proceeds to extract the tooth with the help of certain instruments.
Common tools for tooth extraction: photo, description
For dental manipulations, many specific devices have been created - instruments. The first of these were invented back in the Middle Ages. In the process of tooth extraction, the doctor requires mainly tongs and elevators, in rare cases additional devices.
The forceps are one of the most common tools used by dental surgeons. They consist of three parts: a handle, a cheek and a lock. Over the years, their structure has practically not changed. The cheeks of the forceps allow you to grasp the dental crowns, and the lock serves as a connecting element. Handles are necessary for the convenience of the doctor: holding on to them, operate the instrument. Although the tongs are fairly simple in structure, they have a large number of varieties. Depending on the form they are used in a certain localization: for the lower and upper jaw they will differ significantly.
Dental instruments for tooth extraction include elevators. They consist of three parts: a handle, a connecting and a working part. Due to them, extraction of roots or their separation is possible. In addition, they are used to get dystopic or retinished teeth.
Devices that have fallen into the "second plan"
The use of forceps or elevators is more specific for the ordinary dentist. But there are cases when it is necessary to apply other devices. Among them, such tools are used for tooth extraction, as:
- Excavators - designed to eliminate individual softened tissues of the tooth or its crown part (pulp). Modern clinics use it as an alternative to boron. This is a two-sided tool consisting of small spoons with pointed edges. Despite the simplicity of the design, it is very functional.
- Chisels, chisels and hammers are tools with a long history, used in surgery for tooth extraction for a very long time. With the help of them the hollowing out of the root of the tooth is performed. This method is quite traumatic, so it is practically not used. But the chisel is successfully used to destroy the inter-root joint, which greatly facilitates the procedure for root removal.
- Bormachina - used to remove multi-rooted teeth.
Tools for removing the teeth can successfully carry out the operation, regardless of the complexity of the case. The doctor uses those adaptations that are necessary in a particular situation.
Tongs for extraction of teeth of lower jaw
Incisors, fangs, molars of the upper and lower jaw have some differences in their structure. Access to them is also different. In this connection the set of tools for tooth extraction is divided into two groups: for the lower and for the upper jaw. To perform the procedure using beak-shaped forceps. The handle and cheeks in their structure are located at an angle of 90⁰ (or close to it) with respect to each other. The angle depends on the tooth the tool is intended to remove. For example, to extract the incisors, the blunt-nosed forceps between the cheeks and the handle tending to 90 ° are more appropriate. This is due to their anatomical structure. And to remove molars do not come up better than forceps with a right angle.
For extraction of premolars and incisors, use pliers with narrow cheeks, rounded at the ends. The dental instrument for the removal of teeth of the lower jaw (molars) is characterized by wide cheeks, on the sides of which there are peculiar thorns. They are necessary for tight fixation of the molar. For the extraction of wisdom teeth use horizontal curved forceps. A dentist can resort to them even if the patient can not open his mouth wide enough. There are also tongs with converging and ragged cheeks. The first are used to remove the tooth along with the roots, and the latter - only to eliminate the crown.
Tongs for extraction of teeth of the upper jaw
Tools for removing the teeth on the upper jaw are mainly reduced to the use of forceps. Their appearance and shape differ depending on the position and type of tooth. The tongs are divided into the following categories:
- Straight - used for incisors and canines. Their characteristic feature is that the cheeks and the handle are on the same axis.
- 8-shaped for premolars - are necessary for their extraction. The cheeks of such forceps are located in relation to the handle at an obtuse angle.
- 8-shaped for the first and second molars - differ on the left and right, have a special spike, located on the outside. Thanks to him it is possible to grasp the tooth.
- Bayonet (bayonet) - to remove the third molar, unlike the previous, do not have a spike. Its cheeks are rounded, do not close, are parallel to the handle.
- Bayonets - have elongated cheeks, between which is a transition element, allowing them to be naked or converging. Are intended for teeth with dilapidated crowns.
According to dentists, the removal of the teeth of the upper jaw is somewhat more complicated than carrying out similar manipulations on the lower one.
Operation to remove the tooth with forceps
Imagine that a decision has been made to extract the tooth. The patient is prepared, the tools to remove the teeth too. The doctor selects the forceps of the appropriate shape and size and begins to perform the following sequential actions:
- The tongs are peeled off from the tooth to be extracted. This happens so that the axis of the cheeks coincides with the axis of the tooth.
- The forceps push down the gum up to the neck of the tooth, which allows them to be well fixed. If the crown is broken, the tool is moved to a depth of about 5 mm.
- After verifying the coincidence of the axes of the tooth and cheeks, the forceps are fixed. To do this, the handle is grasped with all fingers of the brush so that the tool and crown become one system.
- Carrying out rotational (for one-root) and pendulum (for multi-rooted) movement, the tooth is dislocated, thereby destroying the periodontal fibers.
- Once the tooth and surrounding tissues are separated, rotational movements remove it from the well.
After the completion of the fifth paragraph, the procedure is considered completed. Tools for removing the teeth are sent to sterilization, and the patient, after some additional manipulation, goes home. The operation on the milk teeth is performed in a similar way, only more accurately.
Elevators: purpose and varieties
Dental instruments for tooth extraction include elevators. Like the forceps, this is one of the most common devices. Due to them it is possible to remove uncut or growing in the wrong direction teeth, as well as their roots. The doctor uses one of the types of the instrument:
- Straight - all its parts are located on one axis, some models are characterized by a slightly curved connecting element. More often it is used to work with the upper jaw.
- Angular - the cheek is inclined at 60 ° relative to the handle. Some models allow you to change the angle. The tool is divided into left and right elevators. Applicable for working with the lower jaw.
- A group of elevators for removing wisdom teeth on the lower jaw are angular, represented by several models: Lecluse (90 ° angle, cheeks pointed), Barry and Winter (divided into left and right sides, triangular cheeks), Pota (angle 60⁰, elongated rod).
- To extract particles of roots - it has thin pointed cheeks, in shape resembles a cylinder.
Elevator - a universal tool for removing the root of the tooth. It is non-traumatic, but requires the dentist certain skills and abilities.
The operation to remove the root of the teeth by the elevator
The method of application of this or that type of elevator is based on the principle of the lever. With a strong penetration of the working part of the instrument into the periodontal gap, it is advanced inward with the help of rotational movements. So the elevator breaks the periodontal tissue and expands the gap. After the tool is embedded at a depth of about 0.5 cm, it acts as a lever. The applied force is transferred to its end and leads to dislocation of the root of the tooth.
If the operation is performed on a multi-root tooth, one of the roots is removed by a straight elevator or forceps, after which a side elevator is introduced. So the second root is pushed out. At the end of the procedure, the entrance to the hole is covered with a "ball" of gauze. The patient is recommended to keep it for 15 minutes, then rinse with antiseptic solutions once every hour.
For the patient, and often for the doctor, the operation to remove the tooth becomes a real stress. Instruments used in extraction can not always cope with complex cases. The least traumatic method of tooth extraction is the use of luxators, which are preferred by more and more dentists.
The instrument has an auger-like design, so it penetrates the periodontal zone without much effort. The working part is neatly inserted at a small angle under the gum. This leads to the separation of periodontal tissues and the dilatation of the socket. Vacuum in the field is eliminated. To pull a tooth with forceps will now be much easier. But if the tooth is single-root, then the use of forceps and does not need.
Removal of the tooth canal
Pulpitis is one of the most unpleasant dental diseases that occurs due to trauma, gum disease or the penetration of bacteria. Without timely treatment, the infection spreads through the root canals to the circumcircular tissues, while the bone at the base of the tooth is damaged. One of the methods of treatment of this disease is depulpation - removal of the nerve in the root and crown parts. After that, the root canal and its crown part are sealed. The operation is rather complicated and requires high skill from a specialist.
Tools for extraction of teeth allow qualitatively to carry out the procedure, achieving the least traumatization of tissues. The correct choice of a device can fundamentally change the course of the procedure, as well as recovery and possible complications after it.