Stages of complex wisdom tooth extraction. Complicated wisdom tooth extraction

Indications for tooth extraction can conditionally be divided into emergency and planned. Emergency removal is performed by:

- in acute purulent inflammations extending to the bone, such as periostitis, osteomyelitis .

With severe toothache, when treatment is no longer possible.

In a planned manner, a tooth can be removed for the following indications:

- Teeth with impassable root canals with chronic near-root periodontitis, cysts, especially complicated by sinusitis, neuralgia.

Inability to restore a broken tooth.

- Tooth mobility third and fourth degree with periodontitis.

Wrong position ubov wisdom or other teeth that injure the mucous membrane, interfere with eating and speech function.

Supernumerary (extra) and impacted (not erupted) teeth that cause pain or inflammation (retention cysts).

Mechanical damage to the tooth ( root fractures ).

Teeth on the line of jaw fractures.

Tumors of the jaw.

During orthodontic treatment.

When carrying out orthopedic treatment (single teeth that interfere with the installation or stabilization of the prosthesis).

Contraindications

- During menstruation (due to poor blood clotting).

With some acute diseases (myocardial infarction, hypertensive crisis, infectious diseases).

When taking drugs that reduce blood clotting (for example, cardio aspirin, warfarin, etc.).

In the initial and last months of pregnancy.

How to correctly remove teeth

1) Tooth extraction is absolutely painless due to high-quality anesthesia with modern painkillers based on articaine (Ultracain, Septanest, etc.).

2) Minimal trauma during extraction is the unconditional guarantee of a successful recovery period after tooth extraction.

3) Refusal to use such aggressive tools as a chisel and hammer in favor of modern methods of removal (drill, apparatus for piezoelectric surgery).

ApparatusPIEZOSURGERY. Thanks to the latest developments, it reduces trauma during any operation in the maxillofacial region to a minimum.

4) The surgeon must perfectly know the anatomy of the roots of the teeth of all groups, this eliminates the risk of developing iatrogenic (due to the fault of the doctor) complications.

Which teeth are the most difficult to remove?

First of all, difficult teeth to remove those who once treated resorcinol - formalin method. Previously, due to the lack of materials and tools for root canal treatment, dentists had to fill the canals of a dead tooth with resorcinol, a formalin paste.

Tooth treated with resorcinol-formalin. A characteristic feature is the reddish tint of the tooth.

This paste was supposed to mummify the remains of the pulp in the root canal and destroy the infection. But in fact, it turned out that this method of treatment is ineffective, and the tooth, impregnated with resorcinol - formalin, becomes brittle, like glass, and fuses with the surrounding bone. Naturally, it is very, very difficult to “pick out” such a piece of glass, tightly soldered to the bone. In this case, the surgeon has to carefully cut out and then dislocate the tooth with a special tool. The success of the removal in this case depends both on the skill of the surgeon and on the quality of the instruments used. In our clinic, we use high-quality high-speed turbine and PIEZOSURGERY device. These tools allow you to remove complex, severely damaged teeth as quickly and atraumatically as possible without injuring or overheating the surrounding bone.

Wisdom tooth or eighth tooth, is often the cause of health problems for many people. Wisdom teeth erupt last in the dental arch of the upper and lower jaws. If there is enough space in the dental arch, then the wisdom teeth can fall into place easily. At the same time, the gum tissues surrounding them are in a healthy state. The teeth in this case are not indicated for removal. Unfortunately, this is quite rare. They can be tilted (which is quite common) and rest against the roots of the adjacent 7th tooth, partially erupt through the gum or be hidden under the gum, often not even cutting through the jaw bone. The main reason for this problem is that there is not enough space in the dental arch for wisdom teeth to erupt. Because of this, wisdom teeth often fail to erupt.

Location of wisdom teeth in the jawbones

In this case, we recommend removing them as soon as possible. Some people neglect the timely removal of wisdom teeth, assuming that as long as they do not interfere with them, it is better not to touch them. This is the wrong approach, because the number of complications increases with age.

If you are going to wait until the wisdom tooth makes itself felt, then the removal will be accompanied by a serious risk of complications. If it is possible to remove impacted wisdom teeth at a young age - from 18 to 30 years old, then there is a high probability that you will be able to avoid serious complications, and if they happen, they can be easily overcome.

Also - if an unerupted tooth starts to bother you, then it can cause serious inflammatory processes in the maxillofacial region. From this follows the only correct conclusion - it is necessary to remove unerupted teeth as early as possible.

In case of incomplete eruption of wisdom teeth, food can get into the gap between the tooth and the gum. In this area, bacteria can multiply intensively and, ultimately, this causes the development of an infectious and inflammatory process. There is swelling, pain syndrome.
The pressure exerted by an erupting wisdom tooth can cause severe pain.
The most severe consequences are the development cystic or neoplastic processes around impacted wisdom teeth, which in turn leads to destruction of neighboring healthy teeth.
Timely removal of impacted wisdom teeth will help to avoid these and other complications.

Examination of the oral cavity, x-rays can provide valuable information to your doctor, make a diagnosis and decide on the need to remove impacted wisdom teeth.
In some cases, it may be necessary to use computed tomography to determine the location (localization) of nearby vital anatomical structures - the mandibular neurovascular bundle.

The more the wisdom tooth is immersed in the hard tissues of the bone, the more difficult it is to remove it. The greater the angle of inclination of the tooth with respect to the vertical axis, the more difficult the process of its removal will be.

Complicated tooth extraction is an extraction in which the doctor uses several tools. Even if the tooth is removed quickly, but forceps and an elevator were used during the intervention (technically, the extraction is simple), the extraction is still considered difficult.

This removal also includes gouging a tooth with a chisel, sawing the roots, cutting out fragments of bone tissue. However, if during the removal process it was necessary to make an incision and cut out the flap, then it is called atypical.

Often, in the process of tooth extraction, it becomes necessary to use several instruments at once (more often, forceps and elevators). This is how roots and badly damaged teeth are often removed. First, the doctor tries to loosen the tooth or root with an elevator, and then dislocates it with forceps.

If there is a fracture of the crown or root of the extracted tooth, this may also require the use of additional instruments. With shallow fractures, you can try to dislocate the tooth with an elevator, but if the tooth breaks off deeply (the tip remains in the hole), it is more convenient to use an excavator.

The excavator has an angled working surface that easily penetrates the hole. They try to move this tool between the wall of the alveolus and the fragment of the tooth, after which they gradually loosen the tip. It is worth paying attention that it is necessary to remove the broken off roots of the upper chewing teeth very carefully so as not to push them into the maxillary sinus.

Use of a chisel

The chisel is used in cases where it is necessary to remove the outer wall of the alveolar process (if it is not possible to use a drill). Such situations happen when the tooth is broken off deeply and it is not possible to get it with an elevator or excavator.

Also, this tool is used when the surrounding bone is dense, and the elevator cannot be advanced between the wall of the alveolus and the root. In such cases, the doctor sets the working part of the bit between the root and the hole, after which he holds it tightly. The assistant strikes the handle of the chisel several times with a hammer, after which the instrument moves between the root and the wall of the alveolus. Next, they try to dislocate the tooth using the lever method (as when working with an elevator).

It should be noted that these manipulations are not accompanied by pain with adequate local anesthesia. However, such removal leaves a lot of "pleasant" memories for the patient.

Recently, doctors are less and less trying to use such a complex removal technique, more inclined to cutting out the roots with a drill.

Using a drill

In the practice of surgical dentistry, a drill is needed:

Firstly, for separation (sawing) of the tooth into separate parts.
Secondly, to remove the bone tissue surrounding the tooth.

When removing destroyed multi-rooted teeth (most often molars), it is not always possible to extract the tooth with forceps, since the crown or root of the tooth is fractured. In such cases, it is more effective to cut the tooth into several roots, and then get them separately.

For this, long diamond burs are used for the turbine handpiece. When removing the molars of the lower jaw, the tooth is sawn into two parts - the distal and medial roots, which are then dislocated with an elevator. On the upper jaw, the molars have three roots (palatine and two buccal), so the tooth is sawn into three parts (most often a T-shaped cut).

With this variant of complex tooth extraction, the trauma to the surrounding mucous membrane and bone tissue is minimal, so recently doctors are increasingly using this technique.

Sawing a tooth from a bone is carried out with carbide burs for a straight handpiece using water cooling. This method removes impacted wisdom teeth, supernumerary teeth, as well as root tips with a thick outer wall of the alveolar process. As a rule, sawing out of the tooth begins after the incision is made and the mucoperiosteal flap is cut out, therefore, such an extraction is considered atypical.

Everyone has had to deal with dental services in one way or another. And of course, everyone roughly imagines what procedure is meant by tooth extraction. Tooth extraction is the process of extracting teeth from gum sockets. This can be the extraction of not only a tooth, but also one root, provided that the tooth has not been preserved.

Complicated tooth extraction is understood as situations in which the dentist, for one reason or another, cannot remove the tooth from the socket according to the developed medical algorithm.

Complicated wisdom tooth extraction.

The wisdom tooth is recognized by many scientists and doctors as a vestigial organ. Due to changes in the diet of modern man in comparison with ancient people, the human jaw has decreased, and the number of teeth has also decreased. Therefore, the extreme position of the teeth may remain in an undeveloped state, or may not appear at all. In cases where they are still present, and this happens most often at a fairly mature age, they cause pain. Often these sensations do not end after eruption, as it happens with the rest of the teeth. Due to its special physiological location in the jaw and its late origin, its eruption is rarely successful in terms of location in the hole. Often, wisdom teeth go crooked, and may not “break through” at all through the gum filaments. These processes cause inflammation, followed by severe pain. Adherents of the most common opinion believe that if the tooth erupted safely, there are no pain and inflammation of the gums, there is no need to remove it. On the contrary, a wisdom tooth can serve well, becoming a support for a bridge or prosthesis. Opponents of this opinion, on the contrary, believe that wisdom teeth should be removed even if they do not cause any inconvenience. This opinion is explained by the fact that the tooth is located in a very inaccessible place. This arrangement suggests the inevitable development of caries. The inevitability of caries is explained by the impossibility of high-quality tooth cleaning due to the same hard-to-reach location. Because of it, the procedure for its treatment is also difficult.

Complicated wisdom tooth extraction, consequences.

The removal of wisdom teeth must necessarily take place with the use of anesthesia. Anesthesia is performed both local and general. The choice of the type of anesthesia depends on the degree of complexity of the removal of the wisdom tooth, i.e. on its physical location and the depth of immersion in the hole. Despite the fact that anesthesia is only in exceptional cases ineffective, in any case, after the operation, pain begins to appear, and intensifies over time. In the case of a simple removal, the pain is within the normal range, and they pass quickly enough, you just need to drink an anesthetic. In this case, the pain lasts no more than 2-3 days. However, in the case of a complex extraction, when the gum structure is damaged or the teeth are divided into parts, and the restoration of the gums required the application of sutures and staples, the pain manifests itself more strongly. Wound healing takes a long time, and is always accompanied by pain. In this case, the dentist should prescribe measures to care for the damaged hole, as well as painkillers that are most suitable for the individual case. Often there are situations when a day passes, and the pain does not go away, weakness appears and the temperature rises. As a rule, this means that an inflammatory process begins in the body, or it indicates a poor-quality operation, during which the tooth particles remained in the damaged gum. In this case, you should contact your dentist as soon as possible. It is better if this is the doctor who performed the indicated operation.

Difficult tooth extraction with separation of the roots.

The extraction of a tooth of this complexity, when separation of the roots is required, occurs when the tooth is multi-rooted, or its shape is so complex that it is not possible to remove it entirely. Sometimes the reason for the difficult extraction with separation of the roots is that the tooth is very tightly located in the gum. Such an extraction consists in cutting the root or destroying the tooth by dividing it into separate parts. After such separation, each part of the tooth is removed separately. This removal may be in whole or in part. There are times when it is not necessary to remove all parts of a split tooth.

Complicated tooth extraction can take a long time to heal, so there is no reason to panic in vain if the extraction site is bothered by mild, barely noticeable pain. This is a normal reaction of the body to a stressful situation, which has become a surgical intervention in the human body.

How much gum hurts after a complex tooth extraction.

A complex extraction can take place in different ways not only for different people, but also for one person, depending on how the tooth is removed, where it is located and how well the removal operation was performed. With a successful removal, the gums can hurt for about 5 days. In more complex cases, this period is extended to two weeks. This is the normal duration of pain in the event that the pain subsides daily and the swelling, if any, subsides.

How long does the gum heal after a complex tooth extraction.

The healing of the gums after a complex tooth extraction occurs only slightly longer than the duration of the pain. It is their weakening that allows us to draw conclusions about the healing of the gums. If the pain does not subside, the inflammation of the wound persists for two weeks, then it is obvious that healing does not occur and urgent measures must be taken. In a successful case, the gum heals after a complex tooth extraction within 5-6 days.

The complex extraction of the roots of a tooth is not much different from the complex extraction of the tooth itself described above. There is only a certain complication in the removal procedure. Usually, the roots that remain in the gum socket are firmly seated, and therefore the removal takes place both with hand tools and using a drill.

After a complex tooth extraction.

After 1-2 hours after a complex extraction of a tooth of any location, pain manifests itself. Aching pain in the affected area is inevitable, since such a procedure is a stressful case for the gums, and when the effect of anesthesia wears off, the body gives signals of stress in the form of painful aching sensations. As a rule, doctors advise not to eat for 2 hours after the removal procedure. And 2-3 days you should not eat very hot, cold or solid food. Many practice rinsing with various herbal decoctions to clean the wound. However, these manipulations should not be performed, so as not to damage the blood clotting at the wound site.

This is a major operation that involves the use of stronger anesthesia and special instruments.

It is done when a tooth with a complex root system or partially hidden in the gum will be removed. The article tells what a complex removal is, how it differs from a simple one, and how much the gum hurts after it.

The method of complex extraction of teeth is different from the usual one. First, a larger set of tools is used. In addition, strong anesthesia is used.

Quite often, the specialist makes an incision in the gums, and then sutures the hole. Usually, before extraction, the dentist says to take an x-ray to see the internal structure of the tooth. In addition, it helps to understand which tools are best to use.

The most difficult removal is considered to be the one during which you want to remove the root. It happens that he deeply sat down in the alveolar formations or broke.

Sometimes a specialist needs to remove the alveolar wall before the roots start and drill a hole in it with a special bur.

Another list of the most difficult cases includes removal in case of acute illness or inflammation. Then the tooth starts to hurt a lot, and you need to put a strong painkiller.

Before that, you still need to mitigate the signs of the disease, but this is not always done. If the disease is very neglected, then it is necessary to carry out the operation only with anesthesia.

Quite often, a complex type of operation is needed for a tooth that has had a nerve removed. As a rule, their enamel is fragile, so they can collapse at any time.

Complicated wisdom tooth extraction is also possible. It is necessary because the molar has ornate nerves and vessels. In addition, it is irregularly shaped, which makes it difficult to even loosen it.

In some cases, the tooth is not completely out and is mostly in the gum. In this case, an incision is made in the gum tissue and the process is lifted above it so that it can be removed completely.

In some cases, the surgeon has to drill it out of the bone tissue. This is especially difficult if the wisdom tooth is removed in the lower jaw, because it has very thick bone tissue.

The situation is further complicated by the fact that many patients want to put in an empty well.

This will not be possible if inflammation remains, so the specialist must proceed very carefully.

If soft tissue damage cannot be avoided, then after removal, the person needs to undergo treatment to restore them.

This method differs from the usual removal operation in terms of reasons and methodology. If, with a simple removal, the process is first loosened and then removed, then the complex involves incisions, drilling, sawing, etc. For this reason, the tools are also different.

For a simple operation, only one device is most often used - forceps. For each tooth, they are different, because the processes differ in their structure, and they must be removed in different ways.

For example, to remove the upper canine, straight forceps are taken, others are removed with an S-shaped tool.

The incisor from below is removed with curved-type forceps with narrow cheeks, which allow you to capture the processes and their roots.

When a simple removal occurs, anesthesia is first placed. Then the gum tissue is separated from the process and forceps are fixed.

After that, the specialist presses on the instrument, turning it to loosen the tooth being removed. Often use rotational or pendulum motion.

At the end, the process is pulled and pulled out of the gum. Complex removal is about the same, only the gums are still incised, and sometimes the tooth has to be broken and taken out in pieces.

How is the removal going?

The technique of complex tooth extraction can be different. It depends on what structure the process has.

The main indication for surgery is that extraction cannot be performed with forceps alone, often access to the tooth is blocked by mucous tissue or bone.

Sometimes an incision is made in the mucous membranes or jawbone to simplify access to the process. This is done with a special saw or with a laser.

After the operation is completed, the dentist polishes the sharp parts of the bone if an incision has been made. After that, it is treated with hydrogen peroxide or furacilin.

Since the extraction is serious, the dentist prepares before it in order to remove the tooth faster and reduce the risk of complications.

As mentioned above, first a picture is taken using an x-ray, then a specialist examines the oral cavity in order to select the necessary tools.

In addition, the doctor must explain to the person what and how he will do so that the patient is less worried.

The main set of tools for this type of removal is forceps, a drill, a scalpel and elevators.

The latter is used if it is necessary to separate the root and the hole. In addition, all devices must be processed so as not to infect the infection. In addition, the doctor must disinfect their own hands, and then put on gloves.

After that, an anesthetic injection is injected (infiltration method). This method of anesthesia is usually used, but there are also application and conduction methods.

In the case of the first, it is necessary to apply an anesthetic to the gum tissue. Lidocaine and other solutions containing it are usually used.

The second type involves the introduction of anesthesia directly into the nerve, which is located in the diseased tooth. This method is the most efficient. After that, the deletion starts.

Since this is a complex operation, the tooth has several roots. Therefore, first it is loosened or destroyed. Sometimes bone tissue is removed if it does not allow a tooth to be removed, or it is broken.

Drilling is used if the operation takes place on the lower jaw. When the process is removed, the wound is sutured and treated with disinfectant solutions to prevent infection. If a wisdom tooth is removed, then most often it is cut into pieces, and then removed.

Complicated tooth extraction with separation of the roots is performed when the root system is very strong, due to which the process cannot be removed. Then the roots are cut into several parts or the tooth itself is broken.

Then it is taken out separately from the gums. In some cases, the separation of the roots causes inflammation if they have not been completely removed. But sometimes the dentist leaves part of the root system if he is sure that it will not cause harm.

Possible Complications

Since the operation involves incision, drilling and complete destruction of the tooth, complications are more likely to occur.

First, an infection may enter the wound or the dentist may incorrectly separate the root.

Many people experience increased bleeding after surgery, or vice versa, dryness in the wound, which should not be allowed. In some cases, the doctor has to carry out additional treatment.

Sometimes a tooth fragment may remain in the gum, which must be urgently removed, otherwise inflammation may begin due to this.

A piece of tooth is taken out with the use of an anesthetic. After that, the wound is again processed so that the infection does not get.

If pus has already formed in the hole, then it is removed using a special tool. At the end it is sewn up.

It is not uncommon for people to start bleeding again after they have returned home. This happens if a large blood vessel has been injured.

This can also happen if a person did not follow all the recommendations of the dentist and did not properly care for the wound. You can stop the bleeding at home using ice.

You need to find a clean swab, attach it to the hole and bite it. If all this does not help, then you need to urgently go to the doctor so that he once again sutured the wound and treated it with an antiseptic.

Even after a complex tooth extraction, the gums begin to hurt. This is completely normal if the pain is aching and not very pronounced.

After two weeks, they should completely disappear. Sometimes this period is a week if the operation went well.

If this does not happen, then you need to see a doctor, but for now you can use some painkillers. Immediately after the operation, it is advisable to ask the dentist what can be taken for pain.

To avoid unnecessary problems, you need to properly monitor the wound and take care of it. First, you can not drink alcohol, smoke and exercise - this can provoke bleeding.

You can not eat within 2-3 hours from the moment of removal. It is not advisable to eat warm or hot food, because this can also cause bleeding.

On the third day, if everything is fine, you need to rinse your mouth with disinfectant solutions recommended by the doctor.

It should be remembered that the cotton swab should be removed 15 minutes after leaving the office. If you keep it longer, it can cause inflammation. Then you do not need to put a new one if the blood has completely stopped.

As mentioned above, you can still apply ice. You can get some frozen product, wrap it in gauze or a towel, and then attach it to the cheek on the side where it hurts.

This will reduce swelling and pain, if any. Cold can be applied for 5 to 10 minutes.

It is usually applied in the first few hours after the operation, then it no longer makes sense and will not give any effect. It should be remembered that it is impossible to heat the oral cavity at this time - inflammation can be caused.

As mentioned above, if the bleeding does not stop, then a new tampon can be applied.

In addition, you can measure the pressure, if it is high, then you need to take the necessary medications, because it prevents the blood from stopping.

Immediately after a complex operation, you should not take hot baths (with the exception of a warm shower), or touch the wound.

It is also undesirable to open your mouth too much, if you put stitches, they can tear. It is not recommended to make a lot of facial movements or sneeze.

In addition, you do not need to rinse your mouth for the first 2-3 days, as this will remove any remaining blood from the wound and it will stop healing.

Tooth extraction in dentistry is divided into simple and complex. With the extraction of a tooth with one root, such manipulation is considered simple. If the tooth has a complex root with several branches, then, accordingly, the procedure for its removal will be difficult and it is carried out using special tools and techniques.

When is dental surgery difficult?

The following situations belong to complex manipulations regarding tooth extraction:

with disconnected roots that are excessively curved inward or directed in different directions;
when the problem tooth is in the affected bone;
in the complete absence of a crown, when there is nothing to grab onto with forceps;
if a filling was previously installed in the tooth, which can crack under the mechanical action of forceps;
when the tooth is impacted or dystopic;
removal of the "eight".

These are the main clinical features in which it is impossible to get rid of a diseased tooth with a standard simple procedure. Moreover, in each specific case, the reasons for complex extraction may be individual.

Cases when a complex operation is necessary

It often happens that the only possible way to get rid of a defect formed by a complex tooth is to remove it.

The indications for this procedure are as follows:

the formation of peridental tumors and edema, accompanied by soreness of the mucous membranes and gums;
numbness of the face resulting from damage to the nerve endings of a sick tooth;
with increased risks of curvature of adjacent teeth;
in the presence of diseases caused by incorrect positioning of the tooth.

Operations to remove problem teeth are contraindicated for those who suffer from pathologies of the cardiovascular system, with poor blood clotting, patients who have undergone a hypertensive crisis, in the presence of infectious or viral processes in the body, as well as other individual contraindications.

Preparation for dental surgery

If the patient is to have a complex tooth removed, then an experienced doctor will not perform such manipulations without prior preparation. Before the operation, an x-ray is mandatory. This is necessary to clarify the location of the tooth in the bone, as well as to assess the tissues surrounding it.

When an inflammatory process occurs in a patient, it is first cured by taking antibiotics.

Complications after pulling out problematic teeth are rare, but in order to avoid them, the procedure should be trusted by a highly qualified doctor.

How complex teeth are removed: basic techniques

In dentistry, various methods are used to eliminate a complicated tooth, the essence of which depends on the instruments chosen for manipulation:

Which method is the best? Each has certain features and is selected based on the condition of the tooth, the number and depth of its roots.

What are problematic impacted teeth

What teeth are called impacted? These are units that, for certain reasons, did not cut through. In most cases, the “eight” is such a tooth, since it erupts rather late and by that time there is no free space in the jaw.

Considering that such teeth do not participate in the process of chewing food and at the same time become the cause of inflammation in the future, it would be more appropriate to remove them.

The complexity of removing an impacted tooth is explained by the fact that in order to open access to them, it is necessary to violate the integrity of the gums due to its inconvenient location. The procedure can take up to an hour or more.

Extraction procedure

The steps for extracting an impacted tooth are as follows:

an incision is made on the gum;
the surgeon drills a recess in the bone;
the problem tooth is pulled out;
all remaining bone fragments are removed from the hole;
the wound is treated with an antiseptic solution;
stitches are applied.

Immediately after the procedure, it is desirable to apply cold to the cheek, accelerating the formation of a blood clot. This will prevent infection of the wound. If necessary, the doctor may also prescribe anti-inflammatory drugs.

A dystrophic tooth: indications for removal

A tooth with an incorrect position in the dentition relative to its neighbors is called dystrophic. It can take the place of another, spontaneously turn, change the angle of growth, which significantly interferes with neighboring teeth and leads to the formation of an abnormal bite.

Indications for the extraction of a dystrophic tooth are:

swelling of the gums and soreness;
numbness of the face due to damage to nerve endings;
pronounced curvature of neighboring teeth;
periodontitis or chronic pulpitis;
when it is impossible to perform prosthetics due to a problematic tooth;
if a dystrophic tooth is the cause of periostitis or osteomelitis.

The extraction process itself is similar to the scheme according to which the impacted tooth is removed.

Tooth with severed roots: features of the operation

If a tooth located in the lower jaw row, the roots of which have inward bends or diverge in opposite directions, is to be eliminated, then a procedure is performed using an angular elevator.

The instrument is placed by the surgeon in the periodontal gap, pressing it between the root and the socket, and gradually moving it deeper. The root is displaced and pulled outward. A similar scheme is done with another branched root.

If the manipulation is carried out correctly, then complications do not arise and the rehabilitation period passes quite quickly.

Extraction of a root stuck tooth

Very often, a complication of tooth extraction is a broken off and stuck root. When the tip of the root remains in the tissues, the surgeon sometimes has to use different tools to remove it. Often it is even necessary to remove a section of the alveolus to get to the remaining fragment. If there are several such fragments, then, accordingly, the operation time will be much longer in comparison with the usual procedure.

Extraction in acute and chronic inflammation

Quite often, the removal of a problem tooth is accompanied by the presence of purulent foci, inflammation of the gums or periodontitis. In such cases, the doctor prescribes enhanced therapy with the use of antibacterial drugs, and only after the suppression of the inflammatory process, an operation is performed to remove the tooth.

There are also situations when a tooth needs to be removed urgently. Only an experienced highly qualified doctor can perform surgical intervention in such cases.

Features of the removal of a "dead" tooth

If you need to eliminate a tooth on which depulpation was previously performed, then such a procedure is also complicated by the nature of the procedure. The fact is that due to depulpation, dental tissues become excessively brittle and the tooth itself is quite fragile. As a rule, such teeth crumble at the first impact of forceps on them, therefore, care and caution are required during the manipulation.

Wisdom teeth: what is the difficulty of their removal

If we are talking about the extraction of a wisdom tooth, then the complexity of the manipulation is explained by its very location in the dentition. Wisdom teeth are considered problematic because they:

cut through much later than others;
often grow with a bias to the side, while violating the evenness of the dentition;
they react to surgical intervention in different ways: pronounced swelling of the gums appears, body temperature rises, pain is much more intense.

Usually, such complications disappear after a few days, provided that the hole and oral cavity are properly cared for.

Complex tooth extraction: when it is necessary

Clinical indications in which the dentist prescribes a complex tooth extraction are as follows:

the presence of an unerupted wisdom tooth in the jaw;
with the wrong location of the "eight";
when removing molars with two or three roots;
with a severely destroyed or twisted root;
in case of fusion of the tooth root with the jaw bone tissue;
in the presence of a fistulous tract or cyst;
with excessive fragility of the crown due to treatment with a resorcinol-formalin composition.

The operation itself consists of several stages and is carried out under the influence of powerful anesthetics.

The operation for complex removal is carried out only after X-ray diagnostics, during which the shape, length and depth of the roots are determined. If the patient has inflammation, he is prescribed treatment with antibacterial drugs.

Procedure technique

Wisdom tooth extraction is carried out in the following order:

the gum is separated from the neck of the tooth by means of an incision in the soft tissues;
if necessary, the inter-root septum is sawn or sections of bone tissue are cut out at the location of the tooth;
then, with the help of forceps, the tooth is swayed and pulled out of the hole;
sutures are placed on the gum.

Painkillers are not required after the end of the procedure, since the effect of anesthetics is still preserved.

The process of healing the hole after a complex removal

Basically, tissue healing occurs after 7-10 days. It should be noted that this period is quite difficult for the patient. As soon as the action of anesthetics ceases, then immediately there is a pain of a aching nature. To eliminate it, you should take pain medication.

The resulting swelling and redness will decrease every day. If there is a slight itching in the area of the hole, then this indicates intensive tissue repair. Removal of sutures after healing is not required because they “resolve” on their own.

During the regeneration period after removal, it is very important not to violate the integrity of the blood clot formed in the hole. To do this, you must follow a few simple rules:

during the first 2-3 hours after the operation, do not drink any drinks, let alone food;
in no case should the well be heated, cleaned or washed;
do not rinse the oral cavity during the day after removal;
when eating, you need to chew it on the opposite side in relation to the hole.

Consequences after extraction of a complex tooth and possible complications

Patients who are about to have a complex tooth removed should be prepared for the fact that tissue restoration will be quite long. If we talk about the consequences, then the most dangerous among them is inflammation of the alveoli.

Its first symptoms appear approximately 2-3 days after the operation. Initially, there is a strong swelling, which gradually spreads throughout the face. An unpleasant putrefactive odor is felt from the mouth, body temperature rises.

The primary cause of such inflammation is improper care and ignoring the doctor's recommendations. Also, alveolitis can be caused by fragments of roots remaining in the hole, which the doctor performing the procedure did not remove due to his inattention.

When observing signs indicating the development of an inflammatory process, you should immediately contact your dentist. To avoid such complications, then only an experienced surgeon should be trusted to carry out such a dental operation.

Certified, experienced and responsible dentists work in the staff of the Beryozka dental clinic, who are able to carry out the most difficult tooth extraction with minimal risks of subsequent complications.