1. Surgical instruments and principles of exodontia
Dr. Soukaina Tawfiq Ryalat

52. Principles of Exodontia
Pain and Anxiety Control
Local Anesthesia: type of local anesthesia
Inferior alveolar nerve
Lingual nerve
Long buccal nerve
Maxillary Nerve (Ant. Middle and post. Superior alveolar Nerve)
Nasopalatine Nerve
Greater palatine Nerve.

53. Contraindications of teeth removal
Systemic conditions
Local conditions

54. Systemic factors Sever uncontrolled metabolic diseases
Un controlled diabetes
End stage renal disease
Un controlled leukemias and lymphoma
Un controlled cardiac diseases (Ischemic heart disease)
Bleeding problems
Medications ( warfarin, steroids, immunosuppressive agents.

55. Local factors History of radiation to cancer (osteoradionecrosis)
Teeth in the area of tumor (dissemination of cells)
Pericoronitis around an impacted mandibular molar

56. Clinical evaluation of teeth for removal
Access to tooth (mouth opening)
Mobility of tooth (periodontal disease)
Condition of the crown ( Large caries, large amalgum restoration)
Scaling before extraction
Radiograghic evaluation of teeth
Configuration of roots
Condition of surrounding bone: periapical pathology

66. Vital structures Maxillary sinus Inferior alveolar canal
Closed versus surgical exrraction

70. Chair position for Forceps extraction
Maxillary extraction: Maxillary occlusal plane is about 60 degrees to the floor.
Mandibular extraction: More up right position , occlusal plane is parallel to the floor

75. Mechanical principles of Extraction
Lever : Elevators
Wedge:1- beaks of the forceps (bone expansion). 2- elevator during luxation
Wheel and axle: Triangular elevator (Cryer)

80. Forceps Use
Apical pressure (center of tooth rotation is displaced apically)
Buccal force
Lingual force or pressure
Rotational pressure ( conic roots)
Tractional force: tooth delivery

86. Alveolar Bone Anatomy Buccal versus lingual movements
Give the bone time to expand
Avoid jerky movements.