Changes

*Supernumerary teeth

*Supernumerary teeth

*Chronic gingivostomatitis

*Chronic gingivostomatitis

==Patient Preparation==

==Patient Preparation==

*General anaesthesia – a cuffed ET tube and throat pack are recommended to secure the airway. Local anaesthesia should also be considered  

*General anaesthesia – a cuffed ET tube and throat pack are recommended to secure the airway. Local anaesthesia should also be considered.

*Pre-emptive analgesia  

*Pre-emptive analgesia.

*Perioperative antibiotics should be given in selected cases only. These include debilitated animals, immuno-compromised animals, animals with severe local or systemic infection, animals with organ disease or endocrine disorders.

*Perioperative antibiotics should be given in selected cases only. These include debilitated animals, immuno-compromised animals, animals with severe local or systemic infection, animals with organ disease or endocrine disorders.

*Scale and polish all teeth prior to performing any extractions. Tooth extraction, by whatever technique, is a surgical procedure and should be performed in as clean field as possible. The surgical site should also be irrigated with a chlorhexidine based mouthwash.  

*Scale and polish all teeth prior to performing any extractions. Tooth extraction, by whatever technique, is a surgical procedure and should be performed in as clean field as possible. The surgical site should also be irrigated with a chlorhexidine based mouthwash.  

*Pre-operative radiographs should be performed. Radiographs will enable the surgeon to assess any abnormal root morphology and the integrity of the surrounding bone. Post op radiographs can be taken to ensure complete tooth root removal.  

*Pre-operative radiographs should be performed. Radiographs will enable the surgeon to assess any abnormal root morphology and the integrity of the surrounding bone. Post-operative radiographs can be taken to ensure complete tooth root removal.  

 

==Techniques==

==Techniques==

Open (surgical) or closed (non-surgical). The use of technique depends on operator’s preference, tooth morphology and disease present. The choice of technique used may depend on a preoperative radiograph which is always recommended prior to an extraction.   

Open (surgical) or closed (non-surgical). The use of technique depends on the operator’s preference, tooth morphology and type of disease present. The choice of technique used may depend on a pre-operative radiograph which is always recommended prior to an extraction.   

 

==Non-Surgical or Closed Technique==

==Non-Surgical or Closed Technique==

This technique is used for all single rooted teeth or teeth that have been sectioned into individual roots.  

This technique is used for all single rooted teeth or teeth that have been sectioned into individual roots.  

The gingival attachment is cut around the whole circumference of the tooth using a no.11 scalpel blade or a sharp luxator. Either a luxator or elevator of appropriate size is then inserted into the periodontal ligament space to cut the periodontal ligament fibres. (pic10) Once some space is created between the tooth and the bone, an elevator is used to work circumferentially around the tooth applying some apical and rotational pressure at and acute angle to the tooth root. Pressure should be applied for 10 seconds at a time to break down the periodontal ligament fibres. It is important that the tooth is not levered. Once the tooth is mobile it can be delivered from the socket using either fingers or extraction forceps. (pic11) It is important to use extraction forceps correctly to avoid root fracture. The forceps should be applied as low down the root as possible. The forceps are initially used in a rotational manner to break down any remaining fibres and when the tooth is able to rotate in both directions, the tooth can gently be pulled from the socket.  

The gingival attachment is cut around the whole circumference of the tooth using a no.11 scalpel blade or a sharp luxator. Either a luxator or elevator of appropriate size is then inserted into the periodontal ligament space to cut the periodontal ligament fibres. (pic10) Once some space is created between the tooth and the bone, an elevator is used to work circumferentially around the tooth applying some apical and rotational pressure at an acute angle to the tooth root. Pressure should be applied for 10 seconds at a time to break down the periodontal ligament fibres. It is important that the tooth is not levered. Once the tooth is mobile it can be delivered from the socket using either fingers or extraction forceps. (pic11) It is important to use extraction forceps correctly to avoid root fracture. The forceps should be applied as low down the root as possible. The forceps are initially used in a rotational manner to break down any remaining fibres and when the tooth is able to rotate in both directions, the tooth can gently be pulled from the socket.  

To section teeth into individual roots use a tapered fissure friction grip bur on a high speed handpiece with watercooling. A small diameter bur should be used. The furcation needs to be identified and as a general rule, lies below the main cusp of the crown. Once the furcation is identified start sectioning the tooth from the furcation towards the cusp, from the buccal to lingual/palatal aspect of the tooth. (pic12) Care should be taken not to damage the gingival attachment at the furcation. To check that the tooth has been adequately sectioned, place an elevator between the two sections of the tooth and gently rotate – both parts of the crown should move independently.  

To section teeth into individual roots a tapered fissure friction grip bur on a high speed handpiece with water-cooling should be used. A small diameter bur should be used. The furcation needs to be identified and as a general rule, lies below the main cusp of the crown. Once the furcation is identified the tooth should be sectioned from the furcation towards the cusp, from the buccal to lingual/palatal aspect of the tooth. (pic12) Care should be taken not to damage the gingival attachment at the furcation. To check that the tooth has been adequately sectioned, place an elevator between the two sections of the tooth and gently rotate – both parts of the crown should move independently.  

==Surgical or Open Technique==

==Surgical or Open Technique==