Dentaltown April 2023 - 30

MESSAGE BOARD 3
Extraction Blooper
Townies share tips to get this doc back on course
after a cracked tooth goes off the rails
ccay
Post: 1 of 31
1/22/2023
Hi, all. One of my patients came with a cracked #31, tooth split into buccal/lingual halves. The tooth is clearly
unsalvageable so I suggested extraction. Because the tooth appears to have fused roots that carry C-type kind of
canals, I jumped into the procedure, totally underestimating the difficulty level of the extraction.
Forceps decoronated the crown. I spent the next hour struggling to get the root out. I troughed the mesial and
buccal bone repeatedly, but the tooth did not bulge. In the end, I had to refer the patient to an oral surgeon to complete
the procedure.
Reflecting on what I have done, some questions popped into
my head. Thanks in advance!
1. Would it have been easier if I had chosen to reflect a flap
after the tooth decoronated, instead of troughing buccal
and mesial without flapping?
2.
3.
Would anybody consider sectioning the tooth? If so, how
do you section a fused root?
Is there anything I missed on the radiograph that would
indicate this being a difficult extraction? n
Fixsmile07
Post: 3 of 31
Use a cowhorn and save yourself a lot of work. In answer to your questions:
1. Go back in with a cowhorn and try to get it out in one piece (yes, even after crown breaks off).
2. I wouldn't section the tooth at all. If Option 1 didn't work, I would trough deeper on buccal. 6-8 mm should
be adequate.
3. No. n
1/22/2023
drtommymurph
Post: 4 of 31
1/22/2023
Fixsmile07 has great advice. Get more training. Don't let easy extractions humble you.
A 6-8 mm trough is great advice. That should have been a mild to moderate case. With no adjacent crowns or
large fillings to worry about, that should have been out in 5-10 minutes, tops. Just my opinion. n
Danishteeth
Post: 5 of 31
1/22/2023
Flap and buccal trough after 10 minutes of intelligent luxation and forceps fail. (Like you are doing a wizzy.) Don't
go ham on the bone but rather most on the tooth.
APRIL 2023 | 30 | DENTALTOWN.COM

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Dentaltown April 2023

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