Dental surgery: difficult extractions – tips and tricks | BSAVA Library

Dental surgery: difficult extractions – tips and tricks

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: Canines and carnassials most often cause problems when extracted. Root fractures, flap dehiscence and jaw fractures are among the most frustrating complications in the field of veterinary dentistry. This lectures gives tips and tricks to avoid these complications. Some of them you might know – some of them might be new.

: Extracting teeth from cats poses many unique challenges, including a small space within which to work, fragile gingival tissues, a thin plate of bone separating the oral and nasal cavities, proximity of the maxillary teeth to the orbit, and tooth resorption. Preoperative imaging (radiographs and/or cone-beam CT) is imperative to assess the teeth and alveolar bone prior to extractions. Excellent lighting, magnification loupes, and specialized instrumentation will facilitate extractions. Specialised instrumentation includes fiber-optic or LED-lit high-speed handpieces with irrigation, small round and tapered diamond burs, small Molt or P24G periosteal elevators, cheek and lip retractors, 0.9-, 1.3- and 2-mm luxating elevators, root tip forceps (e.g. FX-49), 4.75” needle-holders, and 5-0 or 6-0 monofilament suture material on a reverse cutting needle. An open technique with removal of alveolar bone will prevent many root fractures, as will knowing when to perform surgical subgingival crown amputation (aka coronectomy) vs. extraction in toto for teeth with resorption. When root fracture does occur, enlarging the flap, removing more alveolar bone and using a tiny ¼ carbide bur to create a trough around the root will enable positioning of a luxator into the periodontal ligament space that may have previously been inaccessible.

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