Student name: HUYNH NGOC BAO TRAN

Student ID: C190486

Report Assignment 4: Oral and Maxillofacial Surgery (Dr. Ryouji Tani)

Describe the indications and contraindications for tooth extraction.

Indication
1. Teeth of the maxilla or mandible that present un- usual root morphology. In such cases, a
surgical extraction is performed preventively, be- cause their removal is impossible with
the simple technique without complications arising (e.g., root breaking, fracture of
alveolar bone, etc.).
2. Teeth with hypercementosis of root and root tip, presenting large bulbous roots.
3. Teeth with dilaceration of root tips.
4. Teeth with ankylosed roots or with abnormalities, e.g., dens in dente
5. Impacted and semi-impacted teeth. The extraction of these teeth is accomplished
employing a surgical technique, depending on the type and localization of the impacted
or semi-impacted tooth.
6. Teeth fused with an adjacent tooth or teeth fused with an adjacent tooth in the apical area.
If extraction were to be attempted using the simple technique in these unusual cases, then
part of the alveolar process could be fractured or removed together with the teeth.
7. Broken root tips that have remained in the alveolar bone and are involved in osteolytic
lesions, or are in such a position that, in the case of denture placement, they could create
problems in the future.
8. Maxillary posterior teeth, whose roots are included in the maxillary sinus. When the
maxillary sinus extends as far as the alveolar ridge, the bone found in the posterior area
of the maxilla is also weakened. This increases the risk of fracture of the maxillary
tuberosity if the extraction involves a firmly anchored tooth (molar), because with the
simple technique great forces are generated during its removal.
9. Roots of teeth found below the gumline, when their removal is impossible any other way.
10. Roots with periapical lesions, whose entire removal through the tooth socket would not
be possible with curettage alone.
11. Deciduous molars whose roots embrace the crown of the subjacent premolar. If the
simple extraction technique were to be attempted, there is a great risk of concurrent
luxation of the premolar.
12. Posterior teeth with supraeruption. It is well known that when the antagonist is missing,
these teeth present supraeruption to a great degree, which is accompanied by the dragging
down of the alveolar process. As such, the extraction must be carried out using the
surgical technique with concurrent re- contouring of the alveolar process of the area.
Contraindication
Asymptomatic fractured root tips, whose pulp was vital, located deep in the socket. The
extraction of such root tips should not be considered, especially in older patients, when:
  There is a risk of serious local complications, such as the dislodging of a root tip into the
maxillary sinus or injury of the inferior alveolar nerve, mental nerve, or lingual nerve.
 A large part of the alveolar process needs to be removed.
 There are serious health problems present. If a patient with health problems needs to have
a surgical extraction, then it must be performed with the cooperation of the treating
physician and only if the general status of the patient has improved; the necessary
preventive measures must also be taken.

Reference: Fragiskos F. D. (2007). Oral surgery. Springer.