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Principles of surgical extractions

BDJ Student volume 30, page 31 (2023)Cite this article

Surgical extractions at dental school can be daunting especially when it is your very first time attempting the procedure or when a simple extraction does not go as planned. Unlike simple extractions where elevation and forceps may be sufficient in removing the tooth, surgical extractions require further surgical steps within the procedure. These can involve raising a mucoperiosteal flap, bone removal (ostectomy) or tooth sectioning.

A mucoperiosteal flap is a full-thickness flap of mucosal tissue and the underlining periosteum which is reflected from the alveolar bone during oral surgery. The procedure involves creating an incision to raise the flap to allow for a larger and clearer working field. Listed below are a few reasons why a flap might be raised during an extraction:

  • Gain access to the buried object (tooth, root, fracture, pathology, plate or screw)

  • Achieve a deeper application point

  • Completion of a complicated extraction

  • Section roots of a multi-rooted tooth

  • Section crown of impacted tooth.1

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References

  1. Hupp J R, Ellis E, Tucker M R. Contemporary oral and maxillofacial surgery. St. Louis, Mo: Mosby Elsevier. 2008.

  2. Coulthard P, Horner K, Sloan P, Theaker E. Oral and Maxillofacial Surgery, Radiology, Pathology and Oral Medicine. 3rd Edition Churchill Livingstone Elsevier. 2013.

  3. Bailey E, Kashbour W, Shah N, Worthington, H V, Renton T F, Coulthard P. Surgical techniques for the removal of mandibular wisdom teeth. Cochrane database of systematic reviews 2020; 7: CD004345.

  4. Sadler A, Bailey E. Core Oral Surgery for Dental Students. United Kingdom: Sorejaw. 2018.

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Authors and Affiliations

  1. Abacus Dental Care, Milton Keynes, United Kingdom

    Reema Modasia

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  1. Reema Modasia
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Correspondence to Reema Modasia.

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Modasia, R. Principles of surgical extractions. BDJ Student 30, 31 (2023). https://doi.org/10.1038/s41406-022-0918-2

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  • DOI: https://doi.org/10.1038/s41406-022-0918-2

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