There are a number of situations which might warrant the surgical extraction of a tooth or teeth. Procedures may be planned, impromptu or anticipated.
Broken teeth a big portion of the crown is fractured out for a broken tooth, the shape of the remnant tooth is difficult to manipulate with the surgical extraction tools. One of the most complicated situations is when the crown breaks below the gum line. Solution requires the surgeon to remove bone surrounding the damaged tooth to expose it. If there is a need to expose a greater portion of the tooth for better access, then the gum flap is raised and bone below is trimmed.
Impacted teeth the most commonly affected teeth in such a situation is the wisdom teeth or the third molars. Additional surgeries might be required depending on the type of impaction. Impactions can be mesial, horizontal, vertical and distal. Besides the above, there is also soft tissue impaction, where the crown of the tooth has penetrated the bone, but not erupted out yet. Then there is the hard tissue impaction which could be a full bony impaction or a partial bony impaction. Each of these impactions has a separate applied surgical solution.
Anatomical issues such as long roots or curved roots Roots may be hooked or curved and can be difficult to extract. Usage of excessive force can cause damage to the bone besides breakage. The tooth is cut into parts with each part having its own root, thus making it easier to remove. Long and large roots can be stubborn to extract and thin and fragile roots can break very easily if force is applied.
Inelastic and dense bone The bone that encases the tooth may be affected by a condition that aggravates density of the bone and inelasticity might develop due to advanced age.
Removal of root tip A fractured root tip during extraction may be left behind. An incision into the overlying gum tissue can create an access to remove it.
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