By David A. McGowan
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Extra resources for Atlas of Minor Oral Surgery: Principles and Practice
The inclination is disto-angular and the mesial point of application is level with the midpoint of the distal root of the second molar. This tooth has tapered roots and its crown is i ntact distally. The distal bone is level with the tip of the distal cusp, but there is a generous follicular space. The outline of the inferior dental nerve canal crosses the apex and the apical hook. The relationship is best seen on the panoramic radiograph, since the periapical film was not placed distally enough to show the full extent of the root.
The tooth is lifted out by grasping the attached soft tissue with artery forceps - a convenient way of removing both at once. 34 An atlas of minor oral surgery Socket The lingual bony excrescence is nibbled smooth with rongeurs and the socket aspirated clean of debris. Closure The corner of the flap is drawn across to the lingual side. A single suture holds the flap in good position. Follow-up Healing was uneventful. The original complaint of numbness had disappeared by the time the patient came to surgery.
Third molar removal 37 Point of application The point of a curved Warwick-James' elevator is i nserted to confirm that a point of application can be reached. Even a minor degree of movement at this stage will be helpful, but the force should be applied j udiciously. Bone removal A gutter has been created on the buccal and distal side by cutting to a depth of about half the root length, using the root itself as a cutting guide. Elevation is tried and is partially successful, but the crown is held by the disto-lingual bone.
Atlas of Minor Oral Surgery: Principles and Practice by David A. McGowan