By David A. McGowan
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Extra info for Atlas of Minor Oral Surgery: Principles and Practice
Follow-up Healing was uneventful, and there was no alteration in nerve function. 43 44 An atlas Removal of retained unerupted lower third molar of minor oral surgery AF, a 31-year-old prisoner, was referred by his prison dentist with a helpful letter which read: i nferior dental canal, I would be most grateful if you could look at this man and arrange the extraction of the lower left third molar. He is a drug addict and veins in both arms are considerably sclerosed. I saw this man a month ago at his insistence and, because he caused a riot, I arranged for him to be brought to my practice where I removed his remaining standing teeth under general anaesthetic.
The crown is impinging on the distal bone. Elevation moves the crown backwards, as well as upwards, because of the root curvature. Bone removal Bone has been removed to deepen the buccal gutter and relieve the i mpaction distally. 41 42 An atlas of minor oral surgery Elevation and delivery The tooth can now be elevated upwards and backwards out of the socket, using a Cryer's elevator. This has been preferred to a Warwick-James', as the space between the displaced tooth and the second molar is now quite l arge.
It is essential that the subperiosteal plane is identified, especially over the internal oblique ridge distally to the third molar crown, so that a guard instrument can be inserted to protect the lingual tissues during distal bone cutting. The lingual tissues must either be opened gently but widely or else left completely undisturbed. Compromise risks lingual nerve damage. Bone removal The tooth is in clear view and a natural mesial point of application already exists. It is therefore necessary only to relieve the impaction by removal of a gutter of bone distally so that the tooth may be uprighted.
Atlas of Minor Oral Surgery: Principles and Practice by David A. McGowan