hello sir,
i feel quite dfficulty in extractions...especially firm maxillary first molar and third molar....
is there is any technique of extraction or just bucco-lingual movements....
i see my seniors they just put periosteal elevator and tooth is out in a minute!!!
is this is a matter of experience..or any thing else...

Ritu - the buccal lingual movements, if you are able to properly seat the forceps on the teeth, is a very good way of extracting the teeth. The insertion of a straight elevator between the teeth, in maxillary teeth, if would be a slight upward placement, in an attempt to enter the periodontal ligament space between the tooth and bone.  Sometimes that is not possible and the placement in the correct spot cannot be made.  In that situation a smaller and thinner elevator is used initially to widen the periodontal ligament space and then change to a slightly larger one until entrance can be made to manipulate the tooth.  With the elevator proper placement, it is not just a turning of the handle but two movements at the same time.  For maxillary teeth it would be the turning while elevating the handle superiorly,GENTLY,
to elevate the tooth.  Important not to lean on adjacent teeth with the manipulation of an elevator but stay in the ligamental space.  If nothing else, it can slightly loosen the tooth to allow an easier extraction with the forcep.  Too much pressure can cause the tooth to break so you need to learn to the boundaries of pressure than can be applied.

I wish you well and hope you become a great doctor.  If you should have additional questions in the future, feel free to contact me again.


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Joel S. Teig, DMD, Diplomate ABOMS, retired


I am a board certified oral and maxillofacial surgeon and I am available to answer questions related to tooth extractions, implant insertion, facial recontruction, facial and oral tumor removal, TMJ dysfunction and various successful treatments, including surgery if all else fails, and occlusal discrepancy requiring orthognathic or jaw surgery.


Board Certified Oral and Maxillofacial Surgeon practicine for over 20 years. Assistant Clincal Professor and State University School of Dentistry.

American Dental Association, American Association of Oral and Maxillofacial Surgeons, American Board of Oral and Maxillofacial Surgeons

BA -University of Connecticut DMD - University of Pennsylvania School of Dental Medicine

Awards and Honors
National Honor Society (OKU), Philadelphia County Dental Society, Mosby Book Award, Oral Surgery Honors, Summa Cum Laude

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