Indications of Tooth Extraction
by Mahmoud H. Al-Johani
1. Alternative treatments
1.1. RCT: P.A inflammation & Root pattern
1.2. Surgery: apicectomy, hemi-section, Root amputatuion
1.3. Prosthetically: crown, pin-retained
1.4. Periodontological: periodontal treatments
1.5. Orthodontics: mesialization/ distalization of teeth, dental arch expantion
2. Required diagnosis
2.1. Local findings: defects related to the tooth it self
2.2. Extended local findings: defect related to the surronding structures
2.3. General findings: related to systemic conditions
3. Examination tools
3.1. Clinical examination
3.2. Medical history
3.3. Radiographs
4. Therapeutic indications
4.1. Remaining infected roots
4.2. Severe periodental disease
4.3. Orthodontic space creation
4.4. Cyst / P.A infection related tooth
4.4.1. EX: Cementoblastoma
4.5. Tumor relation
4.6. Vertical tooth fracture
4.7. Supernumerary tooth
4.8. Tooth along jaw fracture line
5. Prophylactic indications
5.1. General medical indications prior to:
5.1.1. Organ transplant
5.1.2. Radiotherapy/ chemotherapy (ORN)
5.1.3. Heart valve surgery (endocarditis)
5.2. Tooth with no opposing (over-erupted)
5.3. Impactions
5.3.1. Tooth may cause resorption of root/crown of adjacent
5.3.2. Inside maxillary sinus
5.3.3. Tooth may develop cysts (wisdom teeth)
6. Patient's wish!
6.1. ONLY with the actual indications
7. When to Extract a Tooth ?
7.1. Immediate
7.1.1. Acute tooth pain (not infection)
7.1.2. Initial/ severe inflammatory complications of general disease
7.1.3. Within context of orthodontic treatment ( crowding, impeded eruption)
7.2. Postpone
7.2.1. Acute infection (abscess)
7.2.2. Poor general health
7.2.3. Extraction of wisdom teeth before completion of orthodontic therapy