Page 609 - ONLINE PROCEEDING BOOK WSAVA 2017
P. 609

WSVA7-0372
FELINE MEDICINE (ISFM)
FELINE DENTAL EXTRACTIONS - TECHNIQUES AND TIPS
G. Jerzy1
1Klinika Weterynaryjna, Arka, Kraków, Poland
Feline Dental Extractions - Techniques and Tips Jerzy Gawor DVM PhD, Dipl AVDC, Dipl EVDC, FAVD
Klinika Weterynaryjna Arka, ul. Chlopska 2a Krakow, Poland
jgawor@pp.com.pl
Learning objective: How to perform dental extraction in a cat with minimally invasive still ef cient techniques. How to avoid complications and how to solve postoperative dysfunctions of mouth in a cat.
In ammatory oral diseases in cats are the most important problems in feline dentistry. Controlling in ammation is the key to management of this disease process and so far the most ef cient way to manage it is the surgical treatment.
Extraction of the teeth affected with in ammation from any cause should be extracted. However, since the majority of patients have widespread in ammation, the most successful long-term treatment for cats with chronic gingivostomatitis is the COMPLETE extraction of all premolars and molars including the periodontal ligament as well as smoothing the alveolar bone. Extraction of the canine and incisor teeth is indicated when the in ammation extends to include the gingiva surrounding them. Therefore often is performed
FULL mouth extractions in cases of signi cant oral in ammation, while some veterinary dentists prefer to leave the canines and incisors if at all possible.
Equipment needed. Choosing appropriate hand instruments is critical for achieving successful extractions. It is agreed that the following are always a parts of surgical kit: blade holder #3, tissue forceps, periosteal elevator, tissue scissors, suture scissors.
The surgical kit for cats should have selection of smaller  ne instruments and may be also combined and packed together with diagnostic instruments.
The necessary addition to this kit is an extraction package which contains luxators and elevators assortment as well as extraction forceps and possibly separate set of instruments dedicated of solving complications: root tip forceps, root tip elevator. For cats normally the small slim and medium variations of luxators and elevators are required
A part of extraction kit is also the selection of burs being used while surgical extraction. Most commonly used burs are round burs, pear shaped,  ssure burs, in both standard and surgical length.
High speed diamond burs are also extremely useful when performing surgical extractions in cats. One, in particular, is a medium grit, medium sized, football shaped bur that serves to remove alveolar and buccal bone in a much less aggressive fashion compared to the various carbide burs. This is advantageous when one attempts to smooth and re-contour the sharp edges of crestal bone after a tooth has been extracted.
High speed instrumentation will encompass the high speed hand pieces that attach to any high speed dental unit driven by compressed air or nitrogen gas. Such hand pieces operate by driving compressed air through a high speed turbine.
Both: preoperative and post-operative dental radiographs must be exposed to document complete extraction
of all tooth roots. Producing pre-extraction intraoral radiographs will help de ne the extent of the pathology, and will demonstrate the anatomic variability present
with the tooth in question. Intra-operative radiographs may prove to be valuable when the extraction has
not proceeded as expected, or if root fractures have occurred.
Surgical extraction. The  rst step in surgical extraction
is to create an access  ap. The  rst is parallel to the free marginal gingiva, and is produced by inserting the scalpel blade into the gingival sulcus or immediately parallel
to it, and extending an incision rostral and caudal to achieve the desired length. A periosteal elevator is used to separate the mucosa and periosteum away from the bone to allow limited access and visualization. This is creation of the full thickness  ap.
Once the buccal bone over the root structure has been exposed, a high speed carbide bur can be used in a gentle stroking motion to remove the crest that exists near the level of the original sulcal or para-sulcal incision. When performing an extraction on a multi-rooted tooth, it is often easiest to remove the crestal bone over the central aspect of the tooth  rst to obtain visualization of the furcation before extending the bone removal to the distal and mesial aspects of the root structure.
Buccal bone is removed to expose 30-50% of the overall root length. The crown is then sectioned with a carbide bur at the site of the furcation to separate each root
for individual extraction. The space created by the bur during the sectioning process provides an initial insertion point for a small dental elevator. Gently twisting the eleva- tor in one direction and then the other will start to stress
An Urban Experience
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