Predictable exodontia in general practice.

Exodontia that is carefully and skillfully done by general dentists is a valuable service to patients. The majority of patients would rather have their family dentist perform necessary extractions or other minor surgery procedures than be referred outside the office. Most teeth that need to be extracted could be removed by a generalist if that person has developed the expertise to do not only relatively easy extractions, but also that percentage that is inevitably more difficult--requiring "surgical" removal. To be successful with exodontia, the dentist must have the ability to select cases within his or her level of comfort and ability, have a working knowledge of sound surgical principles, be able to apply a variety of patient management techniques, and then be prepared to handle whatever complications may arise. This article has presented ideas that should be integrated into the operator's own systematic approach to extractions. It is one of many resources to help the general dentist provide a higher level of surgical treatment.

Anterior apicos in general practice: step-by-step guidelines.

Apicoectomy and retroseal procedures should continue to be a mainstay of dental treatment because not all root canal therapy is successful, even when it is amenable to retreatment. Currently accepted methods for performing this operation have been reviewed. With appropriate case selection and the careful implementation of these techniques, the general dentist can confidently provide this service to patients.

Pharmacologic considerations in the management of oral surgery patients in general dental practice.

Minor oral surgery is an integral part of dentistry, whether performed by the generalist or the specialist. Procedures include those within the broad discipline of general oral surgery (such as routine and surgical extractions, impactions, preprosthetics, biopsy, and implants), periodontics (such as periodontal surgery, mucogingival plastic surgery, and implants), and endodontics (periapical surgery). There is considerable overlap among generalists and surgical specialists in terms of the treatment provider. Perhaps the most important consideration with regard to appropriateness and quality of care is not who does the surgery but how it is done. The ability to perform surgery according to sound surgical principles and to properly prescribe medications in association with that surgery is a necessary requisite for quality treatment. This article reviewed how various pharmacologic agents can be administered and how they influence surgical procedures. Whether or not they are used and the manner in which they are used are predicated on the discretion and clinical judgment of the clinician on a case-by-case basis. If used appropriately, these medications can be instrumental in mitigating morbidity and increasing tolerance and overall patient satisfaction with the surgical experience.

The removal of impacted third molars. Principles and procedures.

This article reviews factors relating to the removal of impacted third molars. It covers indications for surgery and how indications and surgical difficulty correspond with the age of the patient. The difficulty of the procedure depends not only on age, but on how the tooth is categorized radiographically (classification, position, angulation) and on the patient's facial characteristics (tapering versus compact facial form). The operator's familiarity with the anatomy of the surgical site is indispensable for uneventful third molar surgery. A signed consent form is necessary to meet medico-legal standards. With a diagnosis, treatment plan, and consent to proceed, these teeth are extricated from their sockets with a modicum of instruments, each one fulfilling a specific purpose. The surgical procedure, whether maxillary or mandibular, can be broken into separate segments for technique elaboration and refinement. These segments are flap development, bone removal, luxation, sectioning, tooth removal, and closure. Specific methods may vary among dental surgeons based on training and experience, but they all should correspond to basic and established principles of surgical technique. Some of these principles and techniques have been outlined in describing the removal of typical mandibular and maxillary third molar impactions.