Exodontia and Minor Oral Surgery
This domain tests safe extraction technique, flap design, bone management and prevention of complications.
Core rules
- Assess tooth and root morphology, bone density, adjacent teeth, sinus and nerve proximity. Obtain imaging before surgical extraction.
- For forceps extraction, apply force to expand the socket, not to fracture the crown. Use an elevator with a finger guard and support adjacent teeth.
- Surgical extraction: raise a full mucoperiosteal flap, remove bone with a bur under irrigation, section multirooted or impacted teeth, and retrieve root fragments.
- Third molar difficulty depends on angulation, depth, root form, ramus relationship, follicle and nerve proximity. Lingual and inferior alveolar nerves are at risk.
- Postoperative care: pressure, suture, written instructions, analgesia, chlorhexidine and review.
- Socket preservation after atraumatic extraction can reduce ridge loss before implant placement.
Worked example
A mesioangular 38 has its crown under the distal 37 and roots near the canal. Plan CBCT if roots are close to the canal. Raise a buccal flap, remove buccal bone, section the crown, elevate the roots and inspect the socket. Document nerve status before and after.
Traps
Excessive lingual pressure; failing to section a difficult tooth; chasing a root into the canal; ignoring anticoagulant or medical history; not warning about trismus, swelling and nerve risk.