Presurgical assessment of the patient includes evaluation of the level of anxiety, ‘determination of health status and any necessary ‘modifications of routine procedures, evaluation of the clinical presentation of the tooth to be removed, and radiographic evaluation of the tooth root and bone. All four of these major factors must be weighed when estimating the difficulty of the extraction. If any factor or combination of factors presents a level of difficulty that seems too great, the dentist should refer the patient to an oral and maxillofacial surgeon.
Curvature of roots of this tooth is unexpected.
Preoperative radiographs allow surgeon to plan extraction more
Hypercementosis increases difficulty of these extractions,
because roots are larger at apical end than at cervical end.
Surgical extraction will probably be required.
Root caries in first premolar tooth make extraction more
difficult. because fracture of tooth is likely. Note hypercementosis of
Internal.resorption of’ root makes closed extraction
almost impossible because fracture of root will almost surely occur.
tooth made brittle by previous therapy it is more difficult to remove
A, Periapical radiolucency, Surgeon must be. aware of this before extraction so that prop-
. er management tltn be delivered. B, Periapical radiolucency around mandibular premolar represents
,mental foramen. Surgeon must be aware that this is not pathologic condition. Intact Iarnina dura is
noted in B but not in A.