assessment of the effects of physics forceps versus the conventional forceps in the extraction of teeth - a randomised controlled study

Before beginningthe procedure a occlusal template will be fabricated using the modelling wax byplacing it over the tooth that is supposed to be extracted and the adjacenttooth in order for the references and the Williams graduated probe is used tocalculate the distance between the lower border of the template to the borderof the gingiva giving pre extraction gingiva and same probe is placed on thebone tip by a deep prick in order to measure the pre extraction bone height.All the measurements are done at 3 different sites i.e mesio-buccal,disto-buccal and mid-buccal region and the mean of the data is obtained andrecorded as pre surgical measurements.

 Extractions weredone following the standard aseptic surgical protocol. Local anaesthesiacontaining 2% lignocaine hydrochloride with 1:2,00,000 adrenaline was used togive regional nerve block along with local infiltrations in every extractionusing 26 gauge disposable syringe.

 Mucoperiosteal flaps reflection usingperiosteal elevator was only done in extractions which were to be carried outusing conventional forceps. Elevators were not used for luxation of tooth to beextracted. Tooth specific forceps were used for extraction of specific tooth inconventional forceps system. The beaks of conventional forceps were placed atthe cement-enamel junction of particular tooth and it was extracted giving thetooth specific movements. The beaks of physics forceps were placed on lingual/palatal aspect of tooth at or below cement-enamel junction and bumper wasplaced on buccal alveolar ridge at mucogingival junction and constantcontrolled traction forces was given until tooth was displaced out of thesocket.

 Time taken forthe extraction was considered from the point of application of the forcepsbeaks on the tooth to the delivery of the tooth out of the socket, measuredusing stopwatch and recorded in seconds. Compressions of the sockets was notdone following the extractions extracted tooth was clinically examined for theroot fracture and adherence of buccal plate to the root and recorded.

 Following theextraction the template was again placed over the teeth and distance betweenthe marginal gingiva and lower edge of template was measured which showed postextraction gingival level. Post extraction bone levels was measured by placingthe probe into extracted socket and feeling the bone margins, distance wasmeasured from the edge of the template.

 The mean value of pre extraction and postextraction level at three points was then calculated and the difference betweenthese two values suggested the amount of marginal gingiva and bone loss.

 The extractionwas given success score based on the criteria given by Choi. Et al 12

Score 5:complete success – extraction without crown and root fracture

Score 4: limitedsuccess with root tip fracture – extraction involving root tip fracture

Score 3: limitedsuccess with root fracture – extraction involving root one or more rootfracture or crown fracture.

Score 2: limitedsuccess with osteotomy – fracture free extraction and partial osteotomy in casedivergent roots and thick cortical bone was present

Score 1: failureto extract