Maxillary root removal technique

# Elevators should not be used to remove palatal root of an:
A. Upper incisor
B. Upper canine
C. Upper premolar
D. Upper molar

The correct answer is D. Upper molar. 

- Elevators should not be used to remove the palatal root of an upper molar.

- The buccal wall of socket does not form satisfactory fulcrum and can be crushed by the elevating force. 

- Furthermore, there is always the danger of forcing the root into antrum.

- The palatal root must be seen clearly, which usually implies the removal of both buccal roots and if necessary some surrounding bone, which can be done with a bur.

- Gentle dislocation with a narrow coupland chisel or rotation with upper root forceps should deliver the root.

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Radix Entomolaris / Radix Paramolaris

The radix entomolaris is an additional root in human's mandibular molar teeth. The human mandibular teeth have two roots usually. In rare cases, however, a root may develop between the distal and the mesial roots which is called entomolaris, if it is located lingual to the tooth.

Such a phenomenon is named radix paramolaris in case an extra root is buccal to a molar tooth. It is important to remember that an extra root can appear both in the first and second molars.

Three roots on mandibular molar, radix entomolaris

Radix entomolaris on a mandibular left first molar

Mandibular molar three roots, Radix Entomolaris

Radix entomolaris, apical view

Straight Elevator

# A straight elevator is properly used to advantage when the:
A. Adjacent tooth is the fulcrum
B. Tooth is isolated
C. Interdental bone is fulcrum
D. Adjacent tooth is not to be extracted

The correct answer is C. Interdental bone is fulcrum.

Straight elevator (Coupland, London Pattern) is the most commonly used. Usually used to luxate and elevate mandibular third molar and when multiple extractions are needed. It is not recommended in upper arch. This utilizes principle of lever mechanism. Alveolar crest acts as fulcrum. Adjacent teeth should never be used as fulcrum.

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Teeth in Line of Fire

# Teeth in line of fire means:
A. Teeth in the area of planned therapeutic radiation
B. Teeth in the line of fracture
C. Teeth within the cancerous region
D. None of the above

The correct answer is A. Teeth in the area of planned therapeutic radiation.

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