Extraction Setup 

  1. In sterilization room, prepare Surgery cassette or pouch.  Basic instruments include Minnesota retractor, periosteal elevator and surgical curet.  The last one may be the most essential
  2. Forceps, upper 3rd  molar elevator for fully bony or extremely tough cases if necessary
  3. Periotome, collagen plug, and bone graft for atraumatic extraction for implant
  4. Surgical handpiece (135 ° angle with long-shanked fissure bur) for partial or full bony lower 3rd molar
  5. Wrap a tray with a plastic bag (cabinet under clean counter or in the drawer underneath the one for cassette wrapping paper) for surgical extraction.  Place the wrapped tray on doctor’s side.  Prepare another tray with paper cover for DA
  6. In treatment room, use a sterilized cup for single extraction or a bowl for multiple extraction.  Pour appropriate amount of sterile normal saline (more for lower tooth extraction) into the cup or bowl.  A 3 cc monojet is needed
  7. For extraction of painful tooth, load syringe with Mepivacaine, prepare 1-2 carpules of Xylocaine (red) and one of Septocaine; for simple extraction, load syringe with Xylocaine (red), prepare each of Xylocaine (red), Mepivacaine and Septocaine
  8. Usually one 2x2 is enough for single extraction.  Prepare one extra in case
  9. Install a plastic surgical suction if pouched instrument is used.  It is good to prepare one or two extra plastic surgical suctions in case the first get blocked during surgery, particularly for lower 3rd molar.  If the surgical cassette has a large diameter suction tip, prepare a plastic suction tip with small diameter, vice versa.
  10. Take out, but not open a #15 blade and plain gut suture (18 inch for single extraction, whereas 27 for multiple one), chromic gut for atraumatic extraction
  11. Bite block for lower extraction, particularly difficult cases
  12. For lower posterior extraction, place a capsule of Tetracycline in the cap of the bottle
  13. Suction and clean the suction lines with surgical suction tip on!  If the tip is blocked, use wire to get through
  14. Save unused materials including carpules, clean if contaminated
  15. Return to Assistant Page

Xin Wei, DDS, PhD, MS 1st edition 06/01/2011, last revision 06/01/2011