Exodontia is the surgical act of extraction of a tooth. A tooth may require extraction for various reasons, from a tooth deteriorated by caries and that is no longer possible to reconstruct, a fractured tooth, or a temporary tooth that does not fall by itself, to periapical pathology that cannot be treated by other means.

Usually, to perform an extraction, the tooth must be held, luxated and finally extracted. A number of instruments, such as forceps and elevators, are available for the luxation and come in a wide variety of designs according to the tooth to be treated.

The complications that may arise when an extraction is performed can occur during the extraction itself or thereafter (view diagram 1).

Diagram 1

The most common complications that occur during tooth extractions include fracture of the tooth itself or of its neighbours, fracture of the alveolar bone, and lesions to the surrounding tissue, whether soft tissue or nerve lesions.

With regard to the postoperative complications, alveolitis is common and is due to the loss of the initial coagulum and exposure of the bone tissue with subsequent bacterial colonisation.

(view diagram 2 / diagram 3).

Diagram 2
Diagram 3

The usual symptom is intense localised pain. Treatment is performed with eugenol dressings to achieve healing by secondary intention. The loss of a tooth gives rise to a significant disequilibrium in the masticatory system.

A tooth remains in its position thanks to the support given by neighbouring teeth, the antagonist tooth and contact with the tongue and cheeks. When a tooth is lost, the posterior tooth begins to deviate forwards and the anterior tooth backwards, and the opposing tooth begins to extrude.

This leads to the loss of the point of contact of the teeth, generating gingival and periodontal problems between neighbouring teeth. In this way, dental loss that started with a single tooth extends to the other teeth (view diagram 4).

Diagram 4