Skills Laboratory: How to extract a maxillary canine in dogs
Follow this straightforward, step-by-step guide to remove this large-rooted tooth by creating a mucoperiosteal flap.
Teeth with gross or radiographic evidence of pulp necrosis are candidates for either endodontic therapy or extraction. Discoloration due to intrinsic tooth staining, tooth fracture with pulp exposure, radiographic evidence of a wide pulp cavity compared with the rest of the dentition, and abnormal lucencies surrounding the tooth apex are all consistent with pulp death and necrosis. In cases of severely fractured teeth or gross or radiographic changes or in cases in which there are financial constraints or extended anesthetic concerns, extraction may be the only viable alternative to root canal therapy. Efficient removal of the comparatively large root of the maxillary canine tooth requires a mucoperiosteal flap. Closure of the defect after extraction is facilitated by proper flap construction.
Proper equipment is imperative when performing surgical extractions. A high-speed delivery system is necessary. Round carbide burs or crosscut tapered fissure burs allow for the removal of vestibular bone and the creation of a mesial and distal groove. Diamond taper or flame burs contour bone after tooth removal. Other necessary instruments include a scalpel handle with a No. 15 blade, a periosteal elevator, Metzenbaum or iris scissors, and 4-0 absorbable suture material with a cutting needle.
Dental radiography equipment is essential in all extractions, and preoperative and postoperative radiography should be performed in every case. Regional nerve blocks are performed to maximize intraoperative patient safety and provide postoperative analgesia. (See How to perform four oral regional nerve blocks in dogs and cats.)
Hemorrhage control is generally not a concern because a high-speed water-cooled hand piece allows good visualization during most of the procedure. However, gauze may be used to blot the incision line to aid in elevation.