In the case of extraction of Maxillary and Mandibular teeth in a full mouth rehabilitation case we need to follow a sequence or step by step procedure to extract all the teeth. Extraction of teeth can be due to many reasons, such as Full mouth rehabilitation where the remaining teeth are not worth saving or cannot be used to replace the missing teeth. With the recent advances, the replacement of all the Maxillary and Mandibular teeth can be done with fixed dentures which take the help of Implants – Implant-supported complete dentures which are fixed. So it is important to make sure that bone is preserved around the tooth which is extracted by making the extractions as atraumatic as possible.
It is also called as “Full Mouth Extraction” as all the remaining teeth are extracted at a time or in a gap of a few days to make way for new teeth – Dentures.
Maxillary teeth are extracted first which is a rule we always follow and also the rule that posterior teeth are extracted before extracting anterior teeth.
Why are Maxillary Teeth Extracted before Mandibular teeth?
- Maxillary teeth get anesthetized before the Mandibular teeth
- It prevents any fall of enamel or restorative debris from falling into the extraction sockets of the lower arch.
- This rule is not required in the removal of Impacted third molars
Both of these rules are followed even in full mouth extraction in both maxillary and mandibular teeth.
The sequence of teeth to be extracted in full mouth extraction:
- Maxillary posterior teeth (1st and 2nd Premolars, 2nd and 3rd molars) except 1st molars
- Maxillary anterior teeth(central and laterals) except canine
- Maxillary 1st Molar
- Maxillary Canine
- Mandibular posterior teeth (1st and 2nd Premolars, 2nd and 3rd molars) except 1st molars
- Mandibular anterior teeth(central and laterals) except canine
- Mandibular 1st Molar
- Mandibular Canine
The 1st molar and canine are extracted last in each quadrant because they help in maintaining the stability and integrity of the alveolar mucosa of the quadrant anteriorly by canine and posteriorly by 1st molar.
We have to first suture the Alveolar mucosa posterior to the 1st molar and alveolar mucosa anterior to the Canine in the quadrant.