Atraumatic Dental Extraction – Clinical/Socket Preservation Techniques
Objectives: 1) To highlight the rationale and benefits of bone preservation when carrying out a dental extraction.
2) To demonstrate two techniques that can be used to extract a tooth or tooth roots atraumatically.
The principles of dental extraction are to either make the socket that contains a tooth larger than the tooth itself, or to make the tooth smaller than the socket that contains the tooth to allow the creation of a path of removal. Atraumatic extraction techniques are based upon preserving the socket size and therefore maintaining the integrity of the surrounding alveolar bone.
Methods: This poster will present the clinical application of two techniques:
Technique 1: Sectioning a tooth into smaller fragments such that they can be removed sequentially and thus preserving the integrity of the extraction socket as well as possible.
Technique 2: In scenarios where a root fragment fractures deep within a socket, a stainless steel endodontic k-file of sufficient rigidity can be used to engage the root canal dentine of the fragment and permit removal.
Results: Both techniques are presented visually with sequential intra-operative clinical photography.
Technique 1: An unrestorable endodontically treated lone-standing mandibular molar is sectioned along the furcation, seperated with a controlled fracture and extracted in two fragments, whilst another molar in similar condition is extracted with a similar technique
Technique 2: A #55 and #90 stainless steel endodontic k-file were used to remove deeply positioned fractured roots without causing further trauma to the surrounding alveolar bone.
Conclusions: These clinical techniques allow the preservation of as much alveolar bone and associated soft tissues as possible. Such techniques greatly improve healing outcomes as there is less physiological trauma for the body to contend with. Preservation of bone and subsequent preservation of gingival contours of adjacent teeth prevents recession and dentine hypersensitivity. Subsequent restorative treatment supported by superior alveolar bone provides better basal foundations for dental implant placement and other prosthodontic solutions.