Minimally Invasive Tooth Extraction With a Novel System

Method: Patients with grossly carious teeth or roots not suitable for forceps extraction were consecutively recruited. Molar teeth were excluded from the study. The teeth were extracted with the use of the Benex® system. At the time of the procedure, various patient, tooth/root and procedural data were recorded and analysed.

Result: 323 teeth were extracted using the Benex® system in 223 patients (mean age 50 yrs, 63% males). Overall, 85% of teeth were successfully removed with Benex®. The success rate was lower in multirooted teeth (70%) compared to single rooted teeth (87%), with a risk ratio for failure of 2.2 (95% confidence interval 1.3 – 4.0, p=0.006). The failure rate was higher in previously root filled teeth (25%) compared to those not root filled (11%) with a risk ratio for failure of 2.1 (95% confidence interval 1.3 – 3.6, p=0.003).  In 43 cases, previous forceps extractions had been attempted, and of these 91% were successfully removed using Benex®. The majority of failures were characterised by failing screw retention and/or root fracture, occurring mainly as a result of divergent roots or undercuts, caries in the root canal, misalignment of the screw by the surgeon, or root fracture. 38% of failures (6% overall) required flap surgery for removal, compared to an estimated need for surgery of 51%, had Benex® not been available.

Conclusions: The Benex® extractor system may be successfully used for minimally invasive tooth/root extractions of a majority of teeth not suitable for forceps extraction. The system has a high success rate with single rooted teeth/roots compared to multirooted teeth. Extraction failure is mostly associated with insufficient retention or misalignment of the screw and root fracture.