Atraumtic extraction of teeth is a surgical extraction technique in which the teeth are extracted with minimal amount of damage to the surrounding bone and tissue structure.
As a dentist, I always focus to deliver optimal dental care to patient. With all extraction, I take special care to minimize discomfort to patient and to efficiently perform the surgery. With the new development of surgery instruments and increased popularity of implants, I am able to perform the surgery of extraction in the most atraumatic ways than it has always been in the past.
In the past, usually the two most common types of instruments are elevators and forceps. The elevators is used to loosen the tooth in the socket by applying torquing pressure on the tooth against the bone socket or the surrounding tissue. After the tooth has become loosen, a forcep is used to further grab the tooth out of the bone socket.
Most of the time, this traditional extraction technique requires a lot of blunt forces in the process of loosening the tooth. Sometimes, the surround bone, especially the buccal bone,might become fractured inevitably in the process.
However, with the increased popularity of dental implants, dentists have become more aware of the importance of preserving the bone. A good natural bone is desirable for optimal implant placement and osseointegration. Thus, a newer generation of surgery instruments are developed.
The newer generation of surgery instruments are periotomes and luxators. Even though they were first used by dentist more than a decade ago, these instruments have recently been reintroduced to the dental offices by popular demand due to their ability to allow dentists to perform atraumatic extraction and surgery.
During extraction, periotome is iinserted into the gum pocket to sever the periodontal ligaments in order to loosening the tooth.
The periotome instrument is a small surgical knife-like instrument that is inserted into the pocket between the tooth and the alveolar bone. In there, there are ligaments and fibers extending from root surface of the tooth to the surrounding alveolar bone. The periotome instrument is inserted and is able to cut through these fibers/ligaments. In essence, the periotome is performing microsurgery to sever the periodontal ligaments. Once the fibers are cut, the tooth will be loosened.
Next, luxator is a small instrument with a thin blade at its tip. The thin blade is further inserted into the space created by the periotome. With a couple of small twist, the tooth will become completely loose and a forcep can be used to grab the tooth out of the bone socket.
Disclaimer: this surgery technique is not applicable to all situation. And even though it was inteneded to perform surgery atraumatically, some unexpected situation may arise and dentist would need to perform additional steps to complete the surgery. Not all tissue or bone can be preserved atraumatically as intended.
Written by Daniel Tee, DDS, MS
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