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as the amount of bone removal re- quired is minimal, thus minimis- ing the postoperative morbidity. However, it cannot be performed inallcasesinwhichtheLM3isclose to the IDC and is certainly contra- indicated when the LM3 is decayed or its roots are associated with a pathology and should be con- sidered with caution in severely inclined mesio-angular and hori- zontalimpactioncases.Theauthor does not recommend distal bone removalorretractionofthelingual flap with the intention of protect- ing the lingual nerve, as these may increase the risk of damaging the lingual nerve. It should be empha- sised that incision may not extend beyond the distobuccal aspect of the tooth. The other important aspect of the dental extraction procedure is the future replacement of the tooth to be extracted. The current trend of tooth replacement for both functional and aesthetic rea- sons is the placement of dental implants. The success of this treat- ment largely depends on the avail- abilityofhealthyboneinsufficient volume. Therefore, it is crucial for the dental practitioner not to com- promise the alveolar bone during extraction of the teeth. Changes in the alveolar bone ridge after an extraction are inevitable. After all dental extractions, bone height and width always undergo dimen- sional changes. Bone does not regenerate above the level of the alveolar crest, that is, its height will not increase during healing. The buccal plate tends to shrink, shifting the crest of the alveolar ridge lingually, and often forms a concavity. Such changes are pro- portionaltotheamountoftrauma to the soft and hard tissue during the extraction. An additional unfavourable change that may take place is the slow remodelling of the bone formed to fill up the extraction socket owing to lack of functional stimulation.Thepresenceofpoorly remodelled alveolar bone may compromise the stability and function of the future implant. Furthermore, studies show that the stripping and elevation of mucoperiosteal tissue produce a highernumberofosteoclastswith- in the alveolar ridge and hence greater resorption and shrinkage are seen after the classical surgical orthetraumaticextractionofteeth. The preservation of alveolar boneforfutureimplantplacement may be achieved by avoiding unnecessary bone removal and strippingoftheperiosteumduring surgery, as well as performing a surgical alveolar bone preserva- tion procedure. Bone removal can be largely avoided or minimised through modification of the tra- ditional extraction technique. The first such modification is the use of dental periotomes and luxatomes to gently strip the peri- odontal ligament fibres and widen the socket without causing cracks or fracture of the cortical plates, as commonly encountered when using dental forceps or the bulky elevators. The use of such gentle instruments also eliminates the need for elevation of mucoperio- steal tissue. However, it should be noted that the safe use of these in- strumentsrequiresadequatetrain- ingandshouldbeencouragedduring undergraduate clinics. Clot stabili- sation through light packing of the socket with collagen sponges may helptominimiseclotdislodgment, as well as accelerate the healing process and bone regeneration. Thesecondstrategyisthealveo- lar bone preservation procedure. This includes packing the extrac- tion socket with different fillers, such as osteoinductive or osteo- conductive materials, like auto- genous, natural or synthetic bone grafting materials that support the alveolar socket walls, thus pre- venting their collapse and shrink- age. It should be noted that this intervention can only slow down the post-extraction changes to improve the success of the dental implant, but cannot stop them altogether. Finally, post-extraction care should include an explanation of the healing process and po- tential symptoms encountered after such procedures. The pre- scription of medications should be limited to non-steroidal anti- inflammatorydrugsinmostcases and imprudent use of antibiotics or socket dressing should be avoided. 21Implant TribuneAsia Pacific Edition | 10/2015 TRENDS&APPLICATIONS Educated in the UK and Ireland, DrKamisGabal- lah is currently an associate professor and senior specialist inoralandmax- illofacial surgery at the Ajman University of Science andTechnology in the United Arab Emirates. He can be contacted at kamisomfs@yahoo.co.uk. www.idem-singapore.com STRIVING FOR CLINICAL EXCELLENCE Featured Speakers APRIL 8 - 10, 2016 Suntec Singapore Convention & Exhibition Centre Online Registration Now Open! IDEM Singapore 2016’s conference theme is built upon the common goal of all dentists – both general and specialist: Striving for Clinical Excellence. Look forward to world-class clinicians, researchers and educators discussing contemporary issues in the field of dentistry. Meet over 550 Exhibitors! Join the IDEM Singapore Trade Fair to meet over 550 internationally recognized manufacturers, distributors and traders. With exhibitors showcasing their latest products and services on levels 4 and 6, your visit will be packed with opportunities to strike new deals and re-enforce existing partnerships. Register online for your FREE exhibition entry. Ms. Cindy Tantarica Tel: +65 6500 6721 Fax: +65 6294 8403 idem-reg@koelnmesse.com.sg Ms. Cindy Tantarica Tel: +65 6500 6721 Fax: +65 6294 8403 idem-reg@koelnmesse.com.sg Robert Edwab, USA Treating Medical Emergencies in the Dental Office Endorsed By Singapore Dental Association Co-organizerHeld In In Co-operation WithSupported By Walter Dias, Germany Clinical Excellence in Aesthetic Restorations - Hybrid and Indirect Techniques Using Smart Composites Elif Keser, Turkey PiezocisionTM for Rapid Orthodontic Therapy: A Multi-disciplinary Team Approach Hien Ngo, Kuwait Chairperson of the Full Day Symposium: Towards the Post-Amalgam Era Ian Meyers, Australia Full Day Symposium: Towards the Post- Amalgam Era Shinya Murakami, Japan Cell to Cell Communcation: Oral Health and General Health – A Video Premiere Periodontal Regeneration: Present Status and Future Outlook AD DTAP1015_20-21_Gaballah 14.10.15 09:25 Seite 2 Tel: +6565006721 Fax: +6562948403 Tel: +6565006721 Fax: +6562948403 DTAP1015_20-21_Gaballah 14.10.1509:25 Seite 2