Please activate JavaScript!
Please install Adobe Flash Player, click here for download
ePaper created 2016-08-01, 17:22:29 | version 1.38.0
July-August 2016 | No. 4, Vol. 6 Published in Dubai www.dental-tribune.me Minimizing alveolar bone loss during and after extractions (Part I) Review of Techniques: Atraumatic Extraction, Root Retention By Shankar S. Iyer, India, Prashanth KonathamHaribabu,India Extraction of teeth perhaps was the first surgical procedure developed in the field of dentistry. Surgical tech- niques have been described since the ancient times in scriptures of Su- shrutha Samhita (circa 6th century BC) [1] and, over time, the design of theinstrumentscontinuedtoevolve to facilitate removal of the tooth in one piece. Aristotle, in mid 300 BC, is known to have used lever mecha- nisms and fulcrums to design dental instruments. Today, current instru- mentation includes various forceps and elevators designed for specific teeth that are designated for maxilla and mandible, left and right, mesial and distal. The primary focus was to remove the tooth as a complete unit; careful attention was paid to minimize any fracture of the crown ortheroot. Traditionally, with extraction proce- dures, a transalveolar surgical proce- dure only became necessary when roots either cracked or fractured or there was insufficient structure remaining on which to engage a forceps. Techniques utilized to re- move the remaining root employed lingual-buccal luxation, alveolar purchase, traction, rotation and con- tinuous pressure in one direction. The alveolus was considered as an impediment to extraction and often therewassacrificeofthebuccalplate inanattempttoremovetheroots. The extraction was not the only insult to the alveolar bone. In the attempt to promote prosthetic re- habilitation with a removable ap- pliance, the alveolar bone was com- pressed following an extraction. The implication was that bleeding can be minimized through compression and any undercuts can also be elimi- A) Cutting within a root with a 700XXL or 701XL bur B) Fracturing off occlusal fragment with an elevator and removing it A B Fig 3: Sectioning of a single root for an atraumatic extraction (Diagrams courtesy of Dr. Michael Leizerovitz) C) Inserting and rotating the periotome blade within the periodontal space (mobilizing the remaining fragment) D) Removing the remaining fragment C D Fig 3(cont): Sectioning of a single root for an atraumatic extraction (Diagrams courtesy of Dr. Michael Leizerovitz ) Fig 1. Gentle tapping with a mallet on the scalpel handle with #15cbladeisused toseparate thecoronalPDLfibers. Fig. 3 Sectioning of a single root for an atraumatic extraction. (A) Cutting within a root with a 700XXL or 701XL bur;(B) Fracturing off occlusalfragment withanelevatorandremovingit;(C)Insertingandrotating theperiotomebladewithin theperiodontalspace(mo- bilizing theremainingfragment);(D)Removing theremainingfragment.(DiagramscourtesyofDr.MichaelLeizerovitz) Fig2:TheperiotomeisengagedintothecreatedPDLspacetolux- ate theroot. AAID-5thGlobalConference meets8thDentalFacial CosmeticInt’lConference inDubai ByDentalTribuneMEA/CAPPEvents DUBAI,, UAE: AAID will hold its 5th Global Conference with the 8th Den- tal Facial Cosmetic International Conference at Jumeirah Beach Hotel Dubaion04-05November2015. World Class Faculty and experts will present the new concepts to explore the controversies surrounding den- tal implant therapy. Which is the bestmethodtogrowbonevertically? Evidence Based Implant Dentistry, The Full arch Implant Supported Strategy, Cerec & Dental Implants - 21st Century Dentistry and several other issues will be presented at this conference. I am delighted to work with Dr. Ninette Banday who is the Secretary for the Congress and has made some significant strides in educating AAID MaxiCourse partici- pantsintheUAEoverthelastdecade. The AAID will be bringing renowned InternationalspeakersfromAAID.In addition to the main congress there will be numerous hands-on courses and the dental industry will proudly be displaying their latest technolo- gies as well. A hallmark of this con- gress will be the pre-conference hands-on advanced bone-grafting Workshop – Implants in the Atroph- ic Maxilla including Sinus Grafting andSinusFloorElevation. I am pleased to invite you to this conference to make the Perfect Den- tal Connection and be immersed with the fusion of Aesthetics and implant dentistry. I am sure you will bring back some valuable tips and information that will enhance your existing implant and aesthetic prac- tice. If you are a novice, you will get excited to incorporate implant den- tistry to expand the scope of your practice. Founded in 1951, the AAID is the first professional organization in the world dedicated to implant dentistry. Its membership includes general dentists, oral and maxillofa- cialsurgeons,periodontists,prostho- dontists, Endodontists, Restorative Dentists and others interested in the fieldofimplantdentistry. The American Academy of Implant Dentistry (AAID) stands for excel- lence in education, scientific devel- opment and patient care. Mem- bers who demonstrate the highest standards in implantology find the AAID to be the organization which supports their clinical and research interests, as well as recognition for their achievements. The Academy’s missionissimple:toadvancethesci- ence and practice of implant dentist- ry through education, research sup- portandtoserveasthecredentialing standard for implant dentistry for the benefit of mankind. The Acad- emy provides bona fide credential- ing in implant dentistry through the Associate Fellow and Fellow mem- bership examinations. The Associate FellowandFellowcredentialsarerec- ognizedbynumerousstateboards. I hope to personally greet you at the conference and welcome you to be part of our International Commu- nity. You will find an atmosphere of camaraderie, warmth and friendli- nessthatwillenticeyoutobethere. ShankarIyer,DDS,MDS,President Elect AAID,DirectorSmileUSA,ClinicalAsst Prof.RutgersUniversity ShankarIyer,DDS,MDS President Elect AAID DirectorSmileUSA ClinicalAsst Prof.RutgersUniversity ÿPage 2