Removing a tooth or root from the alveolar process is usually the first surgical step of the treatment plan for rehabilitating patients with dental implants. Atraumatic extraction is a procedure that requires skill and knowledge on the part of the clinician, as it incorporates the principles of surgery and many principles from physics and mechanics.
Tooth extractions can be a real challenge for the dentist, so a thorough understanding and assessment of the degree of difficulty that is anticipated for removing a particular tooth is fundamental. It is of great importance for this procedure to be carried out in a successful, gentle and minimally invasive way.
Excessive and uncontrolled forces may injure the local soft tissues and damage the surrounding bone, which will lead to post-operative complications and severe atrophy of the site, while incomplete debridement of the post-extraction socket might delay the healing and hamper the integration of bone grafts or implants placed. Last but not least, an unsuccessful laborious extraction will heighten the discomfort and anxiety of the patient, who might then lose confidence in the clinician.
The implant dentist should also be familiar with suturing techniques. Suturing is an important part of every surgical procedure in implantology as sutures are required to reposition a flap after surgery; they aid in haemostasis and in maintaining the blood clot in the post-extraction socket, and help stabilize membranes and soft tissue grafts.
Learning Objectives:
- To be aware of the basic principles of exodontia
- To understand the importance of atraumatic tooth extraction
- To recognize the factors that determine the degree of difficulty of an extraction
- To identify the appropriate instruments required for minimally invasive extractions
- To know how and why to debride thoroughly the post-extraction site
- To be aware of the principles of suturing
- To be familiar with the basic techniques and armamentarium for suturing