Technological Advances in Oral Surgery and Tooth Extraction Techniques

The fields of dentistry and oral and maxillofacial surgery are being revolutionized by a wide range of new tools and methods. The powered periotome, piezosurgery, the Physics Forceps, orthodontic procedures, and the use of polyurethane foam are some of the more recent advances in dentistry that we will discuss here.

In recent years, there have been several fascinating technological advances in extraction methods and outpatient oral surgery. Here are some of the most salient of them:

• A powered periotome has been created to extract teeth painlessly. The implantation of implants, whether immediate or delayed, can benefit greatly from this tool.
• Additionally, a method for tooth extraction before rapid implant placement has been devised employing implant drills.
• The use of piezosurgery in outpatient oral surgery procedures is also growing. Piezosurgery has been utilized for bone grafting and the accurate and simple removal of some third molars.
• In addition, the Physics Forceps was developed, which removes teeth without using excessive force or a squeezing motion using class 1 lever mechanics.
• Additionally, a wide range of outpatient treatments is being performed using lasers, including the excision of oral lesions and the removal of impacted teeth.
• Some doctors are also using orthodontic methods to make it easier to remove impacted teeth that are close to the inferior alveolar nerve.
• Moreover, using polyurethane foam to help shut oral antral communications may provide a simple method of managing this relatively frequent occurrence following dental extractions.

Powered periotome

The dentoalveolar complex is sometimes fractured or deformed during traditional tooth extraction. This frequently necessitates the production of a mucoperiosteal flap, elevation, and luxation with forceps. Due to ridge defects caused, implant placement may become extremely challenging or even impossible in these circumstances.

Additionally, even in relatively atraumatic extractions, the elevation of the mucoperiosteum may impair the periosteal blood flow to the alveolus, resulting in the loss of marginal alveolar bone.

Additionally, if there are extensive restorations or crown coverage on the teeth next to the tooth that needs to be extracted, the motorized periotome avoids the need to elevate against and potentially damage the restorations.

Powered periotome enables precise tooth extraction with little to no alveolar bone loss. The preservation of the architecture of the bone and gingiva gives the doctor the option of inserting future or even immediate implants thanks to this non-traumatic method of dental extraction.

The powered periotome facilitates tooth extraction by employing the mechanisms of “wedging” and “severing.” These devices, which are comprised of very tiny metal blades, are softly wedged down the periodontal ligament space in a circumferential way.

The Sharpey’s fibers, which hold the tooth in the alveolar socket, are severed by the instrument. The tooth can be removed with minimal lateral pressure and gentle rotating movement when most of the Sharpey fibers have been cut from the root surface.

How a powered periotome operates?

A powered periotome is an electric device with a foot control that activates a handpiece with a periotome. The periotome tip’s force and the distance it penetrates into the periodontal ligament space can be precisely controlled with this equipment.

The tool contains an actuator that is controlled by a computer, eliminating any uncertainty during tooth extraction. This device includes a controller box that may be adjusted to 10 power settings.

Additionally, this system often allows flapless removal of teeth, minimizing postoperative pain and discomfort and preserving the periosteal blood flow to the alveolus.

The automated powered periotome technology also reduces concern for buccal plate or lingual bone fracture during challenging extractions. When using a normal periotome, the procedure is significantly more laborious. It may even put the patient through unnecessary pain, particularly if a mallet is required to separate the tooth from the bone.

Starting interproximally seems to work most efficiently when using the powered periotome. The blade must remain parallel to the long axis of the tooth being removed at all times. The blade should move in 2- to 3-mm steps as it circumferentially and apically follows the tooth structure.

Cutting a multirooted tooth into sections and treating each one as a single-rooted tooth maximizes extraction efficiency. Both general practice and oral surgery residents have used this tool for tooth extractions because it can be quickly learned.

Compared to alternative surgical extraction approaches, this product quickly produces an intact extraction socket with excellent patient acceptance while taking little to no extra time.

The preservation of alveolar bone makes more aesthetically pleasing and useful implant restorations possible, regardless of whether an implant is positioned right away after extraction or the socket is grafted in preparation for future implant placement.

Using implant drills to remove teeth

Implant placement is an increasingly popular therapy option for replacing missing teeth. Due to the growing demand for quick restoration, immediate implants are in high demand. As was previously noted, the key to placing effective and durable immediate implants is conserving as much bone as possible by atraumatically removing the tooth.

A new, minimally invasive method has been introduced to help tooth extraction. Implant drills are inserted into the root canals to thin the root walls, allowing for extraction with the use of considerably less power and decreasing the possibility of damaging the delicate buccal bone during elevation.

The walls of the roots are thinned before elevation, making it simpler to extract the teeth and reducing the chance of harming the delicate labial wall, particularly in root fractures when the fracture line is deep inside the socket in immediate implant placement.

This operation has been carried out effectively without requiring flap reflections or incisions and with the labial plate unharmed. The successful application of this method may lessen the requirement for regenerative procedures that can result in difficulties with grafts or membranes.

Piezosurgery

Piezosurgery is a cutting-edge method of bone surgery that generates microvibrations with an amplitude between 60 and 200 mm/s and a modulated ultrasonic frequency of 24 to 29 kHz. Since its debut in 1988, piezosurgery has seen continuous improvement.

The vibrations’ amplitude makes a very clean and accurate surgical cut possible. Piezosurgery scalpel tips oscillate much less than oscillating microsaws, making it possible to perform more precise and secure osteotomies.

Hard and soft tissue cannot be distinguished using conventional burrs or microsaws, but piezosurgery operates selectively and doesn’t injure soft tissues, such as nerves and blood vessels, even when they come into contact with the cutting tip unintentionally. Therefore, it is particularly effective in creating osteotomies, and compared to the use of burrs and surgical saws, which have the potential to harm soft tissue, piezosurgery has a considerable advantage.

Piezosurgery also improves the operator’s field of vision by producing a relatively small bloody area. Moreover, no additional force is required to control the rotation or oscillation of the instrument, making surgical control of the device easier than with rotational burrs or oscillating saws.

Studies have compared postoperative results of rotary and piezoelectric treatments with those of the rotary technique. The piezoelectric technology’s average operating time was 25.83% longer. However, the piezoelectric osteotomy improved postoperative facial edema and trismus despite the treatment taking longer.

Piezosurgery is a helpful technique for performing surgery close to the inferior alveolar neurovascular bundle and/or the roots of neighboring teeth because it allows accurate and selective incisions.

Piezoelectric instrumentation facilitates the removal of the body of the mandible’s lateral cortical by providing sufficient access to the surgical site, excellent visibility, minimal bone loss, and precise cutting ability. It also protects the inferior alveolar nerve (IAN) when osteotomy is carried out blind.

Researchers that have used this procedure have found it straightforward to readapt bone windows to their original location and fixate them because the bone-cutting ability is so accurate with little bone loss. Likewise, sinus lifts can be carried out with extreme precision and control using piezosurgery.

Conclusion

Recent technological advances in tooth extraction methods and oral surgery promise to make dental care less painful and more effective. Visit our website to learn more about Technological Advances in Oral Surgery and Tooth Extraction Techniques.