Minimally invasive tooth extraction

Question 1

How does alveolar bone remodel following atraumatic extraction?

Answer 1

Particular bone resorption on buccal aspect of socket
Cochrane review: reduction in width: 2.6-4.6mm; height reduction: 0.4-3.9mm

Question 2

What does minimally invasive tooth extraction reduce risk of?

Answer 2

(MR)ONJ
Creation of OAC (tuberosity fracture)
Bone resorption/remodelling
Minimise PDL damage
Minimise need for flap surgery
Patient dissatisfaction

Question 3

How is normal forceps extraction not minimally invasive?

Answer 3

Socket expansion is trauma to bone, leading to bone resorption

Question 4

What does minimally invasive tooth extraction involve?

Answer 4

Careful luxation to minimise trauma to buccal plate (luxators, elevators, periotomes)
OR consider novel vertical extraction system
Sectioning molars to yield single rooted units

Question 5

What novel systems are there and for minimally invasive tooth extraction?

Answer 5

Easy X Tract
Benex

No luxation, pressure, fracture to bone. Just rupture to the dental alveolar fibres.

Question 6

Factors for success of benex?

Answer 6

 Screw positioning
 Alignment of pullrope
 Use of support tray

Question 7

Reasons for failure of benex?

Answer 7

 Anatomical factors (hypercementosis)
 Undercuts (eg upper premolar)
 Root divergence
 Root dimensions
 Root curvature

Question 8

Loads of images in this lec pg63 onwards

Question 9

What factors affect force needed during benex extractions?

Answer 9

The bigger/longer the root, the higher the force required
Bone density not a big factor

Question 10

Does benex avoid flap surgery?

Answer 10

In maxilla yes
Cortical bone in mandible doesnt allow for easy luxation, more likely to raise a flap