The process of tooth extraction has rightly constantly been associated with great difficulty, pain, and a rather prolonged healing process. The traditional methods of tooth extraction would subject the surrounding tissues and the tooth’s socket to considerable damage that can itself lead to the development of many other problems. This damage is more usually associated with the necessity to rock the tooth back and forth with a great amount of force in order to pull it out of the socket. Quite naturally, with this technique, pieces of the surrounding tissue, and at times, bone is removed which would cause a comparatively heavy amount of bleeding. Alternatively, atraumatic tooth extraction methods would minimize the damage to the surrounding tissue resulting in less pain and bleeding and an overall faster recovery period. Furthermore, the less invasive methods of atraumatic tooth extraction are recommended in case one opts to replace the lost tooth with a dental implant.
What Is Atraumatic Tooth Extraction
Atraumatic tooth extraction is meant to minimize the damage to the surrounding tissues and bone and to shorten the healing period and maximize the body’s regeneration progress. To successfully do an atraumatic extraction one must have a rather complete understanding of how to maintain tissues so that grafts are not necessary, signs that suggest the necessity of socket grafting and the type of grafting material needed, and the regenerative and healing processes and stimulants. The preservation of the tissues, especially that of the ridge is of utmost importance for the healing process as well as the overall oral health. Additionally, atraumatic tooth extraction and socket preservation are vital to creating a reliable foundation for tooth implants, making it possible to add any necessary grafts (such as bone grafts and socket grafts) immediately after the extraction.
Proximators (also known as Periotomes) are specialized extraction instruments that are used to apply vertical pressure along the long axis of the tooth root in the periodontal ligament space. The instruments used in this method are usually designed to elevate the tooth out of its socket using vertical forces. The Proximators set is one of the most important instrument sets used in the atraumatic extraction technique. Using these instruments and applying force vertically also means there is a lessened chance of breaking the root tip which would itself result in further complications and damage, compromising the healing process.
How Atraumatic Tooth Extraction Is Done
In an atraumatic tooth extraction operation, the first step to be taken is to sever the connective tissue fibers that would result in less damage to the surrounding soft tissue. To do so the periotome is inserted into the periodontal ligament and severs the tissue connected to the tooth that is being extracted. The periotome is then left in place to allow the occurrence of biomechanical creep that would ease the extraction as a result of the consequent bone expansion. The instrument is then gently moved further down up to the crestal one-third of the tooth being extracted at which point the tooth would be somewhat mobile. Thereafter, using the mechanics of levers, M=Fd to be precise (which basically points to the fact that with creating an appropriate amount of distance a lesser magnitude of force is needed), and using the periotome as a lever, would create a greater distance from the fulcrum which would result in less amount of force being used to extract the tooth. However, the force must be applied gently and with great care in order to avoid the possibility of fracturing the tip of the root leaving fragments in the socket. As mobility increases, the periotome is moved apically toward the root apex resulting in a successful extraction.