Abstract :
This paper seeks to enumerate and explain the instruments used commonly for atraumatic extractions, their method of usage and identify their indications. The methodology includes review of journal articles on approaches, benefits and procedures for atraumatic extraction and their compilation. The methodology also includes a review of websites of manufacturers of atraumatic extraction devices and instruments. These sources help to identify the common means for carrying out atraumatic extractions and also the indications for the same. Implants continue to be an exceedingly accepted means to replace an extracted tooth. This may be done immediately following an extraction or at a later date subsequent to satisfactory wound healing. In both situations the need for an atraumatic extraction seems all the more pertinent. Extractions for orthodontic purposes requiring minimal trauma to the surrounding structures of a tooth, particularly the bone, call for a far more atraumatic procedure than the conventional tooth extraction. With the advent of physics forceps, periotomes, luxators piezoelectric instruments and root traction devices atraumatic extractions by preservation of the alveolar bone, the socket, gingival architecture and without trauma to the periodontium has become a necessary skill in the repertoire of the general dental practitioner. This facilitates better implant outcomes or better orthodontic therapy. Newer methods such as Endoscopically Assisted Root Splitting can be used for extractions without causing trauma to the alveolar bone. This can be done using a Storz-Hopkins support endoscope and enlargement of the canals using Lindemann burs followed by longitudinal root splitting and removal using Bein forceps or fragment removal if an implosion technique is used. However, one needs to keep in mind the duration required for such procedure and the cost of instruments required. These methods prevent unnecessary mucoperiosteal flap elevations, incisions and osteotomies thereby minimizing inflammation. To make dental practitioners embrace these procedures, inadequate literature availability and time limitations remain the biggest constraints.
Keyword :
Atraumatic extractions, Physics forceps, Piezotome, Luxators, Implants, Orthodontic extractions.