Troughing Bone To Simplify Extractions | OnlineExodontia.com 

Petros - thanks for watching. With proper light, magnification, suction, and technique this works very well. It does take practice. If the tooth is snapping off on you, trough deeper prior to applying any force and consider doing both sides of the root so that when you apply your pressure the root has somewhere to go. All the best!

That's about your only concerns Tyler. Certainly the lingual nerve in the posterior mandible is something to consider if you're troughing there, (which shouldn't be often) you should consider an instrument subperiosteal to protect the nerve in case you perforate the lingual bone. Thanks for watching!

also for maxillary even tho most dont need to go far into palate, be careful of the palatine nerve(s) foramen where they outlet to innervate palate soft tissue.

3mm Luxator from Hu-Friedy. Truly, any 3mm luxator would do the trick. You can use a 700L FG bur. I believe you can get those from most dental suppliers. All the best to you!

Online Exodontia thank you doc!

@@Qemarbaz101 I guess more specifically, this elevator is the EL3SX Elevating Luxator from Hu-Friedy. All the best!

Sean - you can often get away with extending the bur out of the chuck just a bit. This is terrible for your handpieces, but I admit I do it at times due to this reason. The other option is to look at a 700XXL bur which is even longer. Good for canine root tips or these situations. Or a straight surgical handpiece would do the job as well. All the best! Thanks for watching!

Thanks Calvin! Most times with removing these teeth you're looking to cut them into bits to take them out easier. Part of removing them easier is creating space. Although a thinner bur will section things apart fine, it's a bit harder to maneuver the pieces out of the socket with more tooth structure present. Hope that makes sense? All the best!

@@OnlineExodontia Agree, Thank you very much! look forwards to your new video!

Generally speaking you should be comfortable within 3-5 days and the site should be healing well by a couple of weeks. It can take months for it to completely heal over and fill in, however you’ll be comfortable during that time. All the best!

dental-library.com/petersons-principles-of-oral-and-maxillofacial-surgery-3rd-edition/

take his course

Thanks for watching! This answer is my personal approach to your question...I don't want to get in the middle of a heated debate haha! When faced with a single root on a premolar I will almost always trough with a thin bur. I will go circumferentially, then work the high side of the root to get it out with a root pick. When there are two roots I tend to trough between them and push the roots inward. Having said this however, I will still trough a bifurcated premolar and I will still section the root tip M/D on a single root, just I find it's rare that it's required. Again...just my approach. I can't really think of a reason why either approach would be inappropriate as long as it helps you achieve your desired outcome. All the best!

@@OnlineExodontia Thanks for the detailed response!

I use an electric NSK handpiece for basic surgical extraction troughing and it runs at 40,000RPM. The 1:4.2 increaser however makes it spin much faster.

Thanks for watching Ricardo! I typically operate with one of two handpieces that are both electric as the torque is greater so you can cut a bit easier. The S-12 W&H handpiece (straight) and the Z-45 Ti-Max NSK. The Z45 is designed for surgery in that it doesn't exhaust air forwards. If you use a regular highspeed handpiece you will blow air into the surgical site and you are correct...even without a flap you do risk air emphysema depending on the situation. Other good choices for surgery would be the Impact Air, or Sabra-45 which are both rear-exhaust air driven handpieces.

@Joe Blow This is difficult to say Joe as to what happened there. What I can say is the mouth is very forgiving and almost no matter what the situation, new gum tissue should fill in over time. I wish you the best!

@Joe BlowNo worries! I'm afraid I can't comment on that as I have no prior experience with that product.

@Joe Blow haha I looked up aerogel and it's actually awesome looking stuff! Maybe you were thinking gel foam - this is an oxidized cellulose that helps with clotting. There are indications for this stuff, but it's not routinely employed. For most extractions, it's best just to leave the socket without any foreign material in it to reduce the likelihood of the material habouring bacteria leading to infection. All the best Joe! Hopefully that helps and thanks for bringing Aerogel to my attention!

Great video. Trouble when troughing around the root and removing more of the tooth, sometimes the tooth fractures as it becomes weaker. Any tips?