Make Extractions Less Difficult: Sectioning and Elevating Teeth PDP085

Here with me is Dr Chris Waith and Dr Zak Kara to help us in regain our confidence in extractions and to upskill by Section and Elevation!
Extractions are one of the common procedures Dentists do. But what if you lose your confidence in your ability?
We have all encountered those difficult extractions - that struggle etches a special pattern in our brain for life. It has made many of our colleagues get anxiety about exodontia.
00:00 - Jaz's Introduction
13:46 - Assessing Difficulty of Tooth Extraction
20:23 - Patient Communication for Oral Surgery
29:31 - When to Section Teeth for Success
32:14 - What Handpieces to Use!
41:15 - Advice on Sectioning Teeth
50:08 - Get rid of that Furcation Bone!
Please do check out Dr Chris Waith’s oral surgery course : theoralsurgery...
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[@kamila2858]

Just wanted to say - I have been watching your podcasts for a few weeks now and because of this particular sectioning podcast, today on my last day of DFT, I was finally able to successfully section an upper molar (as previously whenever I tried I failed and needed help). Thank you for your content - I wouldn't have been able to do it without it 😊

[@chriswaith9595]

Amazing!! I’m really pleased….that’s exactly why we wanted to talk about this subject. 😀

[@ZACY1234]

A dry socket podcast and extractions-complications management is a great idea !!

[@drjazgulati]

thanks Dem it's being recorded next month! :D

[@ZACY1234]

@@drjazgulati perfect 👍 looking forward to it!

[@ahmedal-rubie411]

Brilliant episode mate. I've paid for online courses where I didn't get as much value as this! Working in the Aussie outback really upped my exo game... Esp when there's no specialist for 1500km 😂

[@H982FKL-TG]

Thank you for the subtitle. Not a single thing missed 👍🏼

[@aaronreimer1869]

coming from a dental student here, such a helpful video / Discussion, thank you!!

[@protrusive]

thanks Aaron all the best!

[@aaronreimer1869]

@@protrusive 🙌🙌

[@drkk3199]

I encountered a male 60 year old patient with a very thick external oblique ridege that didn't give space to even use my cowhorn. No instrument is actually accesible in the 3rd molar area. U must have sectioned the tooth. To mention it was groslly decated. eventually let the patient go with the roots.

[@parmida6412]

Great episode! I graduated 6 months ago and just started working in a clinic. Your videos are really helpful and educational to me.specially this podcast

[@protrusive]

Congrats on entering a rewarding profession Parmida! Extractions are right up there with essential skills for new grads - all the best

[@queenprincess2902]

Just timely we had difficult extraction recently we sectioned it yet still unable to take out the other root .We sent him home and asked him to undergo xray after a 2 weeks or a month it will surface

[@shathasaleh]

Fantastic discussion! Wish I’d found you earlier in my career! Thank you so much

[@protrusive]

thank you Doc!!

[@cosminhuplea5694]

great podcast! i'm just into 'assesing difficulty part' and i love it!

[@protrusive]

thanks Cosmin for commenting - hope you enjoy the rest!

[@ArlindRamadani-yc1gh]

Thank you guys, loved it.

[@Martin-id4xp]

Brilliant episode 👍

[@protrusive]

thank you sir its one of my favs!

[@PirateTHESteam1]

Correct me if I'm wrong but it seems that you weren't taught to section teeth in dental school? In Sweden we are taught to always section molars, except for extractions on primary teeth ofc.

[@protrusive]

unfortunately correct :(

[@drkk3199]

Why do you section each and every tooth. Most of the teeth come out with luxation. We opt to section teeth only when the tooth didn't move with elevator and forceps. But it's good that u learn in dental school

[@parvanshigupta7074]

Too good Dr. Jazz... Thanks a lot🎉

[@protrusive]

thanks for commenting with appreciation!

[@adamhusayn625]

Any tips on surgically extracting fractured (down to gum level) premolars? How would you use the fast handpiece in this case?

[@protrusive]

HI Adam - firstly, I use an electric HP. As Chris said, only 2 ways to remove a tooth: 1. Make the socket bigger (so in terms of your question, raise a flap and remove bone - interproximal bone is better to remove than buccal/lingual OR 2. make the tooth smaller - you could try sectioning the premolar root (after you have had a GOOD go at loosening with luxators) and split the root in to 2

[@adamhusayn625]

@@protrusive makes sense, thank you!

[@saradayarlagadda9379]

Great video

[@georgesotiriou7051]

Great presentation Jaz. Any advice regarding a rear venting handpiece other than NSK? They are quite expensive.

[@protrusive]

I would check Incidental Ltd online shop - they have great prices on handpieces and I trust them

[@nirmalasesha3992]

Nice video ...very informative...but a suggestion can u make it a little shorter and to the point

[@protrusive]

Thanks Nirmala! My 'shorter and to the point' clinical recordings are part of my paid membership - check it out via the Protrusive mobile app or Web App protrusive.app

[@bmb4cjt]

Hi Jaz, Great video, can I ask what micromotor your nsk is connected to? I've had on ordered at work which connects to the water of the dental unit (via hi speed) line. The foot pedal starts/stops the motor but seems water is driven by air so not sure it's any more suitable that the hi speed 🤦

[@hitmancleaner]

Hi Jaz, you showed a link to buy this 45 angled electric HP earlier but I can't find it now. Can you share the link again please. Many thanks

[@protrusive]

this is one supplier: www.dentalsky.com/ti-max-z45l-1-4-2-45-head-contra-angle-handpiece.html?gclid=CjwKCAiA3pugBhAwEiwAWFzwdaoN2HemFc3ujWKjhEoMLCfEdHq0xlahfXz4lbKx9OG3zf7dfnjB1RoCR5cQAvD_BwE

[@hitmancleaner]

Thanks

[@nawandeepkalra4319]

Hi Dr what is upper limit of blood pressure for surgical extraction as my patient need Exo 12 on anti hypertensive meds her bp was 166/88 please advise

[@protrusive]

@@nawandeepkalra4319 Studies43 have shown that there is no increased risk for adverse perioperative outcomes for patients undergoing treatment with a blood pressure

[@nawandeepkalra4319]

Dr can u please send me the specification of hand piece when you order so that I buy the right hand piece for Exo . Thanks

[@smitaputti5907]

Awesome podcast. Can you use straight hand piece( denture trimming hand piece) with a surgical bur and irrigation for surgical when we raise flap? Or risk of emphysema.

[@protrusive]

hm - I haven't done it that way. Firstly the ideal irrigation would be with an external link to the handpiece. However, most would settle for the nurse using saline from a syringe to keep things cool (but gets tricky and slows you down). As for air emphysema risk - if its driven by air (the bur from the straight handpiece) then there is some concern, if you can't feel any air then much safer

[@corndawg25]

Really helpful Thanks

[@protrusive]

thank you!

[@Lerpultraman]

Thanks! Any suggestions for upper six coronectomy bur ?

[@protrusive]

I honestly just use any old long crown prep bur - only thing I am fussy about is that it has to be coarse and fresh. I want sectioning to be efficient

[@Lerpultraman]

@@protrusive yeah, simple and effective, thanks!

[@abanoubalexander4047]

hello Dr Jaz, i have a question if I may, I need to know when to suture the socket after sectioning procedure and when to not. and in general when i need to suture the socket after extraction procedure

[@protrusive]

Sure - if the by elevating/luxating I see there is almost a flap present and it's not stable (ie. would keep flapping around impeding healing) then I would suture. If the tissues are bound well to bone, I don't suture personally. Some of my colleagues suture everything :)

[@nawandeepkalra4319]

❤

[@protrusive]

thank you!