Upper Molar Extraction by Sectioning and Elevating 4K POV with Jaz's Commentary

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Highlights
00:00 Introduction
00:34 Sectioning School
1:04 Case Introduction
2:48 Checking for Adequate Anesthetic
3:38 Taking Off Old Crown
4:36 Decoronating Process
6:29 Freeing up gingiva
7:45 Sectioning Tooth
12:09 Luxating the Roots
13:07 Breaking Contact Point
13:36 Removing Interfurcal Bone
15:29 Luxating and Removing the Tooth
16:52 Removing Debris/Post Extraction Check
17:28 Packing of Collagen Sponge
18:29 Checking Extracted Tooth
19:24 Protrusive Guidance
Check out more videos just like this, Upper Molar Extraction by Sectioning and Elevating 4K POV with Jaz's Commentary on Sectioning School
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[@xevora9310]

Clear and well presented video. Idea: prepare an access cavity into the pulp chamber before sectioning. With a coarse diamond bur it takes maybe 10 seconds. Then you'll know exactly where the furcation is, zero guessing.

[@DensLeonis1]

That's a great idea !

[@protrusive]

absolutely valid way - I show this in some of the later cases. Thanks for sharing doc!

[@Olibelus]

Great video, thanks for sharing!! Much appreciated.

[@storm1234100]

Amazing video, very informative Jaz! Thank you very much. Keep up the fantastic work you do!

[@pauldeverteuil8937]

Thanks... Learnt a lot

[@philtastic1]

Great instructional video. I wish dental instructors were like you

[@christabelkelly2340]

Dude your videos are the best. As a new grad, I can't thank you enough!!!

[@bhashagurung2515]

Thank you Doc for the video m gonna try this technique very soon this week 🙏

[@drjayarajsr7549]

Nicely done and presented😊

[@mpopa5673]

Thank you!

[@safwankabeer3276]

Fantastic video, you really amalgamated a lot of golden tips from different surgeons! Great job :)

[@protrusive]

thanks for your kindness

[@cwtag]

I'm sharing your channel with all of my dentists in my community health center. Your content is top notch, best on KZbin. Thank you! Cheers from the Pacific Northwest USA

[@protrusive]

thank you so much! means a lot :)

[@marufboyo]

hi its dr.maruf here ,,, sir i liked to thank you a lot i tried u instruction and seriously it helped me a lot...... thanks for you precious tips.....

[@jeffreylukpat3253]

After viewing this video,I became more confident in my extractions and my fear of sectioning went out the door. Life is so much better with no more second guessing myself and no anxiety 😅

[@protrusive]

yay! 100% doc thank you!!

[@arash_LA]

4th year dental student in the US. Great video! Thank you!

[@protrusive]

thanks Arash! Stay stuned on the podcast- a cool (free) resource for Students is out soon!

[@causg7194]

Thank you so much for another awesome video you are doing great!! also like going all around before sectioning just like colleague mentioned.. Never forget to check the sinus.. Best regards

[@protrusive]

thanks for commenting!

[@fatwhitetuna6659]

Nice surgery!!! endodontically treated tooth is much more difficult due to its brittleness.; I used peristomes to loosen PDL and bone expansion, no bone removal

[@adityasharma2k]

Awesome video thanks 🙏 One thing I'd add is while sectioning mb from db I like to retract the gingiva and feel/see the the furcation area between the two from the buccal aspect,therefore deciding the section.

[@protrusive]

thanks for this addition!

[@jimmyharrix7990]

I don't know how i got the chance to see this youtube channel, but thank you, Dr. Gulati, i'm new degreed doctor and assistant in Oral and Maxillofacial surgery, still learning those things... The information was really helpful, i'm gonna use it :)

[@protrusive]

thanks doc!

[@tamannabanu9722]

Is there any new videos on sectioning and surgical extraction? Want more videos. This one was awesome. Learned a lot. Thank you.

[@protrusive]

hiya doc - yes 4 new cases just like this are on Sectioning School- total of 10 to be added by next month www.protrusive.co.uk/ultimate

[@drarjan6422]

As always an awesome video Jaz! Which speed increasing handpiece are you using/ do you receommend?

[@protrusive]

Thanks! I use the Z45L NSK for when I need the angulation help- Z85L NSK is the other one I have :) I know Incidental in the UK do some electric handpieces too 🫡

[@joshstutman746]

Thank you for such an informative video! Do you plan on making a similar instructional video for mandibular molars? And I am also curious about your approach for more badly decayed, less predictable endo-treated posteriors (a tooth you know that will be mush through and through)

[@protrusive]

Hi Dr - yes - 3 cases have already been uploaded to Sectioning School and 7 more to follow including a couple of mushy ones :)

[@tamannabanu9722]

Is it on youtube?

[@mda99das]

I personally like to do pre luxation before sectioning going all the way round. Gives time for bone to expand while you are doing the rest.

[@protrusive]

great tip - induces PDL trauma which causes bleeding and 'self severing' effect of PDL. I sometimes add rotational forces with forceps to induce PDL trauma

[@mohammadebrahim4474]

Jaz do you have an electric motor and handpiece you can recommend we can get for our practice?

[@Chinnyyip]

Nice extraction on a tough tooth. Was there any sign of vertical root fracture on the MB root?

[@protrusive]

a very feint one, yes!

[@cameronramsay6867]

Great video thank you, can you use a electric handpiece for bone removal for a surgical extraction or does it need to be a slecial surgical motor and bur?

[@protrusive]

yes you can - electric without air, water only

[@cameronramsay6867]

Thanks a lot Jaz. Appreciate your response 😊

[@operman828]

All done nice❤may be you could do the Valsava test to be sure the sinus membrane is not perforated…no sutures is the correct answer to this kind of extactions👌

[@protrusive]

thanks doc! You know I was once taught my oral Surgeons to try and avoid the valsalva test as it may make things worse. I see the rationale but it's not something I routinely do after extractions. Thanks for raising it!

[@operman828]

@@protrusive totally agree with you but when doing this test pacient should not blow like crazy 🤪 just a little obstruction so you could be sure that it will be safe and avoid unnecessary complications 🫣🤝All the best😊

[@diesel9442]

Is there any special consideration when it comes to using handpieces? To prevent post OP surgical complications? or a fast handpiece can be used when doing the bone removal?

[@protrusive]

yes there are - we covered this on the webinar which can be found in Sectioning School. You can try a 1 week free trial of the Ultimate Education Plan to access this instantly: protrusive.co.uk/ultimate In a nutshell - we must be careful to not create an air embolism/surgical emphysema. We talked about the gold standard (separate surgical motor with saline), silver standard (electric handpiece) and bronze to the regular fast handpiece - if using the bronze option, we must be careful not to displace tissues or raise flaps. There are also fast hanpieces that are rear venting which can prevent this rare but serious complication.

[@elenasimona6653]

Why not doing an endodontic retreatment?

[@amit.thedentist6843]

Is there a bur which is great for sectioning and a bur great for bone removal for my fast speed

[@protrusive]

lindemann burs are supposedly the best - I bought some and waiting to test :)

[@sukhsingh6997]

You mentioned risk of breaking tuberosity, how can you break that when it’s distal to 2nd molar?

[@protrusive]

a general statement to advocate sectioning - the further back you get, the more the risk is increased. However, once you see the image of the broken tuberosity with all 3 molars attached to the tuberosity, you cannot unsee that! But you're right, the risk is low in this case as it's the first molar

[@georgesotiriou7051]

Thanks for sharing Jaz. May I ask which root forceps did you use?

[@protrusive]

Can.I be super super honest? 'Zoe - get me some root forceps' - I genuinely don't know, so sorry!

[@georgesotiriou7051]

@@protrusive Perfectly acceptable answer

[@bullwhite9695]

Dr i have horizontal impaction in lower jaw is their any danger of lingual nerve damage if i go for operataion my age is 30

[@protrusive]

1) Thanks for commenting 2) This channel is for Dental education for Dentists and as a policy I cannot support all patient queries - mostly because otherwise I would have no time to spend with my family 😅 3) The most common answer to any and all patient queries on KZbin is usually: Speak to your Dentist, they are best positioned to help you 4) Good luck

[@kipetreal]

Are you not suppose to use the bur with air when you drill in to the bone?

[@protrusive]

I'm using an electric handpiece with water only, no air

[@kipetreal]

@@protrusive aight thnx 4 the comment

[@c-137torres8]

Good day, how do you document your cases. Thanks!

[@protrusive]

kzbin.info/www/bejne/iWGqYWCqYsl7hdU

[@c-137torres8]

@@protrusive Thanks! Do you think Go Pro can be used as an alternative?

[@protrusive]

@@c-137torres8 not with ease or quality: kzbin.info/www/bejne/iWGqYWCqYsl7hdU&ab_channel=JazGulati-ProtrusiveDentalPodcast

[@userVera1994]

Hi,, I had a wisdom tooth removed the other day. When can I make an appointment to have the other lower wisdom tooth removed, how long should I wait?

[@protrusive]

as long as you and your dentist are happy there is no minimum time - sometimes all 4 are removed at once!

[@userVera1994]

@@protrusive My dentist told me: don't come back too soon, but schedule it for the next tooth. I'm afraid when I get there He thinks it's too early. How long does it take for the hole to completely grow the bone?

[@protrusive]

​@user-gr3dz3ks9j 60 days for near enough full healing but the full healing is not a prerequisite. I would just check with your own dentist who knows you, your medical health and your mouth the best

[@ankursnd]

Do you prescribe antibiotics if sectioning tooth/inter buccal bone?

[@protrusive]

Nope, trust the body to heal :) remember that I do this flapless too

[@rahireza9124]

Divide and rule ... Thats the technique to remove grossly decayed teeth especially upper molars with three roots 😅😅

[@itsaaronlolz]

You can’t save that tooth? 😭