How to Save ‘Hopeless’ Teeth with the Surgical Extrusion Technique – PDP061
No Ferrule? No problem! Dr Peter Raftery, Endodontist, discusses the contemporary use of the 'Surgical Extrusion Technique' to make hopeless teeth restorable. Crazy, I know, so take a listen because the science makes sense! https://youtu.be/gXN-2tgxtbU Need to Read it? Check out the Full Episode Transcript below! All the way back in Episode 9 with Dr Aws Alani (Restorability with a Restorative Specialist) we briefly mentioned this technique in passing...which led to a cascade in events and Dr Raftery reached out to me with enthusiasm because I called out to the audience if they knew anyone using this technique! I love that! Essentially you are (gently!) extracting a tooth and then intentionally re-implanting the tooth, except this time you are going to be a little greedy and 'grab' some ferrule. Then, a customary Root Canal Treatment 2 weeks afterwards, and you have yourself a restorable tooth. As someone who loves saving teeth, this is just fantastic. We know the science works because we DO re-implant dirty, grotty avulsed incisors of 12 year olds with some decent success rates. Protrusive Dental Pearl: have you used Viscostat clear? It is my preferred astringent and will not interfere with bonding * How to restore teeth which appear to be restoratively hopeless aka no Ferrule * Compared to SCL or Ortho extrusion - could this be more cost effective and less invasive? * Surgical Extrusion technique - either with humble luxator or a posh Benex device I will have to add the resources later - right now I am running late for work! Click below for full episode transcript: Opening Snippet: So yeah odds of it still being there 12 years later still 93% and that was with forceps removal so I’d argue that the Benex only stands to last longer... Jaz’s Introduction: Okay, so you have your patient they’ve come in, they’ve fractured their upper premolar at gingival level. Kaput. There is no ferrule like you can maybe get your perioprobe inside and feel maybe a millimeter subgingival but there’s hardly any tooth structure left. What are you going to do right? Because most of the times it’s going to be for the bin right? Like it’s hopeless, let’s extract it.Now if you want to get really extravagant you could arrange for orthodontic exclusion which takes time and it’s costly or you can do surgical crown lengthening also incur a fee but also involves surgery obviously and it will also mean that the patient will have potentially black triangles and the gingival zenith of that tooth will now no longer be the same as the adjacent tooth so again that all takes time and money and effort so a lot of times people say let’s just take it out and stick an implant in, a bridge in, whatever.Now what if I told you there was one more way? This way I was exposed to it on social media actually in about 2017 and in 2018. I attended a bard lecture about the surgical extrusion technique and it was interesting. It was Italian chap Dr Bachiani talking about this technique and it was the first time I've seen it presented in a scientific way. And then if you remember in 2019 I did a lecture or a podcast with Dr Aws Alani restorative consultant it was restorability with the restorative consultant and I discussed a technique whereby you can partially extrude, surgically a tooth and then gain ferrule and restore it. And I said in the podcast hey I don’t know if anyone’s doing this technique in the UK please get in touch i...