Complex (Surgical) Extraction

Complex Extraction

Unfortunately, not all extractions can be done by simply grasping the tooth with forceps and rocking it out.  What if there is nothing left above the gum line to grasp? Or what if the crown breaks off leaving the roots still in the bone? These things can and do happen, and any dentist that extracts teeth will have to deal with them routinely.

Retain Root

In these cases, it becomes necessary to surgically remove the tooth.    This is frequently accomplished by prying the root out using a sharp instrument that can be forced between the root and the bone surrounding it.  This technique is called “luxation“.  In the case of multiple rooted teeth, the roots are first separated so they can be removed individually.  Unfortunately, not all roots or root fragments may be removed in this fashion. This means that the dentist must make an incision into the gums around the tooth and raise a flap of tissue exposing the tooth and its surrounding bone.

Surgical Extraction – a. Gum flap is raised and surrounding bone is removed. b. The roots of the molar are split with a drill  and removed. c. The flap is held  back in place with sutures

Sometimes, after the flap is raised, there is enough tooth exposed to grab and remove it as in a simple extraction.  Sometimes, the technique described above as luxation may successfully remove the tooth.  If luxation fails,  the dentist must take a handpiece (drill) and cut away some of the surrounding bone in order to gain a purchase on the tooth. After the tooth has been pried out of the artificially enlarged socket, the dentist then sutures (sews) the flap of tissue back in place so that healing can proceed normally.

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Dr. Ng HW

About Dr. Ng HW

Dr. HW NG is a dentist and an oral & maxillofacial surgeon. BDS (MALAYA), MDFS.RCS (ENGLAND), MClinDent (Oral & Maxillofacial Surgery)(MALAYA) Dr. H. W. Ng is an oral & maxillofacial surgeon. He obtained his basic degree as a dental surgeon from University of Malaya in 2001 and become the member of the Faculty of Dental Surgery, The Royal College of Surgeons of England in 2006. He passed his master degree, MClinDent (Oral & Maxillofacial Surgery) from University of Malaya in 2009. Dr. H. W. Ng has more than 5 years of working experience as a general dental practitioner and he worked as a trainee oral & maxillofacial surgeon in a few centres in Klang valley, namely University Hospital, Hospital Tunku Ampuan Rahimah in Klang and Hospital Kuala Lumpur. Currently, he is the visiting Oral & Maxillofacial Surgeon in Columbia Asia Hospital in Bukit Rimau and Puchong, visiting oral surgeon in a few dental clinics in KL and a part-time lecturer in the Oral & Maxillofacial Surgery Department in Dental Faculty, International Medical University (IMU) in Bukit Jalil. His fields of interest are cosmetic dentistry, oral rehabilitation, dental implant and orthognathic (corrective jaw) surgery.

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