Dentaltown December 2021 - 24

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fl etch33
Member Since: 01/06/06
Post: 59 of 149
For everyone who suggested troughing M and D, please go back and review the radiograph.
You get the handpiece off just a bit and you have a good chance buggering up the adjacent tooth.
Trough the palatal, as Tommy-wan Murphnobi suggested. There isn't anything that can be
destroyed there.
As far as extractions being practice-builders, that is really a double-edged sword. If you are
good at it, it's defi nitely a positive. If you suck at extractions and they take you hours to accomplish
and the patient looks like you used a dull chainsaw on them, then it is not. Unless you have
hands that look more like feet, you can learn the routine extractions in a hands-on environment.
The most important thing is to understand your capabilities and be able to recognize when a
case exceeds them. The next thing you need is a quiver full of arrows. You can certainly pick up
a bunch on threads like this, but until you actually deploy that information in a clinical setting,
you only have a small piece of the puzzle.
I saw a young doctor tonight while out to dinner with my wife. He came up and said hi and
rapidly pulled up some of his most recent impactions. (My wife groaned.) Several were challenging.
He smiled and said, " Your fl ap design made the difference in these cases. " If he hadn't
actually raised the fl aps and listened to the critiques in Guatemala and made those suggested
adjustments, he might not have been successful.
Take a hands-on class or work with a qualifi ed mentor who can help guide you through plan
A through Z.
P.S.: Canines can be buggers. You just need to " listen to the tooth " and it will tell you what
needs to be done. ■
4/7/2021
vomer6
Member Since: 10/15/03
Post: 60 of 149
I'd use a thin diamond or a piezo on this tooth, but nothing wrong with a good referral. I
once had a patient I had done sinus lifts, extractions and implants on but she needed an erupted
mandibular third molar out. I thought that this one would be diffi cult and I didn't want to look
bad, so I referred her to an OMS. He spent 2½ hours on it. I'm so lucky. ■
4/8/2021
the mathetes
Member Since: 10/05/07
Post: 61 of 149
I will take your advice and trough the palatal next time. Maybe it will be much easier.
Usually when I get desperate, I start troughing the palatal because I cannot go buccal. I just kind
of worry about roughing up the palatal gingiva. ■
4/8/2021
drtommymurph
Member Since: 04/05/02
Post: 62 of 149
mcole
Member Since: 01/21/15
Post: 80 of 149
Looks like a subgingival crown prep. Little bleeding but no need for fl apping or sutures.
Everything grows back nicely. ■
Use a Brasseler 859.36.010 FG surg needle diamond to widen the mesial and distal (some4/8/2021
times
palatal, avoid the facial) PDL space, then slide in a spade or a proximator to get movement.
Learned that from somebody's post on DT and then recently saw it in Tarnow's book too. It's a
critical tool in my armamentarium. You would likely have been able to get this out. ■
4/8/2021
Read more advice online!
This Townie received lots of helpful advice and
this excerpt is just the beginning! To read the
entire message board and participate in the
discussion, go to dentaltown.com/magazine
and click the link to this thread in the Message
Boards section of the December 2021 issue.
24 DECEMBER 2021 // dentaltown.com

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Dentaltown December 2021

Table of Contents for the Digital Edition of Dentaltown December 2021