Surgical tooth extractions & Tooth sectioning.

A dentist may determine that using of some type of surgical procedure will make the removal of their patient's tooth easier.

This procedure might involve:
1) Removing or reflecting back gum tissue.
2) Removing bone tissue from around the tooth.
3) Sectioning the tooth (cutting it into parts).

In those situations where one or more of these techniques is used during the extraction process, the procedure is categorized as a "surgical extraction."

(Tooth extractions where these techniques are not utilized are termed "simple" extractions.)

Situations where a surgical extraction may be needed.

There can be a number of reasons why removing a tooth surgically might be the best, or even only, option.

A) Limited tooth access.

In some instances, gum tissue and/or bone may cover over or surround a tooth in a way that makes it difficult for the dentist to see or get at it.

Creating a gum tissue flap so a broken tooth can be extracted.

If so, a gum tissue flap can be created and reflected back. Bone tissue can be removed too.


1) Broken or damaged teeth.

If a tooth's crown (the part of a tooth that lies above the gum line) has been severely damaged or lost, a surgical extraction may be needed when removing what's left of the tooth.

A surgical extraction may be needed to remove a root tip.

2) Teeth that break during the extraction process.

Sometimes the initial attempt at removing a tooth fails and surgical intervention becomes necessary.

For example, the crown of the tooth may have broken off, leaving just the root(s). Or possibly a part of the root has fractured and still remains in the tooth's socket.

If so, a "simple extraction" may need to be transformed into a "surgical" one so it can be completed.

3) Third molars.

This technique is used to access all types of impacted wisdom teeth.

B) Surgical technique can lessen the difficulty of an extraction.

A surgical approach may be chosen because without it the extraction might be very difficult, potentially damaging to neighboring teeth and tissues, unpredictable, or even impossible.

Multi-rooted teeth are often sectioned into parts.

1) Tooth sectioning.

"Tooth sectioning" can help to reduce the degree of difficulty of an extraction.

Both a tooth's positioning and/or the shape of its roots (curved, hooked, crooked, etc...) can present challenges for a dentist.

By sectioning a tooth into parts, the dentist can change the nature of an otherwise difficult extraction because once the tooth has been split up, the dentist can focus on removing each individual portion separately.

Wisdom tooth surgery often involves sectioning the tooth.

a) How are teeth divided up?

The goal, when sectioning a tooth, is to divide it up into smaller parts. But each one must still remain large enough to be easily manipulated.

In the case of a two-rooted lower molar, a logical place to cut the tooth is in half, right between its roots.

With some impacted teeth, the tooth's crown portion may need to be cut off and removed first. Then the root portion can be sectioned.

b) How does a dentist section a tooth?

Teeth are typically sectioned using a drill (dental handpiece). The process is performed in the presence of a copious amount of irrigation (a lot of water or saline solution) so to minimize the amount of bone-traumatizing heat that's created by the drilling.

The individual pieces are teased out the same way a tooth is worked out during a normal extraction (using extraction elevators and/or forceps). Sometimes the sections, collectively, have an interlocking nature. If so, after the "keystone" section has been removed the other section(s) come out more readily.

c) Does it hurt?

You might expect that drilling through the tooth's nerve during the sectioning process might be painful. Since your tooth has already been numbed, it won't be. You'll feel the vibrations of the drilling process but otherwise it should be a non-event.

2) Bone removal.

Factors, such as very dense bone (such as that surrounding teeth that function under heavy chewing forces) or inelastic bone (a change often associated with aging), may make some bone removal necessarily before a tooth can be easily, or at least predictably, removed.

This bone removal may or may not be performed in conjunction with tooth sectioning.

Don't be frightened of the idea of having a surgical extraction.

A dentist will only elect to perform an extraction surgically in those cases where doing so facilitates the removal of the tooth.

Besides making some extractions possible where otherwise they would not be, introducing a surgical aspect to the extraction process may make it so it's quicker, more predictable (less force needed, less potential for unexpected tooth or bone fracture) and the cause of less tissue trauma or damage.

All of these attributes are very positive, both for the patient's extraction experience as well as the healing process that will follow.

A surgical extraction isn't necessarily a big event.

A surgical extraction may or may not need to be a big production. You will simply need to ask your dentist what to expect.

At one extreme, performing an extraction surgically may add very little additional time or effort to the tooth-removal process. And, in fact, doing so may actually make it so less time and effort are needed.

In other cases, however, such as the removal of an impacted lower wisdom tooth, the surgical nature of the extraction may require a significant amount of preparation and clinical effort.

 All FYI's ► 

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Topic- Tooth Extractions.
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