Dental Tribune Europe
Bone preservation can be a challenge in extraction with traditional instrumentation. However, with Piezotome, reproducible extractions can be performed with peace of mind. (Image: ACTEON)

Piezotome extractions favour bone preservation with immediate implant placement

November 02, 2020

BORDEAUX, France: Tooth extraction is the most common procedure performed in oral surgery.1 For example, ten million third molars are removed each year in the US alone, according to the American Public Health Association.2 Dentists are ethically committed to using the least traumatic surgical options and least invasive techniques in order to ensure patients’ well-being, thus less traumatic extraction and implant placement are becoming the norm in today’s implant surgery.

In the daily dental routine, there can come a time when all treatment options to preserve the tooth have been exhausted. In this case, the tooth may have to be removed and replaced with a dental implant. It is sometimes difficult to preserve the alveolar bone, particularly in clinical situations such as fractured teeth or roots or ankylosed teeth. Using rotary instruments can, in most cases, lead to sacrificing the alveolar ridge in order to remove the tooth or tooth fragments.3 Also, the use of manual instrumentation often involves too much force, thus leading to bone damage and a poor implant prognosis. Consequently, the need for bone augmentation in order to enable implant insertion will have to be considered as a second step.

However, the use of particularly aggressive techniques is no longer appropriate. Tooth extraction can now be performed using Piezotome CUBE. The use of predictable and safe technology has modified traditional surgery, and minimally invasive treatments can achieve superior results for today’s patient. Ultrasonic instruments are less traumatising. They are gentle on soft tissue, thus reducing the need for surgical flaps, and act essentially on the tooth and not on the bone, which makes it possible to preserve bone (no alveolectomy), essential for osseointegration and immediate implant placement.4

Performing extraction procedures with Piezotome CUBE followed by immediate implant placement will reduce time considerably and reduce the amount of grafting material needed, making every procedure predictable, easier and more acceptable for the patient.

Exclusive tips

ACTEON has developed six ultrasonic tips which are very thin and specifically designed for this procedure. Inserted between the root and the periodontal ligament, the tips will widen the ligament space. Thus, separated from its attachment system, the tooth will be removed rapidly, almost without force, leading to a gentle avulsion and ensuring a lack of trauma to both bone and soft tissue. These tips are:

  • LC1 and LC2: thin ultrasonic periotomes dedicated to anterior extraction areas;
  • LC1 90°: ultrasonic periotome designed to access interproximal, lingual and distal areas of molars;
  • LC2L and LC2R: left- and right-oriented ultrasonic periotomes dedicated to posterior areas; and
  • NINJA: saw tip particularly efficient for hemisections and root amputations.

Benefits for dentists and patients

With this new minimally invasive procedure, postoperative pain and swelling, together with analgesic intake, are reduced by over 50%,5 thus increasing overall patient treatment acceptance owing to better healing results and a better quality of life perceived by the patients.6 Researchers have come to the conclusion that Piezotome surgery “is superior in atraumaticity and soft-tissue safety compared to traditional procedures with burs and grants the patients significantly less post-surgical pain and swelling”.5 Furthermore, the hydrodynamic cavitation makes it possible to clean the surgery site for optimal visibility.

Piezotome CUBE allows for a same-day procedure for extraction and implant placement, making it less traumatising for patients and optimising dentists’ time. Research has shown that Piezotome surgery is the new gold standard in oral surgery.3

Editorial note: A list of references can be obtained from the publisher.

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