Maxillary Molar Extraction Technique: Decoronation and Sectioning
This short video reviews two cases to demonstrate a Maxillary Molar Extraction Technique using Decoronation and Sectioning.
In can be difficult to extract maxillary molars whole, without damaging the surrounding bone and soft tissue. This is because maxilllary molars have 3 roots which are divergent, making the extraction procedure difficult. Several techniques have been offered for these types of extractions. One particular method is known as the "Divide and Conquer" procedure. In this technique, you decoronate the tooth, split the roots, and remove them individually. This helps to perserve the surrounding architecture. 1,2
This short video, from Dr. Gober, reviews 2 cases using the Divide and Conquer method. Specifically, in the first case shown, it is important to note that using the technique there was no need to raise a flap for extraction of the tooth. The 2nd case also shows an extraction, but it was followed by immediate implant. Both cases, provide the following key tip when using Divide and Conquer: Aim to "recreate" the tooth following extraction to make sure everything was properly removed.
References:
1. Extraction of a maxillary molar tooth, Journal of the Irish Dental Association Download, 25/05/2023 19:42
Elevate each root separately with luxators, taking care to keep the buccal and interradicular bony support intact. When there are curved, thin, non-vital, or bulbous roots, significant mobility of each should be achieved before attempted extraction from the socket (Figures 11, 12 and 13). A root forceps may be used to remove each root from its socket (Figure 14). In this case there is no need for a suture as no surgical flap has been raised.
2. Decoronation of an ankylosed tooth for preservation of alveolar bone prior to implant placement A Filippi 1, Y Pohl, T von Arx, Case Reports Dent Traumatol . 2001 Apr;17(2):93-5.
Decoronation is a simple and safe surgical procedure for preservation of alveolar bone prior to implant placement. It must be considered as a treatment option for teeth affected by replacement resorption if tooth transplantation is not feasible.