Patient had significant distal decay on molar. After discussion, the patient requested it be removed. After a double block, buccal and lingual infiltration, the tooth was still painful to touch. A small round bur is used to perform a cortical puncture for intra-osseous injection.
The bur is run straight though attached gingiva aiming down toward the cancellous bone (this photo is staged, you can see the red spot where we did the intra-osseous already).
Since I use a wand, I use the shortest needle. In most cases, I use 3% prilocaine plain and only a 1/4 of a capsule. This case needed more.
Although I knew the tooth would fracture, I still grabbed it with forceps until the crown came off. Then finished decoronating with long shanked TC bur.
The sectioned. Section was not straight into furcation.
You can see the distal inclination of the tooth. I sectioned into the mesial root.
From lower right. Fragment removed with forceps.
Lower left. First section elevated with luxator. Then I could see properly to finish sectioning properly.
Top right. Distal root removed with luxator and fine forceps.
Top left, remaining portion of mesial root elevated with cryers after removed some of the interseptal bone.
Good bleeding. Spongestan and single 5/0 gut suture.
Intra-osseous with Extraction
The bur I’ve used here is a Komet K1SM 2014 012 from Henry Schein Halas
The purpose of this blog is to help fellow dentists
Disclaimer: Dr Lincoln Harris has no economic interests with any company referred to in this or other blogs on this website. All dentistry, surgery and photography by Dr Lincoln Harris is with patient permission. Individual results may vary. Any surgical or invasive procedure carries risks. Before proceeding, you should seek a second opinion from an appropriately qualified health practitioner.
