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Area of operation : lower right third molar with pain ,advised for extraction after confirming with radiographs.
Before I call it a crazy method , I haven’t explored much to assess how many skilled dentist would have tried this technique. And yet it’s not a profound technique nor more of a complex scenario.
Extraction of third molar has always been a bit complicated. We always know of it’s pros and cons in pre-evaluation radiographs . And atraumatic exodontia is always what every dentist is expected to perform. Imagine, if the supportive equipment went wrong and all you have to rely on is the the isolation and management in the old school way. Oh god, it gets gory real soon! There is real pool of blood , the tooth not visible and supporting tissue floating in the blood.
In this case, Our area of operation is on right third lower molar. The initial inferior alveolar block had been good success after the patient confirms of objective and subjective signs . Next, with the Bard Parker no.15, the real surgeon gets confronted for a moment to perform the incision confidently. Then I decide to drill around bone, surrounding the right third molar.
What we all need is to keep “focus” at area of operation to make sure nothing goes wrong or deviate from our plan. That same stubbornness of focus can help if things can’t be done precedent way. You will always find a way, trust me.
And I cut interradicular bone to luxate tooth, it went better enough to take out the mesial root. But distal one, real crux in this operation was awaiting with that bad gesture. When I tried to luxate with crossbar, I could hear some creaking sound with extracting distal 3/4. The rest is inside. Then I stopped , I paused for a while , and I realize the real crux is welcoming me . Being dicey, I tried with files to retrieve the root spicule , and it all went bad due to the blood and isolation was bad as the supportives. But my benevolent staffs , were real supportive angels through out my procedure, their incessant care and love to their duty helped to manage well than I expected. So now, it’s time, I have to show myself whether I have to give up on this distal part or try again. But am never a “ giving up ” guy.
After rationalizing for a moment , enough to think what I can try here, all learned technique have been failing me one by one , even though isolation performing were best driven by our nurses .
Then suddenly in a quick , I decide to keep the distal root back , why I can’t keep tooth back , come on guys . Why we have to pull the distal spicule with file alone ? What if I can keep distal root back to socket , then I can get guidance to distal spicule , (because on other side isolation is compromising ).
Bingo
I tried 30 no. file with much push stroke from access of tooth to apex manner. And with all forces I have got from my workouts, I have pulled back.
Awesome , I got root and distal stump with file in one go. Amen.
What I realized after that case is that, if we are not ready to give up, the right portals opens, that we will find it on our own. It’s just simple and easy as that. And I could see the happy patient smile after all we have been performing to get this tiny thing out of socket.
Signing off
Dr Shaji David
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