Dental Health Magazine Dental Health Digital Issue | Page 37

Issue #5, March 2017
2
37
BONE REMOVAL
Conventionally,
bone
guttering
is
done so that the instruments are
accessible to the impaction undercut.
As the name implies, bone guttering
is forming a gutter of bone around the
impacted tooth. However, the more
bone is removed for guttering, the
more bleeding, swelling and pain one
will experience. Instead, the minimally
invasive approach would be to section
the impacted tooth to many parts for
easier removal. This helps preserve
the socket anatomy and prevents
bone removal. Unfortunately, deeply
impacted tooth still require the need
for bone guttering to obtain adequate
access.
BONE GUTTERING IS DONE SO THAT
THE INSTRUMENTS ARE ACCESSIBLE
TO THE IMPACTION UNDERCUT
3
REMOVAL OF
IMPACTION UNDERCUT
Impaction undercut comes from the
crown of wisdom teeth. In order to
remove this undercut, there are only
2 options; 1, to remove bone; 2, to
section the tooth. The best option
would be to decoronated the tooth.
The crown would be sectioned to 2 or
3 tiny pieces whereas the root trunk
would be sectioned to 2 pieces. This
allows easy removal without gross
bone removal. Therefore, less swelling,
pain and bleeding.
4 SUTURING
As stated above, there will be no bone
guttering for the minimally invasive
approach, and therefore, would have
insufficient soft tissues for suturing.
With insufficient loose soft tissues,
there would be no need for suturing. If
suturing is deemed necessary, partial/
completed sutures can be done as
long as there are no overstretching
of
tissues.
Overstretching
causes