Removal of teeth using ultrasound - indications and contraindications

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Even quality oral care does not eliminate the possibility of trauma or other factor that may require tooth extraction. The need to pull it out with forceps or saw it into pieces with a milling machine for fragmentary removal causes unpleasant associations, becomes a reason to postpone going to the dentist.

The innovation of 2017-2018 was the use of ultrasound equipment in dentistry – piezotome, for tooth extraction. Previously, ultrasound was used for the removal of dental calculus, treatment of periodontal disease.

Equipment

Piezotome includes a block-regulator, which sets the parametric parameters (frequency of oscillation, amplitude), and ultrasonic scalpel with interchangeable attachments. Depending on the quality, structure, density of bone tissue, the surgeon sets the frequency in the range of 10-290000 Hz, amplitude 60-200 microns.

The set of attachments for:

gingival incision;
removal of shallow caries;
cleavage of bone tissue, etc.

Indications, contraindications

Ultrasound is used:

In complex cases of extraction, when traditional surgical methods will lead to significant traumatization of bone, soft tissues and cause the patient serious psychological discomfort.
To quickly, accurately and painlessly remove a dystopian or retined dental element without a full-fledged surgery.
To minimize the patient’s fears, anguish at a simple removal.
In sinus elevators.
In osteoplasty.
To prepare the bed for implant placement.

Ultrasound equipment is contraindicated or used with caution if the patient has:

Cardiovascular disease;
has a pacemaker;
decompensated diabetes mellitus;
immune diseases.

Dental contraindications are also taken into account.

Example. If teeth with large fillings, assess their proximity to the area that will be exposed to ultrasonic vibrations, so that the restorations are not destroyed by the piezotome.

Removal technology

Stages of the procedure on the example of a not fully erupted wisdom tooth:

Diagnosis for contraindications.
The patient is injected with local anesthesia.
Ultrasound “scalpel” peel off the gum tissue to free the operating field.
The tooth is carefully defragmented by ultrasound (without pain, pressure and touching the equipment to the tissues).
The tooth elements are easily removed from the hole together with the roots.
The mucosa is returned to its place, and if necessary, stitches are applied.

Advantages of the method

Complex extraction without general anesthesia under local anesthesia.
High-quality operation in hard-to-reach places.
Non-contact method eliminates the risk of tissue overheating in the process of exposure. The pulp will definitely not get a burn, and the patient – inflammation of the pulp.
Precise localization of exposure determines minimal traumatism. Destroy only hard tissues, and mucosa, nerve endings are not affected.
Rapid healing.

The price of extraction of the dental element piezotome is 2 times higher than the traditional one. But the treatment of the wound surface with ultrasound has a disinfecting effect, the patient saves on taking antibiotics. Minimizing the risk of complications eliminates the cost of their elimination and long-term rehabilitation.

Review: Maria

Wisdom tooth tormented me for 4 years, aggravating always not in time, and never erupted. I read horror stories about how to conduct such operations – cut the gum, saw out pieces of retined eight, imagined a bloody crumble in my mouth, and … every time postponed going to the dentist, drinking tears from pain nimesil. Then the esthetician dentist, from whom I do whitening, told me about ultrasound. For me, the nightmare was over before it had even started! It took 15 minutes for everything, that’s with time to freeze. Showed two scary pieces of tooth, and it had already started to deteriorate under the gum, and separately two long crooked roots. Gargled for 3 days with antiseptic, they didn’t even prescribe an antibiotic. I recommend to everyone who is afraid of tooth extraction and endures torment.