Technique for First Bicuspids: Frequently, because first bicuspids have a buccal and lingual root, lateral luxation results in frequent fracture of one of the roots. It is even more important to use this technique to prevent this from occurring. The periotome is used again circumferentially (Figures 10 to 13). The appropriate forceps is applied and in this case since the fulcrum must be over the anterior teeth, a tongue depressor is placed under the fulcrum to distribute the pressure over several teeth (Figure 14). As in the first case gentle slowly increasing pressure is applied to the forceps handles in the direction of the occlusal surface until the tooth is elevated with both roots intact (Figures 15, 16). The first bicuspids frequently have very slender delicate roots which could be a challenge to remove if fractured and retained in adolescents in cases that have been referred by the orthodontist (Figure 17). I have used this method many times with no root fractures and patients have been much less anxious when no luxation is used. Post-operative healing will be faster. In many cases, an implant can be placed in the lingual root socket immediately after the extraction with no flap and no sutures. Conclusion: If this technique is used, then there will be tremendous impact on clinical care. Since there is no bone traumatizing luxation, root fracture, and sounds of bone fracturing at the edge of the socket, patients will experience much less pain and faster healing after the procedure. With greater preservation of the bone and less damage to the socket, the dentist and the patient will have better options for further restoration of the affected area. Figure 8 Figure 10 Figure 12 Figure 13 Figure 14 Figure 15 Figure 16 Figure 17 Figure 9 Figure 11 WWW.SDDSNY.ORG 5
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