Expandable Micro-motor Bur, design of a new device for least invasive extraction of broken teeth roots
© Shahidi Bonjar; licensee BioMed Central Ltd. 2013
Received: 13 March 2012
Accepted: 13 November 2012
Published: 5 March 2013
Extraction of a broken tooth root is often a traumatic experience for both the practitioner and the patient. To extract broken roots, generally invasive approaches as open window surgeries or mucoperiosteal flap and/or removal of buccal bone are performed.
Presentation of the hypothesis
Expandable micro-motor bur (EMB) is a hypothetical design of a dental instrument proposed for removal of broken teeth roots that cannot be extracted by the routine closed methods and in which common instrumentations cannot afford to accomplish. Implication of EMB would introduce a new technique in removal of broken teeth roots in which surgical trauma is minimized and so post-extraction disorders. It would eliminate surgical invasion to the surrounding tissues; and also it would eliminate profound hand forces by the practitioner, consequently reduces stress for both the practitioner and the patient. It would eliminate high risk aftermaths such as operative morbidity (due to bone loss), maxillary sinus exposure and probable need for additional surgery as are indicative of some conventional open access approaches.
Testing the hypothesis
Further studies are needed to confirm its effect in clinical cases. The effectiveness of EMB should be verified firstly by animal experiments. The likelihood of its negative influence on nearby vascular and nerve system should be well evaluated.
Implications of the hypothesis
Implication of EMB would be of interest to both patients and the surgeon due to the following main achievements: a) no need for mucoperiosteal flap, hence preservation of soft tissue, b) no need for osteotomy, hence retention of buccal bone, c) less risk of sinus exposure, d) minimum chance of post operative infections due to eliminated surgeries in soft tissues and bones and e) in terms of esthetics, it will have a special meaning for immediate placement of dental implants. EMB’s structural components include Bur head, Spacers and Bur base. A micro motor would power its spin. In contrast to conventional surgical approaches, EMB procedure is conservative. It is anticipated that EMB would provide less traumatic and least post-operative complications in extraction of broken teeth roots.
The broken teeth roots may be difficult to remove and the dentist should strongly consider performing an open extraction after initial attempts at forceps removal have failed [1–3]. Open extractions include invasive open window surgeries or mucoperiosteal flap and/or removal of buccal bone [4–10]. Occasionally, it is necessary to prepare a purchase point with the bur and to use an elevator as the Crane pick to elevate the remaining root [11, 12]. However, these treatments have aftermaths characterized by post-operative disorders [13–17]. Therefore, seeking an easy and effective method to remove broken teeth roots and resolve the operative and post operative complications is necessary for dental clinicians and the patients.
General information on extractions of broken teeth roots
As a non-invasive treatment, EMB has not ever been reported to be utilized in dental surgery. The hypothesis I propose here is that EMB may be an adjunct treatment for extractions of broken teeth roots. This hypothesis is based on the following points: (1) No need for mucoperiosteal flap, hence preservation of soft tissue, (2) no need for osteotomy, hence retention of buccal bone, (3) reduced invasion to surrounding anatomical structures and less risk of sinus exposure, hence control of operative and post-operative complications.
Proposed parts of EMB
Comparison between "conventional extraction of complicated roots "and "Expandable Micro-motor Bur technique"
Conventional complicated root-extraction
Expandable Micro-motor Bur
Invasion to surrounding anatomical structures (maxillary sinus exposure, nerve injury and innervations disorders)
Need for mucoperiosteal flap and/or osteotomy of buccal bone
No or with less extension
Operative and post-operative complications
Stress of practitioner and patient
Success of immediate implant placement
Considering the application of this treatment, further studies are needed to confirm its effect in clinical cases. The effectiveness of EMB should be verified firstly by animal experiments. The likelihood of its negative influence on nearby vascular and nerve system should be well evaluated. When these concerns are clear, I believe that EMB could be used as a new tool to assist removal of broken teeth roots in humans.
I like to express my deepest thanks for help, scientific advice and support to: Professor M. Yaghmaei, Oral and Maxillofacial Surgeon and Head of the Oral and Maxillofacial Surgery Department; Dr A. Khojasteh, Oral and Maxillofacial Surgeon and Head of Exceptional Talent Center of the College of Dentistry; Dr M. Nouri, Orthodontist and Head of Communication and Information Technology Center; Dr F. Poordanesh, Oral and Maxillofacial Surgeon; Dr M. Ghasemianpour, Orthodontist; Dental School, Shahid Beheshti University of Medical Sciences of Iran.
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