Biological Extractions
Biological vs "regular" Extractions
A traditional approach to dental extractions would be to just make sure all of the tooth was removed from the socket. Sometimes even this doesn't happen correctly and parts of teeth are left in the bone. A BIOLOGICAL extraction includes removing the entire tooth as well as the Periodontal Ligament which holds the tooth in place.
Biological Extraction Protocol
Dr. Brunner has developed a biological extraction protocol to aid in the healing and natural return to functional activity both orally as well as systemically.
1. Extraction of the tooth
Dr. Brunner uses a local anesthesia without any epinephrine to provide anesthesia when removing the tooth. The epinephrine causes constriction of the blood vessels as well as increasing the patient's heart rate causing anxiety. The blood vessel constriction can lead to areas of necrotic bone and future cavitations.
2. Removal of the Periodontal Ligament
The periodontal ligament (PDL) is a network of fibrous tissue that aids in stabilizing the tooth in the alveolar bone. This fibrous tissue as well as any other granulation tissue or abscess needs to be thoroughly removed during the extraction process. Failure to remove the tissue can allow for small areas of infection to remain in the bone, These areas of infection and dead bone can result in cavitations or recurrent infection. The PDL is removed by using a large round bur under slow controlled speed and ozonated water to keep the bone cool.
3. Ozone Therapy
Ozone is a remarkable adjunctive therapy Dr. Brunner uses to detoxify, sterilize and infuse the tissues with oxygen. Ozone is used to create sterile ozone water to irrigate when using the drill. Ozonated water is also used to saturate sterile gauze before being gently packed into the extraction site. This process forces the oxygen rich water into the bone, both detoxifying the bone and encouraging blood vessel formation. Ozone gas is also injected into the surrounding tissues, as well as the extraction site prior to completion of the surgery.
4. Platelet Rich Fibrin and Bone Marrow
Platelet Rich Fibrin (PRF) and bone marrow are the patients's own biologically active cells to accelerate the healing process. PRF is obtained by a simple blood draw from the arm or hand. The blood is then spun in a centrifuge creating a sticky gel-like substance containing millions of platelets. These platelets are necessary for clot formation and send hormones to the bone and surrounding soft tissue to recruit cells for healing. Bone Marrow is obtained using a small needle, no larger than a tooth pick, and inserting it into the bone behind the last maxillary molar teeth. This procedure is performed under local anesthesia and is completely painless. The bone marrow contains immature bone cells that will be used to aid in the regeneration of the alveolar bone.