Wisdom tooth extraction and ligaments

Wisdom tooth extraction and ligaments

I will probably need my upper wisdom teeth extracted soon.

I read in a couple of places that the oral surgeon is supposed to use a
"burr" to remove the ligaments and the first milimeter or bone in the
socket. Is that something that oral surgeons routinely do, or is it
something I will need to hunt around for? Thanks.

Re: Wisdom tooth extraction and ligaments

On Thu, 1 May 2008 00:19:51 -0400, "Robert"
<guyinct17@NOSPAMyahoo . com > wrote:

>I will probably need my upper wisdom teeth extracted soon.
>
>I read in a couple of places that the oral surgeon is supposed to use a
>"burr" to remove the ligaments and the first milimeter or bone in the
>socket. Is that something that oral surgeons routinely do, or is it
>something I will need to hunt around for? Thanks.
>
>
>
>
Who told/sold you that wagon full of excrement ?

Routinely remove impacted WTs in my practice.
There's nothing to it for an experienced surgeon,
and rarely do I ever need to a use a rotary instrument
for uppers.

Am beginning to think that "Robert" is a troll in the 'classic' sense.

We may have been had, gentlemen.

Re: Wisdom tooth extraction and ligaments

<Newbie@bix.nex> wrote in message
news:1nhi145qhp5ui6mip2jsam01gpqv1j7p57@4ax . com ...
> On Thu, 1 May 2008 00:19:51 -0400, "Robert"
> <guyinct17@NOSPAMyahoo . com > wrote:
>>
> Who told/sold you that wagon full of excrement ?
>
> Routinely remove impacted WTs in my practice.
> There's nothing to it for an experienced surgeon,
> and rarely do I ever need to a use a rotary instrument
> for uppers.

Huh? Obviously I'm hitting on some kind of nerve here, no pun intended. Why
exactly is this an unacceptable question? I just started researching tooth
extraction since I may need one and I came across it. Please explain. I
hate doctors who say don't read up on procedures you are about to undergo.

Re: Wisdom tooth extraction and ligaments

<Newbie@bix.nex> wrote in message
news:1nhi145qhp5ui6mip2jsam01gpqv1j7p57@4ax . com ...
> On Thu, 1 May 2008 00:19:51 -0400, "Robert"
> <guyinct17@NOSPAMyahoo . com > wrote:
>

> Routinely remove impacted WTs in my practice.
> There's nothing to it for an experienced surgeon,
> and rarely do I ever need to a use a rotary instrument
> for uppers.
>

Ok, most of the articles I found are on some dentist's website or another,
so I am trying to find a "scholarly" article on it. But in the meantime,
please explain why this question elicits such a reaction?

Re: Wisdom tooth extraction and ligaments

Newbie@bix.nex wrote:
> On Thu, 1 May 2008 00:19:51 -0400, "Robert"
> <guyinct17@NOSPAMyahoo . com > wrote:
>
>> I will probably need my upper wisdom teeth extracted soon.
>>
>> I read in a couple of places that the oral surgeon is supposed to use a
>> "burr" to remove the ligaments and the first milimeter or bone in the
>> socket. Is that something that oral surgeons routinely do, or is it
>> something I will need to hunt around for? Thanks.
>>
>>
>>
>>
> Who told/sold you that wagon full of excrement ?
>
> Routinely remove impacted WTs in my practice.
> There's nothing to it for an experienced surgeon,
> and rarely do I ever need to a use a rotary instrument
> for uppers.
>
> Am beginning to think that "Robert" is a troll in the 'classic' sense.
>
> We may have been had, gentlemen.


Don't know your dental school vintage, Newbie. We actually were told
to curet the sockets esp. of teeth with molars. The alleged problem was
PDL tissue containing epithelial rests, which I suppose were supposedly
going to magically transform into cysts. Of course we were also
culturing root canals back then.
Robert--I think it's time to get off the web--newbie is right.
Curetting (much less rotary instrumentation) is hogwash--extra pain,
delayed healing and additional trauma for nothing.

Steve

--
Mark & Steven Bornfeld DDS
* w w w .dentaltwins . com
Brooklyn, NY
718-258-5001

Re: Wisdom tooth extraction and ligaments

"Mark & Steven Bornfeld" wrote in message
news:_VmSj.3321$Bd1.267@trndny09...
> Don't know your dental school vintage, Newbie. We actually were told to
> curet the sockets esp. of teeth with molars. The alleged problem was PDL
> tissue containing epithelial rests, which I suppose were supposedly going
> to magically transform into cysts. Of course we were also culturing root
> canals back then.
> Robert--I think it's time to get off the web--newbie is right. Curetting
> (much less rotary instrumentation) is hogwash--extra pain, delayed healing
> and additional trauma for nothing.
>

Thanks - so the ligaments are basically just absorbed into the bone
structure or something?

Re: Wisdom tooth extraction and ligaments

Robert wrote:
> "Mark & Steven Bornfeld" wrote in message
> news: VmSj.3321$Bd1.267@trndny09...
>> Don't know your dental school vintage, Newbie. We actually were told to
>> curet the sockets esp. of teeth with molars. The alleged problem was PDL
>> tissue containing epithelial rests, which I suppose were supposedly going
>> to magically transform into cysts. Of course we were also culturing root
>> canals back then.
>> Robert--I think it's time to get off the web--newbie is right. Curetting
>> (much less rotary instrumentation) is hogwash--extra pain, delayed healing
>> and additional trauma for nothing.
>>
>
> Thanks - so the ligaments are basically just absorbed into the bone
> structure or something?
>
>

Half the time they come out on the root. The rest of the time they
degenerate and/or resorb.

Steve

--
Mark & Steven Bornfeld DDS
* w w w .dentaltwins . com
Brooklyn, NY
718-258-5001

Re: Wisdom tooth extraction and ligaments

"Mark & Steven Bornfeld" wrote in message
news:UipSj.6306$WS1.5991@trndny04...
> Robert wrote:
>> "Mark & Steven Bornfeld" wrote in message
>> news:_VmSj.3321$Bd1.267@trndny09...
>>> Don't know your dental school vintage, Newbie. We actually were told to
>>> curet the sockets esp. of teeth with molars. The alleged problem was
>>> PDL tissue containing epithelial rests, which I suppose were supposedly
>>> going to magically transform into cysts. Of course we were also
>>> culturing root canals back then.
>>> Robert--I think it's time to get off the web--newbie is right. Curetting
>>> (much less rotary instrumentation) is hogwash--extra pain, delayed
>>> healing and additional trauma for nothing.
>>>
>> Thanks - so the ligaments are basically just absorbed into the bone
>> structure or something?
>
> Half the time they come out on the root. The rest of the time they
> degenerate and/or resorb.

It seems like it would be an easy thing for the oral surgeon to remove the
ligament tissue with the tooth, so I wonder why don't they just don't do it?
I'm trying to remember my biology classes from college: does bone reabsorb
non-bone tissues?

Re: Wisdom tooth extraction and ligaments

On Thu, 1 May 2008 18:32:03 -0400, "Robert"
<guyinct17@NOSPAMyahoo . com > wrote:

>"Mark & Steven Bornfeld" wrote in message
>news:UipSj.6306$WS1.5991@trndny04...
>> Robert wrote:
>>> "Mark & Steven Bornfeld" wrote in message
>>> news:_VmSj.3321$Bd1.267@trndny09...
>>>> Don't know your dental school vintage, Newbie. We actually were told to
>>>> curet the sockets esp. of teeth with molars. The alleged problem was
>>>> PDL tissue containing epithelial rests, which I suppose were supposedly
>>>> going to magically transform into cysts. Of course we were also
>>>> culturing root canals back then.
>>>> Robert--I think it's time to get off the web--newbie is right. Curetting
>>>> (much less rotary instrumentation) is hogwash--extra pain, delayed
>>>> healing and additional trauma for nothing.
>>>>
>>> Thanks - so the ligaments are basically just absorbed into the bone
>>> structure or something?
>>
>> Half the time they come out on the root. The rest of the time they
>> degenerate and/or resorb.
>
>It seems like it would be an easy thing for the oral surgeon to remove the
>ligament tissue with the tooth, so I wonder why don't they just don't do it?
>I'm trying to remember my biology classes from college: does bone reabsorb
>non-bone tissues?
>
>
>
You really are a ditz ain't ya ?

Look up the size of the periodontal ligament.
Though I doubt that information is online, but it may be.

Practicing dentists have seen the PDL often enough to recognize
it in a gross specimen. And that's 'gross' as in gross anatomy.
It ain't the teenage meaning, Boris.

Big Huge Frakking Hint:
It takes a microscope to even view the periodontal ligament structure.

Unless you took Histology in college, and specifically a dental
histology monograph, doubt that this was even covered.

Hmmm.... This forum is not the place for a complete course in
histology.

And yet I am willing to recommend that you consider the chapter(s)
on "Connective Tissue" in any basic histology text.

Learn the difference between a ligament and a tendon.

What is periosteum ?

Can you identify a chondrocyte ?

What is the function of an Osteoclast ?

Try not to twist your two neurons connected by a
spirochaete into a knot.

Re: Wisdom tooth extraction and ligaments

On Thu, 01 May 2008 17:16:42 GMT, Mark & Steven Bornfeld
<bornfeldmung@dentaltwins . com > wrote:

>Newbie@bix.nex wrote:
>> On Thu, 1 May 2008 00:19:51 -0400, "Robert"
>> <guyinct17@NOSPAMyahoo . com > wrote:
>>
>>> I will probably need my upper wisdom teeth extracted soon.
>>>
>>> I read in a couple of places that the oral surgeon is supposed to use a
>>> "burr" to remove the ligaments and the first milimeter or bone in the
>>> socket. Is that something that oral surgeons routinely do, or is it
>>> something I will need to hunt around for? Thanks.
>>>
>>>
>>>
>>>
>> Who told/sold you that wagon full of excrement ?
>>
>> Routinely remove impacted WTs in my practice.
>> There's nothing to it for an experienced surgeon,
>> and rarely do I ever need to a use a rotary instrument
>> for uppers.
>>
>> Am beginning to think that "Robert" is a troll in the 'classic' sense.
>>
>> We may have been had, gentlemen.
>
>
> Don't know your dental school vintage, Newbie. We actually were told
>to curet the sockets esp. of teeth with molars. The alleged problem was
>PDL tissue containing epithelial rests, which I suppose were supposedly
>going to magically transform into cysts. Of course we were also
>culturing root canals back then.
> Robert--I think it's time to get off the web--newbie is right.
>Curetting (much less rotary instrumentation) is hogwash--extra pain,
>delayed healing and additional trauma for nothing.
>
>Steve


They didn't exactly teach us impaction removal in DS '84

Learned from a couple of good surgeons after graduation.

If there is a follicle, I remove it with a curved hemo.
really simple, and the PDL comes with the tooth.

There really is no need to currette the WT crypt, unless
it is filled wth lots of granulation tissue, even then, using
a sharp periosteal and a curved mosquito are still the
best instruments for the task IMO.

Re: Wisdom tooth extraction and ligaments

<Newbie@bix.nex> wrote in message
news:6tgk14dsf7a4c4n4h3bbcvs7o20qaso0hu@4ax . com ...
> They didn't exactly teach us impaction removal in DS '84
>
> Learned from a couple of good surgeons after graduation.
>
> If there is a follicle, I remove it with a curved hemo.
> really simple, and the PDL comes with the tooth.
>
> There really is no need to currette the WT crypt, unless
> it is filled wth lots of granulation tissue, even then, using
> a sharp periosteal and a curved mosquito are still the
> best instruments for the task IMO.

Ok, so it sounds to me like removing the ligament tissue is not a bad thing,
and no one really knows what ultimately becomes of it, so why not just
remove the stuff routinely? Seems like a no-lose precaution, at least to a
non-professional.

Re: Wisdom tooth extraction and ligaments

Robert wrote:
> <Newbie@bix.nex> wrote in message
> news:6tgk14dsf7a4c4n4h3bbcvs7o20qaso0hu@4ax . com ...
>> They didn't exactly teach us impaction removal in DS '84
>>
>> Learned from a couple of good surgeons after graduation.
>>
>> If there is a follicle, I remove it with a curved hemo.
>> really simple, and the PDL comes with the tooth.
>>
>> There really is no need to currette the WT crypt, unless
>> it is filled wth lots of granulation tissue, even then, using
>> a sharp periosteal and a curved mosquito are still the
>> best instruments for the task IMO.
>
> Ok, so it sounds to me like removing the ligament tissue is not a bad thing,
> and no one really knows what ultimately becomes of it, so why not just
> remove the stuff routinely? Seems like a no-lose precaution, at least to a
> non-professional.
>
>
>
>

As I said, it is normally attached to the root. If there is extensive
granulation or other soft tissue, it usually can be picked out pretty
easily as newbie said. Usually these are teeth with long-standing,
chronic infections. Often the granulation is adherent to the root as well.

Steve

Re: Wisdom tooth extraction and ligaments

On Thu, 01 May 2008 23:12:41 -0400, Steven Bornfeld
<dentaltwinmung@earthlink . net > wrote:

>Robert wrote:
>> <Newbie@bix.nex> wrote in message
>> news:6tgk14dsf7a4c4n4h3bbcvs7o20qaso0hu@4ax . com ...
>>> They didn't exactly teach us impaction removal in DS '84
>>>
>>> Learned from a couple of good surgeons after graduation.
>>>
>>> If there is a follicle, I remove it with a curved hemo.
>>> really simple, and the PDL comes with the tooth.
>>>
>>> There really is no need to currette the WT crypt, unless
>>> it is filled wth lots of granulation tissue, even then, using
>>> a sharp periosteal and a curved mosquito are still the
>>> best instruments for the task IMO.
>>
>> Ok, so it sounds to me like removing the ligament tissue is not a bad thing,
>> and no one really knows what ultimately becomes of it, so why not just
>> remove the stuff routinely? Seems like a no-lose precaution, at least to a
>> non-professional.
>>
>>
>>
>>
>
> As I said, it is normally attached to the root. If there is extensive
>granulation or other soft tissue, it usually can be picked out pretty
>easily as newbie said. Usually these are teeth with long-standing,
>chronic infections. Often the granulation is adherent to the root as well.
>
>Steve


Yes, and stated so well.

Took a #17 out today, pericoronitis, profuse granulation tissue
around the crown, and a 1mm thick follicle remnant from buccal
groove to lingual groove, distal aspect.
The follicle came with the tooth as did the PDL.
Removed all remaining granulation tissue by the technic previously
described. 3/0 gut X2.

SB, you have the patience of a saint.
Any way for me to nominate you for that title ?

No matter, would really love to share a steak dinner,
with fine single malt, lobster on the side, and NY Cheesecake
dessert with you and Amatus.

Is there any chance we can put this together ?
If we all chose the same C-ED course we can meet
anywhere in the USA...

Re: Wisdom tooth extraction and ligaments

Newbie@bix.nex wrote:
> On Thu, 01 May 2008 23:12:41 -0400, Steven Bornfeld
> <dentaltwinmung@earthlink . net > wrote:
>
>> Robert wrote:
>>> <Newbie@bix.nex> wrote in message
>>> news:6tgk14dsf7a4c4n4h3bbcvs7o20qaso0hu@4ax . com ...
>>>> They didn't exactly teach us impaction removal in DS '84
>>>>
>>>> Learned from a couple of good surgeons after graduation.
>>>>
>>>> If there is a follicle, I remove it with a curved hemo.
>>>> really simple, and the PDL comes with the tooth.
>>>>
>>>> There really is no need to currette the WT crypt, unless
>>>> it is filled wth lots of granulation tissue, even then, using
>>>> a sharp periosteal and a curved mosquito are still the
>>>> best instruments for the task IMO.
>>> Ok, so it sounds to me like removing the ligament tissue is not a bad thing,
>>> and no one really knows what ultimately becomes of it, so why not just
>>> remove the stuff routinely? Seems like a no-lose precaution, at least to a
>>> non-professional.
>>>
>>>
>>>
>>>
>> As I said, it is normally attached to the root. If there is extensive
>> granulation or other soft tissue, it usually can be picked out pretty
>> easily as newbie said. Usually these are teeth with long-standing,
>> chronic infections. Often the granulation is adherent to the root as well.
>>
>> Steve
>
>
> Yes, and stated so well.
>
> Took a #17 out today, pericoronitis, profuse granulation tissue
> around the crown, and a 1mm thick follicle remnant from buccal
> groove to lingual groove, distal aspect.
> The follicle came with the tooth as did the PDL.
> Removed all remaining granulation tissue by the technic previously
> described. 3/0 gut X2.
>
> SB, you have the patience of a saint.
> Any way for me to nominate you for that title ?
>
> No matter, would really love to share a steak dinner,
> with fine single malt, lobster on the side, and NY Cheesecake
> dessert with you and Amatus.
>
> Is there any chance we can put this together ?
> If we all chose the same C-ED course we can meet
> anywhere in the USA...


Really should be able to. I've almost never done any real traveling
for CE hours, but I'd do it to visit--Marie's always talking about going
back to Michigan. Biggest problem is the kid's schedule--a week here, a
week there--but still should be able to work something out--I hope.

Steve

Re: Wisdom tooth extraction and ligaments

On Fri, 02 May 2008 09:04:58 -0400, Steven Bornfeld
<dentaltwinmung@earthlink . net > wrote:

>Newbie@bix.nex wrote:
>> On Thu, 01 May 2008 23:12:41 -0400, Steven Bornfeld
>> <dentaltwinmung@earthlink . net > wrote:
>>
>>> Robert wrote:
>>>> <Newbie@bix.nex> wrote in message
>>>> news:6tgk14dsf7a4c4n4h3bbcvs7o20qaso0hu@4ax . com ...
>>>>> They didn't exactly teach us impaction removal in DS '84
>>>>>
>>>>> Learned from a couple of good surgeons after graduation.
>>>>>
>>>>> If there is a follicle, I remove it with a curved hemo.
>>>>> really simple, and the PDL comes with the tooth.
>>>>>
>>>>> There really is no need to currette the WT crypt, unless
>>>>> it is filled wth lots of granulation tissue, even then, using
>>>>> a sharp periosteal and a curved mosquito are still the
>>>>> best instruments for the task IMO.
>>>> Ok, so it sounds to me like removing the ligament tissue is not a bad thing,
>>>> and no one really knows what ultimately becomes of it, so why not just
>>>> remove the stuff routinely? Seems like a no-lose precaution, at least to a
>>>> non-professional.
>>>>
>>>>
>>>>
>>>>
>>> As I said, it is normally attached to the root. If there is extensive
>>> granulation or other soft tissue, it usually can be picked out pretty
>>> easily as newbie said. Usually these are teeth with long-standing,
>>> chronic infections. Often the granulation is adherent to the root as well.
>>>
>>> Steve
>>
>>
>> Yes, and stated so well.
>>
>> Took a #17 out today, pericoronitis, profuse granulation tissue
>> around the crown, and a 1mm thick follicle remnant from buccal
>> groove to lingual groove, distal aspect.
>> The follicle came with the tooth as did the PDL.
>> Removed all remaining granulation tissue by the technic previously
>> described. 3/0 gut X2.
>>
>> SB, you have the patience of a saint.
>> Any way for me to nominate you for that title ?
>>
>> No matter, would really love to share a steak dinner,
>> with fine single malt, lobster on the side, and NY Cheesecake
>> dessert with you and Amatus.
>>
>> Is there any chance we can put this together ?
>> If we all chose the same C-ED course we can meet
>> anywhere in the USA...
>
>
> Really should be able to. I've almost never done any real traveling
>for CE hours, but I'd do it to visit--Marie's always talking about going
>back to Michigan. Biggest problem is the kid's schedule--a week here, a
>week there--but still should be able to work something out--I hope.
>
>Steve


Since you mentioned Michigan, and I want Amatus to fix #'s 19 and 31..

Summer Solstice anyone ?

If we are able to agree on a time and place, I will be there and buy
us all dinner, drinks, and dessert.