An extraction involves removing a tooth, whether it be a stubborn baby tooth that won’t let go on its own, a wisdom tooth that threatens to cause problems, or a chronically infected tooth or failed root canal. While some general dentists are uncomfortable performing extractions, Dr. Ulm is both incredibly skilled and gentle at removing teeth safely. As a biological dentist, there are a few additional steps Dr. Ulm takes while extracting permanent teeth which result in better healing and fewer post-operative complications, such as infection and dry socket.
- Removal of Periodontal Ligament (PDL), Debridement, and Ozone Therapy: In addition to removing the tooth itself, the soft tissue surrounding the tooth, the periodontal ligament (PDL), is also removed, along with any infected/compromised bone surrounding the root. The socket is then flushed with ozonated water to disinfect and kill pathogenic bacteria.
- Platelet-Rich Fibrin Grafting: Prior to the extraction a blood draw is taken from the patient, and the vials of blood are spun in a calibrated centrifuge right here in our lab. The blood separates into plasma, red blood cells and heme, and a wonderful substance called platelet-rich fibrin, or PRF. This PRF includes platelets, or clotting agents, as well as growth factors and fibrin, and has been shown to have marked therapeutic benefits in bone healing (http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3740636/). One or more PRF grafts are placed inside the socket to fill the void left by the tooth, and another is pressed flat and stitched over the socket to close it. The stitches resorb after 3-5 days and do not require removal. The PRF graft adheres to the socket walls, preventing dry-socket, food impaction, and infection.