Dentistry by Dr. Ara Nazarian
Figure 1: Preoperative image of non-restorable maxillary teeth requiring extraction.
Figure 2: Prior to utilizing the Physics Forceps for atraumatic extraction the Separator #1 Blue Titanium Bayonet (GoldenDent) and The Wedge (GoldenDent) instruments are used as a pre-extraction step to start to sever the PDL and to elevate the teeth.
Figure 3: The Reflector (GoldenDent) allows for easy retraction of larger areas of soft tissue for various procedures including an exposure of a surgical site for bone leveling, grafting and dental implant placement. The elevator style handle of the Reflector allows the practitioner full control when reflecting the mucoperiosteum away from the bone in just a few simple rotations
Figure 4: The Distal Elevator (GoldenDent) is utilized on the last upper molar in the mouth to prevent the removal of tuberosity during the extraction of the tooth.
Figure 6: The Physics Forceps Standard Series instruments (GoldenDent) are used to atraumatically extract all the upper teeth in an efficient manner.
Figure 7: Note the roots are in tact while utilizing the Physics Forceps, where breaking root tips or damaging bone is rare when the technique is used properly.
Figure 10: All upper teeth successfully extracted in a predictable and efficient manner utilizing the Physics Forceps, in combination with the Separators and The Wedge instruments.
Figure 11: Extended friction grip burs from the NAZARIAN OSSEOUS CLEANING & SHAPING bur kit (GoldenDent) were used and designed to precisely and effectively remove unwanted tissue without grabbing or damaging the surrounding bone to ensure no interference with the graft material. Easily remove tissue from extraction site socket that may be difficult to achieve (or access) manually with a surgical curette instrument.
Figures 12: Round and football shaped carbide burs from the NAZARIAN OSSEOUS CLEANING & SHAPING bur kit (GoldenDent) were used designed specifically to effectively and predictably level and shape bone at the ideal width, shape and size in preparation for dental implants and dentures; and long shank design allows for proper and easy connection for straight nose cone hand piece.
Figure 13: GoldOss 100 DBM putty (GoldenDent) was used, which is a demineralized bone matrix (DBM). All GoldOss 100 DBM products are verified for osteoinductivity post-sterilization prior to release for distribution. In-vivo test results demonstrate all 5 bone-forming elements present (chondrocytes, osteocytes, bone marrow cells, cartilage, and new bone) in our implants. GoldOss 100 DBM putty does not contain any extrinsic carriers and is made from 100% human bone. Special slow flow tip allows for easier placement.
Figure 14: Maxillary arch sutured.
Figure 17: Four lower dental implants are placed for overdenture.
Figure 19: Radiograph immediately post-op depicted.