What should be done if buccal plate is removed during extraction of upper right second molar?
– name not given
Dear name not given,
I’m reading between the lines here, judging from your e-mail address and your using the terminology buccal plate rather than some lay term, that you are the dentist and you’re asking me what to do when the buccal plate fractures as you are extracting an upper second molar.
That buccal bone can sometimes be quite thin and it can be difficult to not damage it or even remove it in the case of a difficult extraction of an upper molar. What you would do about it would depend on the treatment that is planned after the extraction. If no tooth replacement is contemplated, then this isn’t a big problem, and I would tend to do nothing. The patient won’t have as much bone there when the area heals, but they won’t need any.
If an implant is going to be placed, you need a good quantity of bone to support the implant. Or if removable dentures are going to be made for this patient, it would also be desirable, though not essential, to have as much bone there as possible. You should be able to tell, during the extraction, if that buccal plate begins to crack, and if that happens, I would do all that I could to separate that buccal bone from the tooth and leave it in place, attached to the overlying soft tissue, even if it is loose. It will act as a bone graft. If this can’t be done, then it becomes a judgment call that probably should be left to the patient. Do they want to have a separate bone graft procedure? If a dental implant is contemplated, I imagine it would be worth it.
Dr. Hall
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About David A. Hall
Dr. David A. Hall was one of the first 40 accredited cosmetic dentists in the world. He practiced cosmetic dentistry in Iowa, and in 1990 earned his accreditation with the American Academy of Cosmetic Dentistry. He is now president of Infinity Dental Web, a company in Mesa, Arizona that does advanced internet marketing for dentists.
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