A dental extraction (also referred to as exodontia) is the removal of a tooth from the mouth. Extractions are performed for a wide variety of reasons, including tooth decay that has destroyed enough tooth structure to render the tooth non-restorable. Extractions of impacted or problematic wisdom teeth are routinely performed, as are extractions of some permanent teeth to make space for orthodontic treatment.
Historically, dental extractions have been used to treat a variety of illnesses, as well as a method of torture to obtain forced confessions. Before the discovery of antibiotics, chronic tooth infections were often linked to a variety of health problems, and therefore removal of a diseased tooth was a common treatment for various medical conditions. Instruments used for dental extractions date back several centuries. In the 14th century, Guy de Chauliac invented the dental pelican, which was used through the late 18th century. The pelican was replaced by the dental key which, in turn, was replaced by modern forceps in the 20th century. As dental extractions can vary tremendously in difficulty, depending on the patient and the tooth, a wide variety of dental instruments exist to address specific situations.
The use of platelet rich plasma (PRP) following tooth removal appears to speed healing and bone formation, according to an article in the Journal of Oral Implantology.
When a tooth is removed, poor healing can lead to excessive bone loss in the jaw that can delay tooth replacement, require costly reconstructive surgery, or even be impossible to fix, according to the authors. "Patients and clinicians could benefit if a cost-effective, simple technique were available that decreased bone-healing time and increased the predictability of favorable results," they write.
For the study, radiography techniques were used with patients to detect bone changes after surgery to remove molars - specifically, the bilateral mandibular third molar. For each patient, one extraction site was treated with PRP and the site on the other side of the mouth was not, serving as the control. Three patients received PRP on the right side and three on the left.
The patients returned after the operation for evaluations and digital radiographs at 3 days plus weeks 1, 2, 3, 4, 6, 8, 12, 16, 20, and 24. Observers checked them visually to evaluate the extraction site's tissue opening, bleeding, inflammation, facial edema, and pain. The early radiographs found a significant increase in bone density in the PRP-treated sites.
"The PRP treatment had a positive effect on bone density immediately following tooth extraction," the authors write, while the control site had a decrease in bone density during the first week after surgery. After the initial two weeks, both sites had relatively parallel increases in bone density.
"It took approximately 6 weeks for the control sites to reach the same bone density that the PRP-treated site had reached by week 1," according to the article. "The immediate start of bone formation seen with PRP treatment is of clinical relevance because it is the initial 2 weeks following bone-manipulation oral surgery that are important."
Patients did not report significant differences in their perception of pain, bleeding, numbness, facial edema, or temperature between the different sites, according to the study.