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HomeAnswersDentistrytooth extractionIs it needed to remove the periodontal ligament to extract teeth?

Does tooth extraction involve periodontal ligament removal?

The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.

Medically reviewed by

Dr. Divya Banu M

Published At January 29, 2020
Reviewed AtApril 26, 2024

Patient's Query

Hi doctor,

My lateral incisor #7 fractured at the gumline and will likely require a surgical extraction. Also, while a temporary filling was provided after removal of pulp pending a root canal, the root canal was not done for many months due to an insurance lapse, and the tooth became infected as well as surrounding bone. I have read that some dental surgeons advocate for the removal of the periodontal ligament during extraction to facilitate healing and the proliferation of new bone cells, and that this must be done explicitly with a bone burr. I have read that this is common practice for "biologic" dentists and biologic dental surgeons, and uncommon otherwise. My Med-Cal / Denti-Cal providers are not "biologic" dentists.

I have four questions. 1) How important do you think the complete removal of the periodontal ligament really is? 2) If the extraction is surgical vs. simple, is it likely that the ligament would be removed anyway? Perhaps because some extra surrounding bone may need to be removed? 3) If removal of the tendon is not standard practice by the dental surgeon, can I request it and would they know what to do and not be offended?, and finally 4) If an implant is contemplated, would the region of the removed tooth and perhaps some surrounding bone immediately be packed with a bone substitute for socket preservation? Or would the infection need to clear first?

Answered by Dr. Naveen Thomas


Welcome to icliniq.com.

There is nothing like "Biological" dentists as such, but you might be referring to Oral and Maxillofacial Surgeons. Anyway the removal of root stump of a lateral incisor is a simple procedure and any dentists should do it. There is no separate removal of periodontal ligament, which usually is resorbed by the wound healing itself. In any case, if you are planning implant you should not be removing any surrounding bone at all to get maximum implant attachment and minimal bone graft.

Same symptoms don't mean you have the same problem. Consult a doctor now!

Dr. Naveen Thomas
Dr. Naveen Thomas


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