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Definition of a Surgical Extraction

Discussion in 'Dental Residents and Practicing Dentists' started by MrRongeurs, 04.18.13.


  1. Thanks to Crack the NBDE
  1. MrRongeurs

    MrRongeurs Dental Student

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    Different faculty have given us different definitions of surgical extraction and students at my school are clueless (a 4th year told me she didn't want me to lay a flap because it would make it surgical - increased cost to the pt...).

    I was always under the impression that surgical extraction meant, either:
    1) Sectioning the tooth (with or without surgical handpiece)
    2) Removal of bone (with or without surgical handpiece)

    Are there different definitions (AAMOS vs CDT Codes) for surgical extractions?

    Thanks for all the help! Any resources would be greatly appreciated.
  2. tingting

    tingting

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    You are correct. There needs to be sectioning of the tooth and/or bone removal. I cant speak to the with/without surgical handpiece aspect because I always use one for a surgical ext.

    Personally I always lay a flap on a surgical extraction, however it is not required for the code and is thus irrelevant.
  3. KinKs

    KinKs

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    Good question - generally if I touch a hand piece or raise a flap (15 blade) I deem it surgical. I don't think just sectioning a tooth is a sufficient definition. # 23 will section a tooth sometimes and the extraction does not necessary become surgical.
  4. djeffreyt

    djeffreyt Senior Member

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    Check the dental code definition:

    D7210
    Surgical removal of erupted tooth requiring elevation of mucoperiosteal
    flap and removal of bone and/or section of tooth

    So by definition, there must be raising a flap AND removal of bone/tooth sectioning

    So, if you raie a flap but don't remove bone or section the tooth, then it's not considered surgical
    If you section the tooth but don't raise a flap, it's not considered surgical
    etc.

    In practice, people bill surgicals all the time even if they don't do both a flap and bone removal and sectioning. Some people like to say severing the PDL is raising a full thickness "flap" to make it fit the definition. Then they section the tooth and elevate the roots out. And, frankly, there is a lot to be said for experience. A lot of dentists who practice for long enough know how to get teeth out without flaps and bone removal, but an inexperienced dentist might have problems and need to remove bone and raise a flap. By definition, the inexperienced dentist did a surgical while the experienced one did a simple extraction, but it's unfair that the dentist who is just better at the procedure cannot be paid the same as the inexperienced dentist.
  5. DrTacoElf

    DrTacoElf

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    Surgical extraction has nothing to do with a flap. It is surgical if bone is removed or tooth is sectioned. End of story.

    Soft tissue impaction has to do with a flap but not bone removal.
  6. bsp1013

    bsp1013

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    If I pick up a handpiece, it's surgical.

    If I lay a flap, it's surgical. (but if I'm doing that, I'm going to remove bone, so kind of a moot point)

    If I remove bone, it's surgical.
  7. Diezel69x

    Diezel69x The Oral Pathologist

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    Agreed 100%, but, a case where a tooth has a lot of bone loss on the x-ray and looks like a 2 second extraction but u break off a root tip, lay a flap and get it out do u bill as a surgical?
  8. HupHolland

    HupHolland

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    ^ If I'm fishing for root tips, I bill surgical.
  9. marrkarnell

    marrkarnell

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    To prepare the patient for surgical extraction, a local anesthetic is first applied to numb the tooth and surrounding area. Typically within 5 to 10 minutes the area will be completely numb, lasting between 2 to 3 hours. After numbness has been confirmed by the dentist, the extraction will begin by gaining access to the tooth. Usually this requires opening the gum tissue with a small incision to expose root or bone. With more difficult teeth, a sectioning technique is used to make removal easier. Once the tooth is removed, sutures may be required to close the extraction site.
  10. The Anhedonia

    The Anhedonia

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    wait, i thought it was doorknob + string = tooth extraction. wtf local ane..... what is that?
    :laugh:

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