Periotomes Versus Conventional Elevators for Orthodontic

Tooth extraction traditionally involves forceps and elevators, which can cause significant tissue trauma. Preserving soft and hard tissue architecture is crucial for long-term oral health, function, and aesthetics. The periotome, a novel instrument combining a mini scalpel and miniature elevator, offers a potential alternative to conventional extraction methods.Aim: To evaluate the efficacy of periotomes compared to conventional elevators during orthodontic premolar extractions.Methods: A comparative split-mouth study was conducted with 15 patients requiring bilateral premolar extractions. Extractions were performed using two different techniques:-Test side: Periotomes-Control side: Coupland No. 1 elevator Both sides used a wedging technique without flap elevation, with tooth delivery accomplished using premolar forceps. The study assessed multiple parameters including:-Extraction duration-Intraoperative pressure perception-Postoperative pain (days 1, 3, and 7)-Gingival laceration grading-Potential complications-Rescue analgesic consumption Statistical analysis was performed with a significance level set at P<0.05 and a 95% confidence interval. Results: While periotomes required longer extraction times, they demonstrated superior outcomes across multiple parameters including, reduced intraoperative pressure perception, decreased postoperative pain, minimal gingival laceration, fewer complications and reduced rescue analgesic usage.Conclusion: Despite longer extraction times, periotomes provide a more atraumatic approach to tooth extraction compared to conventional elevators,potentially offering improved patient comfort and tissue preservation.