Most general dentists who do surgical extractions use a high-speed.
But if they won’t use a straight hand-piece when needed, they will fail.
However, the straight hand-piece can be one they already own like the Star brand in picture 1 (20,000 rpm).
By fail, I mean they will resort to buccal bone removal which means unnecessary treatment time, trauma and expense (grafting) for their patients.
WHY would you occasionally need a straight?
1. Teeth that are decayed or fractured “sub-crestal” to the ridge (see picture 2) often require skinny bur troughing (see picture 3).
2. Into the depth of that trough, is inserted a 3-5 mm wide skinny instrument vertically (like a Luxator) to apply lateral rotation and cause luxation. That trough could be 10 mm deep (give or take).
3. If there is an intact crown on the mesial and distal of the tooth you are extracting, the big high-speed head plus the fact you can’t extend the bur out of the head more than 1-2 mm, means you can never attain the required trough depth.
4. You also will not be able to get the angle to create the trough “in the periodontal ligament” where ideally you would be removing half bone and half tooth.
5. Irrigation would be required. See picture 4 for syringes used for sterile saline.
A 20K rpm straight hand-piece is not used to section enamel but is more than adequate for going into the PDL to cut bone and dentin. If your high-speed is not a “surgical” one, you open yourself to litigation.
These principles are covered in Continuum. 1 (surgical extractions model work), Cont. 3 (patient treatment), and Continuum. 4 (third molar surgery).
