instruction: hi doctor my lateral incisor 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 how important do you think the complete removal of the periodontal ligament really is if the extraction is surgical is simple is it likely that the ligament would be removed anyway perhaps because some extra surrounding bone may need to be removed 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 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
output: hello 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 resorted 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