Extractions, Bone Graft, Sinus Lift, Membrane | Oral Surgery Techniques #1 with Dr. Gallagher

Key Concepts:

1. Less Traumatic Extraction for Future Implant Sites - Prioritizing preservation of interradicular bone and the buccal cortical plate while extracting broken-down, root canal–treated molars, since that bone is critical for long-term implant stability.

2. Lateral Window Sinus Lift Technique - Creating a controlled bony window on the lateral sinus wall, then carefully elevating the Schneiderian membrane without perforation to gain vertical bone height for future implant placement.

3. Socket Preservation & Bone Grafting - Grafting extraction sites (teeth #14–15) simultaneously with the sinus lift to preserve alveolar ridge volume and prepare an adequate implant site.

4. Flap Design and Primary Closure Technique - Using a full-thickness mucoperiosteal flap with a sulcular incision extended to a distal releasing incision, then achieving primary closure with a layered suturing approach over the grafted membrane.

Key Instruments:

- Straight Back-Action Elevator - Wedged into the PDL space between the alveolar bone and root (not into the root) to gain a purchase point and elevate posterior root fragments with a wiggling motion, minimizing surrounding bone removal.

- Spade Elevator - Used as a secondary instrument when the straight elevator couldn't gain sufficient purchase, especially useful near interradicular bone to further minimize drilling.

- Periosteal Elevator - Used to reflect a full-thickness mucoperiosteal flap by elevating tissue cleanly off the bone, exposing the surgical site for the sinus lift and grafting.

- Sinus Curette (Sinus Augmentation Curette Kit) - Spoon-shaped instrument used to gently push and release the sinus floor/Schneiderian membrane after the bony window was created, without tearing the membrane.

- Root Tip Picks (as needed) - Used selectively for retrieving small remaining root fragments while preserving as much surrounding bone as possible for the future implant site.

Top 15 Viewers on this Episode on TikTok LIVE 115 Q&A:

1st – kim baker🌷, @kimdotybaker

2nd – S, @sattyboiii

3rd – USU, @hx.amza

4th – Marcus Chan, @marcuschan60

5th – Joi, @thisisjoi

6th – Deyvvi🇪🇨, @deyvida07

7th – @fratdaddykush

8th – David, @davelo6

9th – sriacosta, @sriart8

10th – Lion, @408williamrd

11th – granitq, @xozen00

12th – Carleigh B, @carleighbryant

13th – Apo kirkuki, @apo.reben

14th – @hofblinders

15th – Kay flynn, @kayflynn17

Top Questions:

(11:36) "Did you do a bone graft after the extraction?"

(14:39) "How did you get primary closure?"

(16:47) "What is a sinus lift? Isn't the sinus your nose?"

(16:47) "What about removing buccal bone?"

(19:46) "Can impurity from a sinus lift perforation cause a sinus infection?"

Now available on:

- Dr. Gallagher’s Podcast & YouTube Channel

My watch in this episode = Tag Heuer Aquaracer Calibre 16 Chrono

9.2026

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