This emergency patient presented to my office with a non-salvageable upper left first molar.
I was successful in removing the roots without raising a flap. This less traumatic procedure eliminated the need for sutures and minimized post operative discomfort.

Key points: 1. High powered magnification (6.00). 2. Xylocaine with 1:50,000 epinephrine to control bleeding and allow better visualization. 3. A surgical currette to remove overlying granulation tissue. 4. A narrow long shanked bur to remove minimal amount of bone circumferentially around the root. 5. A root elevator to gently mobilize the exposed roots. It is also very important to have the patient raise his head to allow direct visualization.

That, and a good dental assistant (or two) that knows procedures (proper suctioning) and instrumentation.