November 20, 2025

Surgical Extrusion Technique Update – Alternative to Ortho Extrusion or CLS – PDP249

1 hour 7 minutes

Do you have a “hopeless” retained root you’re ready to extract?

Think implants, dentures, or bridges are the only way forward?

What if there’s a way to save that tooth — predictably and biologically?

In this episode, Dr. Vala Seif shares his experience with the Surgical Extrusion Technique — a game-changing approach that lets you reposition the root coronally to regain ferrule and restore teeth once thought impossible to save.

Jaz and Dr. Seif dive into case selection, atraumatic technique, stabilization, and timing, all guided by Dr. Seif’s own SAFE/SEIF Protocol, developed from over 200 successful cases.

https://youtu.be/2TyodqgAP9w

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Protrusive Dental Pearl: When checking a ferrule, consider height, thickness, and location of functional load. Upper teeth: prioritize palatal ferrule. Lower teeth: prioritize buccal. Tip: do a partial surgical extrusion, rotate the tooth 180°, then stabilize.

Need to Read it? Check out the Full Episode Transcript below!

Key Takeaways

Surgical extrusion is a technique-sensitive procedure that requires careful planning.

Case selection is crucial for the success of surgical extrusion.

A crown-root ratio of 1:1 is ideal for surgical extrusion.

Patients are often more cooperative when they see surgical extrusion as their last chance to save a tooth.

Surgical extrusion can be more efficient than orthodontic extrusion in certain cases.

The importance of ferrule in dental restorations cannot be overstated.

Proper case selection is crucial for successful outcomes.

Atraumatic techniques are essential for preserving tooth structure.

The ‘Safe Protocol’ offers a structured approach to surgical extrusion.

Patient communication is key to managing expectations.

Flowable composite is preferred for tooth fixation post-extraction.

Understanding root morphology is important for successful extractions.

Highlights of this episode:

00:00 Surgical Extrusion Podcast Teaser

01:07 Introduction

02:38 Protrusive Dental Pearl

05:53 Interview with Dr. Vala Seif

08:57 Definition and Philosophy of Surgical Extrusion

15:30 Indications, Case Selection, and Root Morphology

21:37 Comparing Surgical and Orthodontic Extrusion

25:54 Crown Lengthening Drawbacks

28:39 Occlusal Considerations

33:53 Midroll

37:16 Definition and Importance of the Ferrule

43:07 Clinical Protocols and Fixation Methods

01:00:01 Post-Extrusion Care and Final Restoration

01:05:04 Learning More and Final Thoughts

01:09:29 Outro

Further Learning:

Instagram: @extrusionmaster — case examples, papers, and protocol updates.

Online and in-person courses in development (Europe + global access).

Loved this episode? Don’t miss “How to Save ‘Hopeless’ Teeth with the Surgical Extrusion Technique” – PDP061

#PDPMainEpisodes #OralSurgeryandOralMedicine #OrthoRestorative

This episode is eligible for 1 CE credit via the quiz on Protrusive Guidance.

This episode meets GDC Outcomes C.

AGD Subject Code: 310 ORAL AND MAXILLOFACIAL SURGERY

Aim: To understand the biological and clinical principles of surgical extrusion as a conservative alternative to orthodontic extrusion or crown lengthening for managing structurally compromised teeth.

Dentists will be able to –

Identify suitable clinical cases for surgical extrusion, including correct root morphology and crown–root ratios.

Describe the step-by-step SAFE Protocol for atraumatic surgical extrusion, fixation, and timing of endodontic treatment.

Evaluate the advantages, limitations, and biomechanical considerations of surgical extrusion compared with orthodontic extrusion and crown lengthening.

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By Jaz Gulati

4.7

2020 ratings