{"id":19247,"date":"2024-10-18T14:55:53","date_gmt":"2024-10-18T12:55:53","guid":{"rendered":"https:\/\/www.zerodonto.com\/en\/?p=19247"},"modified":"2024-10-21T16:35:00","modified_gmt":"2024-10-21T14:35:00","slug":"extraction-without-forceps-ewf-an-innovative-technique-for-atraumatic-dental-extraction","status":"publish","type":"post","link":"https:\/\/www.zerodonto.com\/en\/2024\/10\/extraction-without-forceps-ewf-an-innovative-technique-for-atraumatic-dental-extraction\/","title":{"rendered":"Extraction Without Forceps (EWF): An Innovative Technique for Atraumatic Dental Extraction"},"content":{"rendered":"<h2>Introduction<\/h2>\n<p>Dental avulsion is a common surgical procedure in dentistry, often involving the use of forceps to grasp and remove the tooth from its socket. However, the use of forceps can be associated with a certain degree of trauma to the surrounding tissues, resulting in pain, swelling, and post-operative complications, such as bone and root fractures. In recent years, a new <strong>tooth extraction technique<\/strong> that does not require forceps, called &#8220;<strong>Extraction Without Forceps<\/strong>&#8221; (<strong>EWF<\/strong>), has been developed. This technique, conceived and perfected by me, Dr. Fabio Cozzolino, is based on using elevators to luxate and remove the tooth a-traumatically.<\/p>\n<h2>Physical Principles of Levers<\/h2>\n<p>Levers are simple machines that allow the amplification of the applied force. The operating principle of a lever is based on the law of moments, according to which the moment of a force around a point is equal to the product of the force and its distance from the point. In other words, a small force applied at a great distance from the fulcrum can generate a large force at a short distance from the fulcrum.<\/p>\n<div style=\"width: 1170px;\" class=\"wp-video\"><video class=\"wp-video-shortcode\" id=\"video-19247-1\" width=\"1170\" height=\"658\" preload=\"metadata\" controls=\"controls\"><source type=\"video\/mp4\" src=\"https:\/\/www.zerodonto.com\/en\/wp-content\/uploads\/2024\/10\/Estrazione-atraumatica-senza-pinze-EWF-technique-E.W.F.-Cozzolino.mp4?_=1\" \/><a href=\"https:\/\/www.zerodonto.com\/en\/wp-content\/uploads\/2024\/10\/Estrazione-atraumatica-senza-pinze-EWF-technique-E.W.F.-Cozzolino.mp4\">https:\/\/www.zerodonto.com\/en\/wp-content\/uploads\/2024\/10\/Estrazione-atraumatica-senza-pinze-EWF-technique-E.W.F.-Cozzolino.mp4<\/a><\/video><\/div>\n<p>Archimedes, the famous Greek mathematician and inventor, recognized the power of levers and stated:<\/p>\n<blockquote><p>&#8220;Give me a place to stand, and I will move the Earth.&#8221;<\/p><\/blockquote>\n<p>While hyperbolic, this statement illustrates the potential of levers to amplify force. Common examples of levers in everyday life include crowbars, scissors, and wheelbarrows.<\/p>\n<p><a href=\"https:\/\/www.zerodonto.com\/en\/wp-content\/uploads\/2024\/10\/Leva-per-estrazione-indolore-dente-del-giudizio-EWF.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"alignnone wp-image-19260 size-full\" src=\"https:\/\/www.zerodonto.com\/en\/wp-content\/uploads\/2024\/10\/Leva-per-estrazione-indolore-dente-del-giudizio-EWF.jpg\" alt=\"atraumatic extraction EWF technique - lever\" width=\"1500\" height=\"924\" srcset=\"https:\/\/www.zerodonto.com\/en\/wp-content\/uploads\/2024\/10\/Leva-per-estrazione-indolore-dente-del-giudizio-EWF.jpg 1500w, https:\/\/www.zerodonto.com\/en\/wp-content\/uploads\/2024\/10\/Leva-per-estrazione-indolore-dente-del-giudizio-EWF-300x185.jpg 300w, https:\/\/www.zerodonto.com\/en\/wp-content\/uploads\/2024\/10\/Leva-per-estrazione-indolore-dente-del-giudizio-EWF-1024x631.jpg 1024w, https:\/\/www.zerodonto.com\/en\/wp-content\/uploads\/2024\/10\/Leva-per-estrazione-indolore-dente-del-giudizio-EWF-768x473.jpg 768w, https:\/\/www.zerodonto.com\/en\/wp-content\/uploads\/2024\/10\/Leva-per-estrazione-indolore-dente-del-giudizio-EWF-550x339.jpg 550w\" sizes=\"auto, (max-width: 1500px) 100vw, 1500px\" \/><\/a><br \/>\nThe mechanical advantage of a lever is the ratio between the resisting force (the force to be overcome) and the driving force (the applied force). In the case of EWF, the resisting force is the tooth&#8217;s resistance to extraction, while the driving force is the force applied to the lever. The mechanical advantage depends on the length of the lever arms: the greater the arm of the driving force relative to the resisting force arm, the greater the mechanical advantage.<\/p>\n<p><iframe loading=\"lazy\" title=\"Extraction Without Forceps (EWF technique) - upper molar - Dr. Fabio Cozzolino\" width=\"1170\" height=\"658\" src=\"https:\/\/www.youtube.com\/embed\/gjg-LUViO7s?feature=oembed\" frameborder=\"0\" allow=\"accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture; web-share\" referrerpolicy=\"strict-origin-when-cross-origin\" allowfullscreen><\/iframe><\/p>\n<h2>Types of Levers<\/h2>\n<p>From a biomechanical perspective, there are three types of levers, classified based on the position of the fulcrum, driving force, and resisting force.<\/p>\n<ul>\n<li><strong>First-class levers:<\/strong> The fulcrum is between the driving force and the resisting force (e.g., seesaw, scissors).<\/li>\n<li><strong>Second-class levers:<\/strong> The resisting force is between the fulcrum and the driving force (e.g., wheelbarrow, nutcracker).<\/li>\n<li><strong>Third-class levers:<\/strong> The driving force is between the fulcrum and the resisting force (e.g., tweezers, fishing rod).<br \/>\nIn EWF, depending on the position of the lever and the tooth, different types of levers may be used.<\/li>\n<\/ul>\n<div id=\"attachment_19258\" style=\"width: 1410px\" class=\"wp-caption alignnone\"><a href=\"https:\/\/www.zerodonto.com\/en\/wp-content\/uploads\/2024\/10\/Leva-personalizzata-per-estrazione-atraumatica-EWF-Cozzolino.jpg\"><img loading=\"lazy\" decoding=\"async\" aria-describedby=\"caption-attachment-19258\" class=\"wp-image-19258 size-full\" src=\"https:\/\/www.zerodonto.com\/en\/wp-content\/uploads\/2024\/10\/Leva-personalizzata-per-estrazione-atraumatica-EWF-Cozzolino.jpg\" alt=\"Custom Lever for Dr. Cozzolino - EWF technique\" width=\"1400\" height=\"935\" srcset=\"https:\/\/www.zerodonto.com\/en\/wp-content\/uploads\/2024\/10\/Leva-personalizzata-per-estrazione-atraumatica-EWF-Cozzolino.jpg 1400w, https:\/\/www.zerodonto.com\/en\/wp-content\/uploads\/2024\/10\/Leva-personalizzata-per-estrazione-atraumatica-EWF-Cozzolino-300x200.jpg 300w, https:\/\/www.zerodonto.com\/en\/wp-content\/uploads\/2024\/10\/Leva-personalizzata-per-estrazione-atraumatica-EWF-Cozzolino-1024x684.jpg 1024w, https:\/\/www.zerodonto.com\/en\/wp-content\/uploads\/2024\/10\/Leva-personalizzata-per-estrazione-atraumatica-EWF-Cozzolino-768x513.jpg 768w, https:\/\/www.zerodonto.com\/en\/wp-content\/uploads\/2024\/10\/Leva-personalizzata-per-estrazione-atraumatica-EWF-Cozzolino-550x367.jpg 550w\" sizes=\"auto, (max-width: 1400px) 100vw, 1400px\" \/><\/a><p id=\"caption-attachment-19258\" class=\"wp-caption-text\">Custom Lever for Dr. Cozzolino<\/p><\/div>\n<p>Each lever has its method of use. In general terms, the lever should pivot on the bone and be used with a rotational motion applied to the handle, along with pressure directed apically and toward the tooth to be extracted. This approach helps avoid damage to the adjacent tooth.<\/p>\n<p><a href=\"https:\/\/www.zerodonto.com\/en\/wp-content\/uploads\/2024\/10\/Leva-personalizzata-per-estrazione-E.W.F.-Dr-Fabio-Cozzolino.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"alignnone wp-image-19259 size-full\" src=\"https:\/\/www.zerodonto.com\/en\/wp-content\/uploads\/2024\/10\/Leva-personalizzata-per-estrazione-E.W.F.-Dr-Fabio-Cozzolino.jpg\" alt=\"\" width=\"1400\" height=\"935\" srcset=\"https:\/\/www.zerodonto.com\/en\/wp-content\/uploads\/2024\/10\/Leva-personalizzata-per-estrazione-E.W.F.-Dr-Fabio-Cozzolino.jpg 1400w, https:\/\/www.zerodonto.com\/en\/wp-content\/uploads\/2024\/10\/Leva-personalizzata-per-estrazione-E.W.F.-Dr-Fabio-Cozzolino-300x200.jpg 300w, https:\/\/www.zerodonto.com\/en\/wp-content\/uploads\/2024\/10\/Leva-personalizzata-per-estrazione-E.W.F.-Dr-Fabio-Cozzolino-1024x684.jpg 1024w, https:\/\/www.zerodonto.com\/en\/wp-content\/uploads\/2024\/10\/Leva-personalizzata-per-estrazione-E.W.F.-Dr-Fabio-Cozzolino-768x513.jpg 768w, https:\/\/www.zerodonto.com\/en\/wp-content\/uploads\/2024\/10\/Leva-personalizzata-per-estrazione-E.W.F.-Dr-Fabio-Cozzolino-550x367.jpg 550w\" sizes=\"auto, (max-width: 1400px) 100vw, 1400px\" \/><\/a><\/p>\n<p>In dental extraction with an elevator, the biomechanical situation is dynamic and can vary depending on:<\/p>\n<ul>\n<li><strong>The type of lever used<\/strong>: Elevators come in different shapes and sizes, each with its point of force application and different fulcrum.<\/li>\n<li><strong>The position of the lever with the tooth<\/strong>: Depending on how the elevator is inserted and manoeuvred, the fulcrum can shift, allowing the elevator to act as a first-, second-, or third-class lever.<\/li>\n<li><strong>The phase of extraction<\/strong>: During the initial luxation, the elevator may act as a first-class lever, with the fulcrum on the alveolar bone. Later, during the tooth elevation, it could function as a second-class lever, with the fulcrum on the adjacent tooth.<\/li>\n<\/ul>\n<p>For these reasons, EWF utilizes the principles of all three types of levers.<\/p>\n<p><iframe loading=\"lazy\" title=\"Dr. Fabio Cozzolino | Wisdom tooth Extraction Without Forceps (E.W.F.) | Zerodonto\" width=\"1170\" height=\"658\" src=\"https:\/\/www.youtube.com\/embed\/DVVlhWzmcN8?feature=oembed\" frameborder=\"0\" allow=\"accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture; web-share\" referrerpolicy=\"strict-origin-when-cross-origin\" allowfullscreen><\/iframe><\/p>\n<h2>Application of Levers in EWF<\/h2>\n<p>In EWF, levers are used to apply controlled forces to the tooth, exploiting the principle of levers to amplify the force and luxate and extract the tooth from the socket. The elevator is positioned between the tooth and the alveolar bone, and force is applied in an apical and lateral direction while simultaneously rotating the lever along its axis. The choice of the type of lever and the force application point depends on the shape and position of the tooth.<\/p>\n<div id=\"attachment_19257\" style=\"width: 1010px\" class=\"wp-caption alignnone\"><a href=\"https:\/\/www.zerodonto.com\/en\/wp-content\/uploads\/2024\/10\/EWF-extraction-without-forceps-Dr-Fabio-Cozzolino.jpg\"><img loading=\"lazy\" decoding=\"async\" aria-describedby=\"caption-attachment-19257\" class=\"size-full wp-image-19257\" src=\"https:\/\/www.zerodonto.com\/en\/wp-content\/uploads\/2024\/10\/EWF-extraction-without-forceps-Dr-Fabio-Cozzolino.jpg\" alt=\"EWF-extraction-without-forceps-Dr-Fabio-Cozzolino\" width=\"1000\" height=\"1000\" srcset=\"https:\/\/www.zerodonto.com\/en\/wp-content\/uploads\/2024\/10\/EWF-extraction-without-forceps-Dr-Fabio-Cozzolino.jpg 1000w, https:\/\/www.zerodonto.com\/en\/wp-content\/uploads\/2024\/10\/EWF-extraction-without-forceps-Dr-Fabio-Cozzolino-300x300.jpg 300w, https:\/\/www.zerodonto.com\/en\/wp-content\/uploads\/2024\/10\/EWF-extraction-without-forceps-Dr-Fabio-Cozzolino-150x150.jpg 150w, https:\/\/www.zerodonto.com\/en\/wp-content\/uploads\/2024\/10\/EWF-extraction-without-forceps-Dr-Fabio-Cozzolino-768x768.jpg 768w, https:\/\/www.zerodonto.com\/en\/wp-content\/uploads\/2024\/10\/EWF-extraction-without-forceps-Dr-Fabio-Cozzolino-550x550.jpg 550w, https:\/\/www.zerodonto.com\/en\/wp-content\/uploads\/2024\/10\/EWF-extraction-without-forceps-Dr-Fabio-Cozzolino-80x80.jpg 80w\" sizes=\"auto, (max-width: 1000px) 100vw, 1000px\" \/><\/a><p id=\"caption-attachment-19257\" class=\"wp-caption-text\">elevators for atraumatic extraction &#8211; Dr. Fabio Cozzolino<\/p><\/div>\n<div id=\"attachment_19256\" style=\"width: 1010px\" class=\"wp-caption alignnone\"><a href=\"https:\/\/www.zerodonto.com\/en\/wp-content\/uploads\/2024\/10\/leve-per-estrazione-atraumatica-EWF-E.W.F.-Cozzolino.jpg\"><img loading=\"lazy\" decoding=\"async\" aria-describedby=\"caption-attachment-19256\" class=\"size-full wp-image-19256\" src=\"https:\/\/www.zerodonto.com\/en\/wp-content\/uploads\/2024\/10\/leve-per-estrazione-atraumatica-EWF-E.W.F.-Cozzolino.jpg\" alt=\"levers for atraumatic extractions E.W.F.\" width=\"1000\" height=\"1000\" srcset=\"https:\/\/www.zerodonto.com\/en\/wp-content\/uploads\/2024\/10\/leve-per-estrazione-atraumatica-EWF-E.W.F.-Cozzolino.jpg 1000w, https:\/\/www.zerodonto.com\/en\/wp-content\/uploads\/2024\/10\/leve-per-estrazione-atraumatica-EWF-E.W.F.-Cozzolino-300x300.jpg 300w, https:\/\/www.zerodonto.com\/en\/wp-content\/uploads\/2024\/10\/leve-per-estrazione-atraumatica-EWF-E.W.F.-Cozzolino-150x150.jpg 150w, https:\/\/www.zerodonto.com\/en\/wp-content\/uploads\/2024\/10\/leve-per-estrazione-atraumatica-EWF-E.W.F.-Cozzolino-768x768.jpg 768w, https:\/\/www.zerodonto.com\/en\/wp-content\/uploads\/2024\/10\/leve-per-estrazione-atraumatica-EWF-E.W.F.-Cozzolino-550x550.jpg 550w, https:\/\/www.zerodonto.com\/en\/wp-content\/uploads\/2024\/10\/leve-per-estrazione-atraumatica-EWF-E.W.F.-Cozzolino-80x80.jpg 80w\" sizes=\"auto, (max-width: 1000px) 100vw, 1000px\" \/><\/a><p id=\"caption-attachment-19256\" class=\"wp-caption-text\">(Photo by Dr. Fabio Cozzolino \u2013 elevators for atraumatic extractions E.W.F.)<\/p><\/div>\n<p>During a traditional tooth extraction with forceps, force is applied at two points, forcing the tooth to follow a predefined direction, which may not coincide with its path of least resistance. This can cause stress on the root and increase the risk of fracture, especially if the root is thin or has a pronounced curvature.<br \/>\nIn contrast, during tooth extraction with elevators, force is applied at a single point, allowing the tooth to rotate and follow its path of least resistance within the socket. This way, the root experiences less stress, and the risk of fracture is significantly reduced.<\/p>\n<p>For example, if you have a toy train on a track and apply an oblique force to it, its movement will not precisely follow the direction of the force but rather that of the tracks. Why? The force is applied at a single point, so the resultant force will push it in the direction of least resistance, following the track\u2019s path. If forceps were used, it could change the train\u2019s path, forcing its movement, which likely would not follow the path of least resistance, causing the train to derail.<\/p>\n<div style=\"width: 1170px;\" class=\"wp-video\"><video class=\"wp-video-shortcode\" id=\"video-19247-2\" width=\"1170\" height=\"658\" preload=\"metadata\" controls=\"controls\"><source type=\"video\/mp4\" src=\"https:\/\/www.zerodonto.com\/en\/wp-content\/uploads\/2024\/10\/estrazione-atraumatica-cozzolino.mp4?_=2\" \/><a href=\"https:\/\/www.zerodonto.com\/en\/wp-content\/uploads\/2024\/10\/estrazione-atraumatica-cozzolino.mp4\">https:\/\/www.zerodonto.com\/en\/wp-content\/uploads\/2024\/10\/estrazione-atraumatica-cozzolino.mp4<\/a><\/video><\/div>\n<h2><strong>Advantages of EWF<\/strong><\/h2>\n<p>EWF offers several advantages over traditional extraction with forceps:<\/p>\n<ul>\n<li><strong>Reduced perception of force:<\/strong> Using levers allows for a lower force to achieve the same extraction effect, reducing the patient&#8217;s perception of force.<\/li>\n<li><strong>Lower risk of fractures:<\/strong> With EWF, the tooth is free to follow its path of least resistance during extraction, reducing the risk of root fractures.<\/li>\n<li><strong>Faster extraction:<\/strong> The force amplification provided by levers allows for quicker tooth extraction. Often, an extraction can be completed in just a few seconds.<\/li>\n<\/ul>\n<p><iframe loading=\"lazy\" title=\"Dr. Fabio Cozzolino - Lower Wisdom Tooth Extraction Without Forceps (E.W.F.)\" width=\"1170\" height=\"658\" src=\"https:\/\/www.youtube.com\/embed\/g7tfbmJEImg?feature=oembed\" frameborder=\"0\" allow=\"accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture; web-share\" referrerpolicy=\"strict-origin-when-cross-origin\" allowfullscreen><\/iframe><\/p>\n<h2>EWF Technique<\/h2>\n<p>The EWF technique involves the following steps:<\/p>\n<ol>\n<li><strong>Anaesthesia:<\/strong> Local anaesthesia is administered to ensure patient comfort.<\/li>\n<li><strong>Probing:<\/strong> A periodontal probe is used to evaluate the depth of periodontal pockets and the anatomy of the tooth.<\/li>\n<li><strong>Elevator insertion:<\/strong> The elevator is inserted into the periodontal space, between the tooth and the alveolar bone.<\/li>\n<li><strong>Force application:<\/strong> Controlled force is applied to the lever in an apical and lateral direction, rotating the lever along its axis. This first luxates the tooth and then avulses it from the socket.<\/li>\n<li><strong>Tooth removal:<\/strong> Once the tooth is displaced from its socket, it is gently removed, possibly using dental forceps.<\/li>\n<li><strong>Stitches:<\/strong> If possible, it is recommended to avoid stitches. While stitches stabilize the clot, they are also the primary cause of post-extraction alveolitis, as food can get trapped inside the socket, causing inflammation of the surrounding tissues.<\/li>\n<\/ol>\n<p><iframe loading=\"lazy\" title=\"Wisdom Tooth Extraction Without Forceps (E.W.F.) | Dr. Fabio Cozzolino, Zerodonto\" width=\"1170\" height=\"658\" src=\"https:\/\/www.youtube.com\/embed\/x65o5L4cmH4?feature=oembed\" frameborder=\"0\" allow=\"accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture; web-share\" referrerpolicy=\"strict-origin-when-cross-origin\" allowfullscreen><\/iframe><\/p>\n<h2>Possible Complications<\/h2>\n<p>Like all techniques, this one is not free from complications and is operator-dependent.<br \/>\nAlthough the force applied by the operator is minimal, the force exerted on the tooth is significantly greater \u2013 due to the lever principle \u2013 and some complications can arise:<\/p>\n<ul>\n<li><strong>Bone fracture:<\/strong> This can occur if the fulcrum, which must bear the load, fails, causing a bone fracture.<\/li>\n<li><strong>Fracture of adjacent teeth:<\/strong> If force is applied by leveraging an adjacent tooth, it may result in a fracture of that tooth.<\/li>\n<\/ul>\n<p><iframe loading=\"lazy\" title=\"Extraction Without Forceps (E.W.F.) - Dr. Fabio Cozzolino | Zerodonto\" width=\"1170\" height=\"658\" src=\"https:\/\/www.youtube.com\/embed\/ka1F-rcsIiU?feature=oembed\" frameborder=\"0\" allow=\"accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture; web-share\" referrerpolicy=\"strict-origin-when-cross-origin\" allowfullscreen><\/iframe><\/p>\n<h2>Clinical Experience<\/h2>\n<p>In my clinical practice, using EWF has led to a significant reduction in root fractures during dental avulsion. Although no scientific data is available to support this observation, my experience suggests a reduction of over 80% in fractures compared to traditional forceps extraction.<\/p>\n<p>In my thirty years of experience, I have not encountered bone or adjacent tooth fractures. However, I have twice seen the fracture of a ceramic crown on an adjacent tooth, leading me to advise against using elevators between two teeth if the adjacent tooth has a ceramic crown.<\/p>\n<p>My clinical data reinforce the idea that EWF is a less traumatic technique, more respectful of the tooth&#8217;s anatomy.<\/p>\n<p><iframe loading=\"lazy\" title=\"Double Elevator Wisdom Tooth Extraction Without Forceps - Dr. Fabio Cozzolino | Zerodonto\" width=\"1170\" height=\"658\" src=\"https:\/\/www.youtube.com\/embed\/t_ayPHJwJtA?feature=oembed\" frameborder=\"0\" allow=\"accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture; web-share\" referrerpolicy=\"strict-origin-when-cross-origin\" allowfullscreen><\/iframe><\/p>\n<h2>Conclusions<\/h2>\n<p>EWF represents a significant innovation in dental avulsion. This technique, based on applying the physical principles of levers, offers numerous advantages over traditional forceps extraction, including reduced patient perception of force, a lower risk of root fractures, and faster extraction times.<\/p>\n<p>EWF is a safe and effective technique that can improve the patient&#8217;s experience during dental avulsion.<\/p>\n<h2>References and links<\/h2>\n<ul>\n<li class=\"heading-title\"><span class=\"authors-list-item \">L Montebugnoli, <\/span>[<em>Lever in tooth extraction. Physical and clinical principles<\/em>] &#8211; Dental Cadmos,<span class=\"period\">\u00a0<\/span><span class=\"cit\">1990 Oct 15;58(15):101-5. &#8211; <\/span><span class=\"identifier pubmed\"><span class=\"id-label\">PMID:\u00a0<\/span>2279594<\/span><\/li>\n<li class=\"heading-title\"><span class=\"authors-list-item \">L Montebugnoli<span class=\"comma\">,\u00a0<\/span><\/span><span class=\"authors-list-item \">G P Rizzi<span class=\"comma\">,\u00a0<\/span><\/span><span class=\"authors-list-item \">M A Vaccaro, <\/span>[<em>Forceps in tooth extraction. Method of use and working position<\/em>] &#8211; Dental Cadmos, 1991 May 31;59(9):54-61. &#8211; <span class=\"identifier pubmed\"><span class=\"id-label\">PMID:\u00a0<\/span>1864424<\/span><\/li>\n<li class=\"heading-title\"><span class=\"authors-list-item \">Carl E Misch<sup class=\"affiliation-links\"><span class=\"author-sup-separator\">\u00a0<\/span>1<\/sup><span class=\"comma\">,\u00a0<\/span><\/span><span class=\"authors-list-item \">Helena M Perez, <\/span><em>Atraumatic extractions: a biomechanical rationale<\/em> &#8211; Dent Today, <span class=\"period\">.\u00a0<\/span><span class=\"cit\">2008 Aug;27(8):98, 100-1. &#8211;<\/span><span class=\"identifier pubmed\"><span class=\"id-label\">PMID:\u00a0<\/span>18717405<\/span><\/li>\n<li><span class=\"authors-list-item \">Tushar N Bhosale<span class=\"comma\">,\u00a0<\/span><\/span><span class=\"authors-list-item \">Kalyani Bhate<span class=\"comma\">,\u00a0<\/span><\/span><span class=\"authors-list-item \">Sherwin Samuel<span class=\"comma\">,\u00a0<\/span><\/span><span class=\"authors-list-item \">George Jacob, <\/span><em>Comparative evaluation of efficacy of physics forcep and conventional forceps for extraction of maxillary molars &#8211;\u00a0<\/em>Minerva Dent Oral Sci, 2024 Apr;73(2):75-80.<br \/>\n<span class=\"citation-doi\">doi: 10.23736\/S2724-6329.23.04740-X.<\/span>\u00a0<span class=\"secondary-date\">Epub 2023 Jun 16. &#8211;\u00a0<\/span><span class=\"identifier pubmed\"><span class=\"id-label\">PMID:\u00a0<\/span>37326503<\/span><\/li>\n<li><span style=\"text-decoration: underline;\"><a href=\"https:\/\/it.wikipedia.org\/wiki\/Estrazione_dentaria\" target=\"_blank\" rel=\"noopener\">Estrazione Dentaria su Wikipedia<\/a><\/span><\/li>\n<li><span style=\"text-decoration: underline;\"><a href=\"https:\/\/it.wikipedia.org\/wiki\/Dente_del_giudizio\" target=\"_blank\" rel=\"noopener\">Dente del Giudizio su Wikipedia<\/a><\/span><\/li>\n<\/ul>\n","protected":false},"excerpt":{"rendered":"<p>Introduction Dental avulsion is a common surgical procedure in dentistry, often involving the use of forceps to grasp and remove the tooth from its socket. However, the use of forceps can be associated with a certain degree of trauma to the surrounding tissues, resulting in pain, swelling, and post-operative complications, such as bone and root fractures. In recent years, a new tooth extraction technique that does not require forceps, called &#8220;Extraction Without Forceps&#8221; (EWF), has been developed. This technique, conceived and perfected by me, Dr. Fabio Cozzolino, is based on using elevators to luxate and remove the tooth a-traumatically. Physical Principles of Levers Levers are simple machines that allow the amplification of the applied force. The operating principle of a lever is based on the law of moments, according to which the moment of a force around a point is equal to the product of the force and its distance from the point. In other words, a small force applied at a great distance from the fulcrum can generate a large force at a short distance from the fulcrum. Archimedes, the famous Greek mathematician and inventor, recognized the power of levers and stated: &#8220;Give me a place to stand, and [&hellip;]<\/p>\n","protected":false},"author":2,"featured_media":19257,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[41],"tags":[],"coauthors":[23],"class_list":["post-19247","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-oral-surgery"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v28.7 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Extraction Without Forceps (EWF): An Innovative Technique for Atraumatic Dental Extraction | Zerodonto | Dentistry in Blog<\/title>\n<meta name=\"description\" content=\"The EWF technique, developed and refined by Dr. Fabio Cozzolino, is an atraumatic tooth extraction method based on the use of elevator.\" \/>\n<meta name=\"robots\" content=\"index, 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