For the next several weeks, we're sharing exclusive Q&A sessions from The Definitive Veterinary Extraction Protocol, recorded live during the July 2026 course.
As a listener of The Vet Dental Show, you have a limited-time opportunity to purchase the complete course for $300 off.
Learn more and enroll here:
https://ivdi.org/extract
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Host: Dr. Brett Beckman, DVM, FAVD, DAVDC, DAAPM
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In this episode, Dr. Brett Beckman answers practical questions about difficult root tip retrieval in brachycephalic dogs, preventing root fractures, maxillary molar flap closure, and the use of PerioVive and bone graft materials in veterinary dental extraction sites.
He explains why rotated 106 and 206 teeth in brachycephalic patients can make palatal root access especially challengingβand why adequate bone removal, controlled elevation, and patience are critical for reducing root fractures.
Dr. Beckman also discusses whether attached gingiva must cover the distal root of the maxillary fourth premolar after M1 extraction, his perspective on Restorix versus PerioVive, and how extraction-site bleeding influences when and where he places PerioVive.
What You'll Learn in This Episode
π― Why 106 and 206 root retrieval can be difficult in brachycephalic dogs
π― How tooth rotation complicates access to the palatal root
π― Why adequate bone removal can reduce heavy-handed elevation
π― How to approach a palatal root when an apical approach isn't possible
π― Why a circumferential groove can help with difficult root retrieval
π― How excessive elevation pressure contributes to root fracture
π― Why patience can reduce the risk of fracturing difficult roots
π― How to position a diverging incision during maxillary M1 extraction
π― Whether attached gingiva must completely cover the distal root of PM4
π― Dr. Beckman's perspective on Restorix versus PerioVive
π― When to place PerioVive based on extraction-site bleeding
Key Veterinary Dentistry Takeaways
π Brachycephalic anatomy can make 106 and 206 extractions more challenging because tooth rotation may limit access to the roots, particularly the palatal root.
π Adequate visualization and bone removal can reduce the force required during elevation and help minimize root fracture.
π When an apical approach isn't possible, Dr. Beckman recommends creating a circumferential groove and carefully leveraging the root outward without applying apical pressure.
π Increasing torque because a tooth isn't moving can turn a difficult extraction into a root tip retrieval. Controlled, patient elevation is key.
π Complete gingival coverage adjacent to the distal root of PM4 may not always be achievable after M1 extraction. Appropriate flap design, remaining attached gingiva, home care, and postoperative reevaluation are important.
π Dr. Beckman does not routinely recommend Restorix for general practice dentistry and discusses why he prefers the approach he uses with PerioVive.
π In sites with minimal bleeding, PerioVive can be placed directly against bone. In more vascular sites, it can be incorporated as the blood clot begins to form.
Questions This Episode Answers
β Why are 106 and 206 extractions harder in brachycephalic dogs?
β How should you approach a difficult palatal root tip?
β Can better bone removal help prevent root fractures?
β What should you do when you can't approach a palatal root apically?
β Why does excessive torque increase root fracture risk?
β Do you need attached gingiva around PM4 after M1 extraction?
β How does Restorix compare with PerioVive?
β When should PerioVive be placed during an extraction?
β Does extraction-site bleeding change how PerioVive should be used?
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Ready to take your dentistry skills further?
π FREE RACE-Approved CE Course
https://ivdi.org/free
π¦· Live & Online Veterinary Dental Courses
https://veterinarydentistry.net/
π οΈ Dr. Brett's Trusted Equipment & Instruments
https://drbrettspets.com/
π» The Definitive Veterinary Extraction Protocol
https://ivdi.org/extract
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