Dr. Tony Pogrel: Nuances of Coronectomy and Intentional Root Retention During Extraction

Everyday Oral Surgery

Welcome back to the Everyday Oral Surgery Podcast! Joining us in conversation today is Dr. Tony Pogrel, an oral and maxillofacial surgeon practicing in San Francisco. Tune in today to hear the story of how Dr. Pogrel first discovered coronectomy during a talk by a Scottish surgeon, and the work he has done to popularize the method and educate surgeons on its benefits. We talk through insurance, obstacles practitioners face, and which situations the surgery is most appropriate for. We touch on conversations with patients, root mobilization, statistics, and more, before finding out what has been inspiring Dr. Pogrel lately. Join us today to hear more.

Key Points From This Episode:

• Where to pose your questions about Everyday Oral Surgery online.
• An introduction to today’s guest, Dr. Tony Pogrel, and his career history.
• The story of how he came to be a part of the faculty of the University of California, San Francisco.
• His research into coronectomy with a talk by a Scottish surgeon involving long-term follow-ups.
• The criticism and derision he experienced when he first started performing the coronectomy.
• How he went about popularizing and educating folks about this method.
• Medical insurance, coronectomy coverage, and the standard of care.
• Biggest obstacles faced by practitioners in terms of coronectomy, including convincing other surgeons, and billing for it.
• When it is necessary to get a CT scan: when it is going to make a difference to what you do.
• Cases where it is appropriate to consider the option of having a coronectomy.
• The kind of conversation you have to have with a patient before doing the procedure.
• The infection rate which is lower than that of wisdom tooth removal.
• The biggest problem: coronectomy stimulating the roots left behind, and the eruption that occurs.
• Different coronectomy techniques and why you cannot afford to mobilize roots.
• Which patients you can’t do a coronectomy on: younger patients.
• Controversial issues across the globe: leaving the socket open, antibiotics, and more.
• A detailed summary of the surgery performed during a coronectomy.
• How studies have shown that it is not beneficial to fill the space with collagen, bone graft, or another material.
• How insurance works and the letter of explanation that you can write to get coverage.
• Why he teaches students that if the remaining root has not been mobilized, they can leave it in.
• Where to reach Dr. Pogrel via the University of California.
• The best book he has read this year: Successful Aging.
• A non-oral surgery method he implements that helps him with his daily skills: he makes things, most recently, a garden shed.
• The forceps he uses to extract Tooth 14: regular left molar forceps
• His favorite film: Casablanca or Gone with the Wind.
• Favorite quote: Churchill and Lady Aster on poison.

Links Mentioned in Today’s Episode:

Successful Aging on Amazon — https://www.amazon.com/Successful-Aging-Neuroscientist-Explores-Potential/dp/1524744182

Dr. Tony Pogrel on Twitter — https://www.linkedin.com/in/tony-pogrel-b26618218/

Dr. Grant Stucki Email — [e-mail]

Dr. Grant Stucki Phone — 720-441-6059

Everyday Oral Surgery — https://www.everydayoralsurgery.com/