The iM3 Vet-Tome is making both routine and challenging dental extractions easier on the veterinary practitioner. This new and unique machine can greatly reduce operating time, operator fatigue, and patient trauma. It not only minimizes the need to remove bone (although not in every case), but also reduces the use of elevators and luxators. In some cases, it even eliminates the need to complete a periodontal flap.
What is the iM3 Vet-Tome? The iM3 Vet-Tome is essentially an automated electric periotome with foot pedal control. Its jack-hammer-like mechanical movement (calculated at 20 cycles per second) is designed to sever the periodontal ligament without damaging bone or soft tissue. The unit comes with two sizes of replaceable tips that are designed to stay in the periodontal ligament space during use. It is important to understand that the Vet-Tome is not intended to replace conventional extraction techniques; instead it should been seen as an additional tool to assist with certain extraction cases.
"The Vet-Tome gives you the ability to perform a truly minimally invasive extraction, which means more rapid socket healing and less pain for the pet. In my humble opinion, the Vet-Tome will be a game changer for the veterinary profession" Anthony Caiafa BVSc BDSc MANZCVS
The operator should begin the extraction procedure using conventional techniques, using a scalpel blade or elevator to cut the epithelial attachment around the tooth. The tip of the Vet-Tome can then be inserted parallel to the tooth root at a 45° angle. The manufacturer recommends a duty cycle of 10 second intervals (10 on/10 off) to allow the handpiece to cool throughout the procedure.
For medium and large sized dogs, the manufacturer recommends starting the luxation process with the V2 tip. The V2 tip (IM-V2002) is a thicker, less flexible tip used to create room in the periodontal ligament space. Because the V2 tip is less likely to bend with the curvature of the root, it is usually followed by the use of the thinner, more flexible V1 tip (IM-V2001). For cats and small dogs the manufacturer recommends that the V1 tip is used for the entire procedure, as the V2 tip is too bulky and inflexible for smaller patients.
The Vet-Tome is programmed with power settings from 1 -10, with the manufacturer recommending that a setting of 2 be used for cats and small dogs and a setting of 7 be used for medium and large dogs. It is suggested, however, that all new users take the time to try out each of the settings in order to get a feel for what works most efficiently for them.
It is essential that the operator fully support the jaw while the Vet-Tome is being used. A gentle side to side action by the user is used to sever the periodontal ligament while gradually progressing towards the apex of the root. The same side to side action is used to withdraw the tip as needed. When you have inserted the tip as far as it will go, simply withdraw the tip and follow the same motion on a different surface of the tooth root until you have worked around the circumference of the tooth. This process is repeated in order to make your way further along the root of the tooth. A higher pitched sound and a sensation similar to hitting a “dead end” or “wall” will indicate that you have run into bone. If you do find that you have run into bone, simply redirect the angle of the tip to make sure that it is in the periodontal ligament space before continuing.
After you have made your way around the apical circumference of the root, use an elevator to assess the mobility of the tooth to determine whether further luxation/elevation is needed. If the tooth is sufficiently mobile, use your extraction forceps to remove the tooth. Once the tooth has been extracted, be sure to complete post-operative x-rays and curette and flush the socket before closing.
When is it appropriate to use the iM3 Vet-Tome?
In order for the iM3 Vet-Tome to be a useful extraction tool, there must be a healthy and intact periodontal ligament present. The tips cannot cut through bone, therefore, if there is tooth resorption and ankylosis, the Vet-Tome will not work. Here are some examples of where the iM3 Vet-Tome can be incredibly useful:
- Procedures where there is a great concern for jaw fracture to occur. - Procedures where operator fatigue is highly likely (i.e. multiple extractions). - Fractured mandibular canines (because there is often no bone loss from periodontal disease). - Deciduous tooth extractions where it is important to prevent damage to the developing adult teeth.
iM3 Vet-Tome Maintenance
Before using the Vet-Tome, please read the user manual for further maintenance and product details. Below is a simplified outline of the required maintenance:
- The controller and foot pedal should be wiped down after use with microbiologically tested surface disinfectants or alcohol as required. - The handpiece and tips can be autoclaved (134 °C) once the solenoid is removed. - The flexible V1 tip can be straightened and re-used, but this will eventually cause the tip to fatigue and break over time. - As a general rule, tips should be replaced after every 10 uses.