Letters to the Editor

It would seem that this technique tip¹ has started some debate, and I thank Dr Malden for his reply to my letter.² I note in his reply that Dr Malden refers to Geoffrey Howe's Minor Oral Surgery.³ I have the 1988 reprint of the third edition. It sits in my office and is still a useful guide on technique, although my Registrars regularly remind me it was written before they were born!

Dr Malden points out that the use of cowhorns is a ‘traumatic technique’. While back in the day, it may have been acceptable to undertake 28 serial traumatic extractions in an hour with his beloved cowhorns, this is no longer the case, nor is it required. Modern oral surgery departments and practices in the UK are all equipped with surgical handpieces when required. Closed atraumatic techniques, using luxators and periotomes, are much less traumatic to the tissues and, more importantly, to the patient. The use of the surgical handpiece, when required, can supplement these techniques, negating the need for archaic instruments such as cowhorns, and minimizing the crush injuries he talks about.