Extraction of teeth is likely the most common oral surgical procedure performed. Teeth may be extracted for a number of reasons: crowding, decay, periodontal disease or as a means of preventing these problems as with third molars or other impacted teeth. Extraction of teeth is simultaneously one of the simplest procedures and technically potentially one of the most difficult. The simplest because of the common nature of the procedure i.e.) with repetition comes familiarity. The most technically difficult because of the delicate nature of the oral anatomy, limited access and proximity of the teeth to adjacent structures. The difficulty of extraction is compounded by the oral surgeons innate instinct to view the extraction as only one step in a series of steps leading ultimately to restoration of the missing tooth and /or protection of the adjacent dental structures. This requires that the tooth or teeth be removed with minimal trauma and preservation of the alveolar bone and gingival tissues.