A surgical extraction is needed when a diseased tooth cannot be successfully removed by a simple extraction. This may be because the tooth has only one diseased root, with one or more strong and healthy roots. Or the exposed surface of the tooth is weakened by disease and would fracture off if a simple extraction was attempted, leaving behind root fragments. A surgical extraction involves the creation of a gingival flap over the area of the tooth’s root, removal of the roots with a drill, possible placement of a bone grafting material in the defect left and closure of the extraction site by suturing the gingival flap in place.