Introduction: Traditional dental extraction can cause excessive swelling, pain and many complications. Atraumatic or conservative extraction techniques try to minimize these complications. ATM is considered one of the recently invented conservative extraction techniques, it implies the use of modified periotomes followed by insertion of modified post in the root canal, followed by vertical extraction of the straight remaining root using special nuts and wrench.

Methodology: Five patients requiring extraction of multiple remaining roots were enrolled in this study. Roots required for extraction were divided into 2 groups; in the study group extraction was made by the new technique (ATM), while in the control group, extraction was made using traditional elevators and forceps. Pre and postoperative ultra-low dose cone beam computed tomography (CBCT) examinations were made for each patient to assess bone remodeling and compare the two techniques.

Results: The new technique showed better results regarding time of surgery, postoperative pain, and bone resorption. However; these results were not statistically significant.

Conclusion: The use ATM as conservative extraction technique of single straight remaining roots is considered a successful promising technique. However; larger sample size and a multicenter study is required for better assessment and development of the technique.