Vital root resection in maxillary molar teeth: A longitudinal study

Filipowicz, Francis; Umstott, Paul; England, Marshall C.

doi:10.1016/s0099-2399(84)80060-6

Cited by 11 publications

(4 citation statements)

References 27 publications

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“…Root resection has been considered a viable treatment for multi‐rooted teeth with furcation defects before considering tooth extraction and subsequently, the need to prosthetically replace the missing teeth . ‒ Through this procedure, Class III furcation involvements of multi‐rooted teeth are converted into two‐ or single‐rooted units to create an environment that facilitates adequate oral hygiene.…”

Section: Introductionmentioning

confidence: 99%

Outcomes of root resection therapy up to 16.8 years: A retrospective study in an academic setting

Alassadi

Qazi

Ravidà

et al. 2019

Journal of Periodontology

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Background: Root resection has been considered a viable treatment option for molars with furcation defects. However, need of a multidisciplinary approach could potentially deem this procedure less successful. The aim of the present article was to determine survival rates of root resection procedure and reasons for failure in an academic setting.Methods: Patient-related demographic data, medical history information, and relevant data pertaining to the root-resected teeth performed from January 1990 to September 2017 were reviewed through electronic and paper chart. Survival rates were analyzed using Kaplan-Meier estimate. Association between the reasons for failure and independent variables was established by a Pearson Chi-squared and Kruskal-Wallis test.Results: A total of 85 patients with an average follow-up of 5 ± 4.3 years (range: 1 to 16.8 years) were included in the present article. A total of 47 molar teeth treated with root resection remained as part of the dentition (55.3%) and 38 (44.7%) failed. The mean survival time with the Kaplan-Mayer analysis was 109.9 months (9.1 years).Fracture (39.5%), caries (26.3%), and periodontal disease (23.7%) were the most common causes for failure. Interestingly, the majority of failures occurred in the first 4 years after therapy (n = 31; 81.5% of all failures). Conclusions:Root resection therapy remains a treatment solution for molars with furcation defects. In an academic setting, >50% of teeth remained functional after 9 years of root resection therapy. K E Y W O R D Sfurcation lesions and treatment, periapical diseases, periodontal surgery, periodontitis, prognosis, tooth loss, tooth root

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Section: Introductionmentioning

confidence: 99%

Outcomes of root resection therapy up to 16.8 years: A retrospective study in an academic setting

Alassadi

Qazi

Ravidà

et al. 2019

Journal of Periodontology

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“…In humans, conventional endodontic therapy is the standard of care for teeth treated with resective procedures; 2,10,76 vital pulp therapy has also been described but has had poor long-term success. 85 Conventional endodontic therapy before a resective procedure has been recommended in humans in case complications arise, such as root fracture, perforation, or inability to instrument a canal. 2 In animals, both vital pulp therapy and conventional endodontic therapy have been described in the treatment of sectioned teeth.…”

Section: Partial Tooth Resection Root Resection Hemisection and Trise...mentioning

confidence: 99%

Diagnosis and Management of Furcation Lesions in Dogs – A Review

Zacher

Marretta

2022

J Vet Dent

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The furcation is the anatomic area where the roots divide on a multirooted tooth. Periodontal disease causing alveolar bone loss can lead to furcation lesions of various stages. Once furcation involvement has occurred, the area can be more difficult to clean or treat due to the complex anatomy and morphology of furcations. Teeth with short root trunks, longer tooth roots, and roots with wide furcation entrance areas/degrees of separation and wide root divergence are considered better candidates for long term maintenance. Dog teeth possess many of these advantageous anatomic features compared to human teeth. Treatment options for teeth with furcation lesions include: closed debridement, open debridement, furcation plasty, tunneling, partial tooth or root resection, root separation (hemisection or trisection), regenerative therapies, or exodontia. There are many factors to consider in determining treatment options. The favorable and unfavorable characteristics for maintenance of teeth with furcation lesions are summarized. Home care and ongoing professional care are important aspects of periodontal disease control for any patient. Studies of systemic and local antibiotic therapies in human patients have not demonstrated reduction of furcation stages, and probiotic effects at furcation sites have not been specifically examined. Human review studies show that most molar teeth once deemed “hopeless” due to stage 3 furcation lesions can be maintained for at least 5 to 15 years with supportive periodontal therapy. Similar long term studies in dogs are needed to improve the evidence-based management of canine patients with furcation lesions.

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“…In order to preserve the vitality of the tooth, the subsequent pulp wound must be adequately treated. In early case reports on such procedures, calcium hydroxide was used for radicular pulp capping and yielded inconsistent results (Filipowicz et al, 1984;Haskell, 1966Haskell, , 1969.…”

Section: Introductionmentioning

confidence: 99%

Vital root resection with radicular retrograde partial pulpotomy in furcation‐involved maxillary molars in patients with periodontitis: Technique description and case series considering clinical and economic aspects

Ciardo,

Rampf,

Kim

2024

Int Endodontic J

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AimConventional root resection in periodontally compromised furcation‐involved maxillary molars requires preceding endodontic treatment and is therefore associated with loss of tooth vitality, higher invasiveness, treatment time and costs, and the risk of endodontic complications. Vital root resection (VRR) could overcome these disadvantages while establishing stable periodontal and endodontic conditions. This case series aimed to introduce the concept of one‐stage VRR with radicular retrograde partial pulpotomy (VRRretro).SummarySeven vital maxillary molars with residual probing pocket depths (PPD) ≥ 6 mm and furcation ≥ class 2 of five patients with stage III/IV periodontitis were treated with VRRretro using mineral trioxide aggregate. Teeth with residual through‐and‐through furcations were additionally tunnelled. Follow‐up up to 2.5 years postoperatively during supportive periodontal care included full periodontal status, percussion and thermal sensitivity testing. Periapical radiographs were obtained to rule out possible periradicular radiolucencies. All seven treated molars were in‐situ at an average of 26.84 ± 5.37 months postoperatively and were clinically and radiographically inconspicuous independent of tooth position, the resected root, the need for tunnelling and the restorative status. The mean PPD on the seven treated molars was 4.02 ± 0.85 mm (6–10 mm) preoperatively and 2.62 ± 0.42 mm (3–4 mm) at the last follow‐up. Clinical attachment level and bleeding on probing could also be decreased. The teeth showed no mobility over time and furcations class 2 were reduced to class 1 while the tunnelled furcations were accessible with interdental brushes. All molars reacted negatively to percussion and positively to thermal sensitivity testing.Key learning pointsIn carefully selected cases considering patient‐ and tooth‐related factors, VRRretro could be a promising treatment option to establish stable periodontal and endodontic conditions in furcation‐involved maxillary molars while preserving tooth vitality.

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Vital root resection in maxillary molar teeth: A longitudinal study

Cited by 11 publications

References 27 publications

Outcomes of root resection therapy up to 16.8 years: A retrospective study in an academic setting

Outcomes of root resection therapy up to 16.8 years: A retrospective study in an academic setting

Diagnosis and Management of Furcation Lesions in Dogs – A Review

Vital root resection with radicular retrograde partial pulpotomy in furcation‐involved maxillary molars in patients with periodontitis: Technique description and case series considering clinical and economic aspects

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