Vital root retention: A clinical procedure

Fareed, K.; Khayat, R.; Salins, Paul C.

doi:10.1016/0022-3913(89)90176-5

Cited by 17 publications

(9 citation statements)

References 7 publications

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“…Unless contaminated by an infectious lesion, a tooth does not cause problems even when the root rest is in the alveolar bone. There are also surgeries wherein the root rest is left intentionally to preserve the alveolar bone 12,13 . In addition, Kim et al 14 reported that 90% of the tooth's organic components are type I collagen, which is very important in the calcification of bone.…”

Section: Sung-min Park Et Al: Clinical Application Of Auto-tooth Bonementioning

confidence: 99%

Clinical application of auto-tooth bone graft material

Park

Kim

et al. 2012

J Korean Assoc Oral Maxillofac Surg

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(J Korean Assoc Oral Maxillofac Surg 2012;38:2-8)Introduction: Auto-tooth bone graft material consists of 55% inorganic hydroxyapatite (HA) and 45% organic substances. Inorganic HA possesses properties of bone in terms of the combining and dissociating of calcium and phosphate. The organic substances include bone morphogenetic protein and proteins which have osteoinduction capacity, as well as the type I collagen identical to that found in alveolar bone. Auto-tooth bone graft material is useful as it supports excellent bone regeneration capacity and minimizes the possibility of foreign body reaction,genetic diseases and disease transmission. Materials and Methods: Implant placement combined with osteoinductive regeneration,preservation of extraction socket, maxillary sinus augmentation, and ridge augmentation using block type,powder type, and block+powder type autobone graft materialwere performed for 250 patients with alveolar bone defect and who visited the Department of Oral and Maxillofacial Surgery, College of Dentistry, Dankook University from September 2009 to August 2011. Results: Clinical assessment: Among the 250 patients of auto-tooth bone graft, clinical assessment was performed for 133 cases of implant placement. The average initial stabilization of placed implants was 74 implant stability quotient (ISQ). Radiological assessment: The average loss of crestal bone in the mandible as measured 6 months on the average after the application of prosthesis load was 0.29 mm, ranging from 0 mm to 3.0 mm. Histological assessment: In the histological assessment, formation of new bone, densified lamellated bone, trabecular bones, osteoblast, and planting fixtures were investigated. Conclusion: Based on these results, we concluded that auto-tooth bone graft material should be researched further as a good bone graft material with osteoconduction and osteoinduction capacities to replace autogenous bone, which has many limitations.

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Section: Sung-min Park Et Al: Clinical Application Of Auto-tooth Bonementioning

confidence: 99%

Clinical application of auto-tooth bone graft material

Park

Kim

et al. 2012

J Korean Assoc Oral Maxillofac Surg

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“…It is known that broken fragments of vital teeth generally heal without complications; if a root is broken during extraction of a regular uninfected tooth, it can safely be left in situ [ 15 , 26 ]. Coronectomy exploits this assumption.…”

Section: Introductionmentioning

confidence: 99%

Coronectomy as a surgical approach to impacted mandibular third molars: a systematic review

et al. 2015

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The aim of this systematic review was to evaluate the clinical effectiveness of the surgical technique of coronectomy for third molars extraction in close proximity with the inferior alveolar nerve.A literature survey carried out through PubMed, SCOPUS and the Cochrane Library from inceptions to the last access in January 31, 2014, was performed to intercept randomised clinical trials, controlled clinical trials, prospective cohort studies or retrospective studies (with or without control group) that examined the clinical outcomes after coronectomy. The following variable were evaluated: inferior alveolar nerve injury, lingual nerve injury, postoperative adverse effects, pulp disease, root migration and rate of reoperation. Ten articles qualified for the final analysis. The successful coronectomies varied from a minimum of 61.7% to a maximum of 100%. Coronectomy was associated with a low incidence of complications in terms of inferior alveolar nerve injury (0%-9.5%), lingual nerve injury (0%-2%), postoperative pain (1.1%-41.9%) and swelling (4.6%), dry socket infection (2%-12%), infection rate (1%-9.5%) and pulp disease (0.9%). Migration of the retained roots seems to be a frequent occurrence (2%-85.3%).Coronectomy appears to be a safe procedure at least in the short term, with a reduced incidence of postoperative complications. Therefore, a coronectomy can be indicated for teeth that are very close to the inferior alveolar nerve. If a second operation is needed for the remnant roots, they can be removed with a low risk of paresthesia, because the roots are generally receded from the mandubular nerve.

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“…mucosa-borne dentures and class I dentures as described by Craddock 13 ). It has been demonstrated that many of these resected retained roots remain vital [14][15][16] and that in many cases, broken fragments of vital teeth may heal without further complications 17,18 . Although this may be the case, the fact remains that whether or not these roots have healthy pulp may be of little consequenceespecially if left unsealed or with a poor coronal sealwhich has been demonstrated in more recent endodontic studies 19,20 .…”

Section: Historymentioning

confidence: 99%

The coronectomy technique for lower third molars: past and present

2016

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Aim: To discuss the past and present evidence for the coronectomy technique for third molars. Materials and Methods: A review of the past and present literature related to the healing of extraction sockets in the presence of root fragments. Results: High-quality research studies surrounding the coronectomy procedure are lacking and it is important therefore that surgeons are aware that change of practice is not yet supported. The long-term consequences, in terms of infection or other, are not known as study follow-up is short. Conclusion: If coronectomy is to be considered then the authors would suggest that this is only for patients at high risk of potential nerve injury and that the patient is made aware of the risk of failure, the possible need for re-operation and our lack of knowledge of long-term consequences. HistoryExperiments relating to the healing of extraction sockets in the presence of root fragments date as far back as 1924 1 . This marked a peak in interest in Germany and many experiments were carried out to assess healing of post-extraction wounds in the presence of root fragments 2-4 . These were non-clinical animal studies and related to reimplantation of root fragments rather than post-extraction retained root fragments per se. Although at the time this had no effect on the management of retained roots, it created interest concerning what happens to root fragments that are reimplanted within the mandible and maxilla.The first known data collected in reference to retention of root fragments, rather than reimplantation, were in 1947, where the healing of extraction sockets in the presence of retained root fragments was assessed histologically in rats 5 . This experiment demonstrated for the first time that root remnants deep within a wound may be tolerated by the adjacent tissues and retained without symptoms. Furthermore, the retained root fragments may go on to be covered by a cementum-like peripheral layer, also suggested previously by others in the literature 6,7 .The period 1974-1976 marked a further surge in interest with regard to root retention with a focus on preservation of the alveolar ridge 8 . It was shown for the first time in monkeys that vital submerged roots which were traumatically amputated, exposed to transient bacterial invasion and covered primarily, were free of any type of inflammatory infiltrate 9 . The same experiment showed that gutta-perchafilled roots submerged in the same way were associated with a mild pericoronal inflammatory response. The technique of reducing vital roots by 2 mm below the alveolar crest bone and suturing to cover the root surfaces was described in an animal study in 1976, and showed histologically that: • Roots retained a vital pulp. • Cementum covered the cut dentine. • Periodontal membrane covered the buried roots 10 .

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Vital root retention: A clinical procedure

Cited by 17 publications

References 7 publications

Clinical application of auto-tooth bone graft material

Clinical application of auto-tooth bone graft material

Coronectomy as a surgical approach to impacted mandibular third molars: a systematic review

The coronectomy technique for lower third molars: past and present

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