Root pieces are retained tooth structure with complete loss of crown portion. They are less prone to infection when retained in the gums. Retained root piece is a cause of grossly decayed tooth or trauma to tooth wherein there is total loss of crown structure.
Root piece can be dormant or act as a dead tooth structure with no pain and infection. Such root pieces are usually not extracted as they act as space maintainers. If a prosthesis or replacement of the particular tooth is planned in future, the root piece can be then extracted. Extraction of a root piece with immediate implant placement is also a choice of treatment. In some cases it is seen that a root piece is the only source of abutment for a bridge work. If in good condition and still above the gums level with even a millimetres, the line of treatment is to save that particular root piece by through debridement of the root canals and placement of a gutta percha points. After the endodontic treatment, some part of the gutta percha is removed maintain 1/3 of gutta percha in the apex portion of the root. The later is then replaced by a post which is a metallic rod.
How do posts stabilise root piece?
Post give more stability to the root structure. It is followed by a core material which forms the crown structure of that tooth core material. Core material such as composite, resin can be used. Post and core treated root pieces act as an whole tooth for which a crown is fabricated. The tooth can also act as a abutment for further prosthesis.
Badly decayed root piece at times can be infections due to secondary cavities and patients negligence. Such root pieces develop root abscess, further enhancing the pain and infection to the surrounding tissues.
Certain root pieces are treated with only excavation of the secondary cavities. They are not extracted as they are close to the nerves in order to avoid nerve damage. Clinical examination should include an IOPA of the root piece in order to determine the integrity of the root and the surrounding tissue. A line of treatment modalities such as complete extraction of root piece should be followed by restoring the missed tooth from implants to fixed bridge or removable dentures thus restoration of the alveolar structure and gums is necessary, for proper denture stability.
If possible a root canal treatment followed by post and core can be done in such infectious root pieces. If not a complete extraction of one or all piece of the root is advisable.Leave a reply