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 structure is a cause of grossly decayed tooth or trauma to tooth wherein there is total loss of crown structure.
A root piece may be dormant or act as a dead tooth structure without pain or infection. Typically, such structures are not removed as they serve as space maintainers. If future plans involve a prosthesis or replacement for the specific tooth, the root structure can be extracted at that time. Another treatment option is extracting the pieces with immediate implant placement. In some cases, a root structure is the sole source of abutment for a bridge. If the root is in good condition, still above the gum level by a few millimetres, the preferred treatment involves saving the root through debridement of the root canals and placement of gutta-percha points. After endodontics treatment, part of the gutta-percha is removed, leaving 1/3 in the apex portion, and it is then replaced with a metallic rod post.
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 structures act as a whole tooth for which a crown is fabricated. The tooth can also act as a abutment for further prosthesis.
Badly decayed root structures at times can be infections due to secondary cavities and patients negligence. Such root structures develop root abscess, further enhancing the pain and infection to the surrounding tissues.
Some roots are treated by excavating only the secondary cavities, avoiding extraction due to their proximity to nerves to prevent nerve damage. A clinical examination, including an IOPA of the root structures, is essential to assess root and surrounding tissue integrity. Treatment options may involve extracting the root piece and restoring the missing tooth with implants, a fixed bridge, or removable dentures. This ensures the restoration of the alveolar structure and gums for proper denture stability.
If possible a root canal treatment followed by post and core can be done in such infectious structures that remain. If not a complete extraction of one or all piece of the tooth is advisable.Leave a reply