Definition & Overview
The surgical removal of dental roots is a dental procedure performed following a simple tooth extraction, where the whole tooth was not completely removed, and the root remains lodged in the underlying bone.
Tooth extraction is one of the most common dental procedures and is usually considered when the tooth is determined to be beyond restoration due to disease, crowding, or trauma. In most cases, it is a pretty straightforward process performed in an outpatient or clinic setting. However, there are instances in which the tooth breaks off before or during the extraction process, making it difficult for the dentist to remove all the tooth fragments, especially the roots buried below the gum line.
There are typically four roots in each tooth, functioning as anchors that hold the tooth in place. They are embedded in the bone and make up the bigger part of the tooth. Because of their function, it is quite difficult to extract the dental roots, especially if the crown is heavily fragmented and broken. This condition would necessitate a more complex process of surgically removing dental roots. The residual root often causes pain and promotes the development of infection if left unattended.
Who Should Undergo and Expected Results
The surgical removal of dental roots can be recommended for:
Patients whose decayed tooth has broken off in fragments. In some cases, a simple extraction may lead to surgery if the tooth has become weak and brittle. This would mean removing the decayed parts one piece at a time.
Patients with impacted teeth, where most of the crown and its remaining parts are left buried below the gum line
Patients with curved dental roots - The same technique is also applicable for patients who have curved dental roots that make conventional tooth extraction not a viable option.
The surgical removal of dental root is an outpatient procedure, which means that the patient is allowed to go home on the same day. The results of the procedure are permanent and patients typically do not need any additional dental procedures afterwards.
How is the Procedure Performed?
The procedure starts with the application of local anaesthesia to numb the affected gum area. The dental surgeon will then make an incision along the gum line and create a surgical flap, which is then lifted to provide access to the bony side of the jaw where the dental roots are located and encased. The encasing bone is thinned out by slowly removing the layers until the residual root is exposed. At this point, the surgeon will assess the root if it can be removed as a whole or not. There are some instances wherein the root needs to be cut into pieces in preparation for removal. Using a pair of forceps and other specialised tools like dental elevators, the dental surgeon will rock the root back and forth to loosen it from the surrounding bone before it is pulled. Depending on the need, the incision may be sutured closed or left unstitched to heal on its own. In some cases, the surgeon may do a tooth socket graft to avoid bone mineral breakdown.
There may be stiffness and soreness in the affected area following the procedure. The patient is asked to rest for several days and not engage in strenuous physical activities. Soft food diet is also recommended for the first couple of days to encourage healing and avoid opening the stitches.
Possible Risks and Complications
The procedure carries the risk of bleeding in the affected area as well as infection. As such, patients are typically prescribed with antibiotics that must be taken for several days to avoid the development of abscess.
In some cases, the blood clot that formed in the surgical site is dislodged and patient may experience bleeding. This can be addressed by putting surgical gauze over the surgical site.
There are also other rare complications and one example is injury to surrounding parts, especially the nerves. There are also reports of fracturing the mandible in which the bone breaks after excessive force is applied.
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