Dental Education Lecture: Root Removal
Root removal is reserved for severe cases. Mr. Wang has severe root tip infection (Fig.1 arrowheads) when he comes to my office initially. This molar (M) has three roots (1-3). Six months after root canal, the infection around root tips (#2 and 3 in Fig.2) has cleared (as compared to Fig.1), whereas there is still bone loss around the root #1 (arrowheads in Fig.2), suggesting the presence of severe gum disease. We have to remove the root #1 as indicated by dashed line in Fig.2.
Clinically, there is a deep pocket as shown by a metal probe in Fig.4 behind the root #1. After raising the gums, the root #1 is removed (Fig.5). The part of the root #1 is shown in Fig.6. Fig.7 shows that the gums are pushed back and sutured in place (arrowheads). The white asterisk (*) is the place where the root #1 was located. Two months after surgery, the gums heal very well (Fig.8). The black * is an extra bone, which is common among people who chew heavily. Mr. Wang is doing well 3 years after root removal (Fig.9); bone heals well around the removed root area (Fig.3). Without one of smaller roots, the molar is still doing ok.
If problem is confined to the root tip, we just need to remove it. The surgery is much more conservative. The patient recovers more quickly.
Xin Wei, DDS, PhD, MS 1st edition 02/21/2011, last revision 03/06/2011