When is a tooth root 100% subject to extraction?
Tooth root removal is performed if:
- the root is softened below the gum level,
- the root of the tooth is below the level of the surrounding bone tissue,
- the root of the tooth has cracks
:
- the root of the tooth is chipped
:
- the root of the tooth is severely damaged, for example as a result of canal treatment with resorcinol
:
- There are various inflammatory processes around the root and under the root of the tooth - cyst, cystogranuloma
:
- the root of the tooth is mobile,
- there is a deep dental pocket.
How is tooth root removal done?
Are there any features or important points when removing a tooth root? Of course, any removal - be it tooth extraction, wisdom tooth removal, impacted tooth or tooth root should be carried out as atraumatically as possible, preserving the tissue structure
that surround a tooth or tooth root:
The goal of atraumatic root removal is to preserve bone
. Removal should be done painlessly.
The clinics of the German Implantology Center are supporters of atraumatic and painless removal. Our technologies have been proven over the years, and our patients feel very comfortable with them. It is no secret that many patients have fears about removal, and these fears sometimes postpone the surgical stage of treatment for a long time. In our clinics, we help patients overcome these fears. The patient may not be afraid of anything - both in the case of a single extraction and in case of multiple extractions of teeth
:
Tooth extension onto a pin
When thinking about whether it is possible to build a tooth onto the root, the use of a pin comes to mind. It is used if both the body and the root are severely damaged.
The procedure includes:
- obtaining an x-ray;
- cleaning the mouth, removing stones;
- removal of damaged areas;
- computer tooth modeling;
- removal of saliva;
- anesthesia;
- cleaning of channels;
- implantation of a pin, cleansing the area around it;
- filling the space around the pin with a composite or photopolymer;
- polishing and grinding.
Dentists build up teeth under crowns only if the remainder is in good condition and does not rot or decompose.
What is atraumatic tooth root removal?
What instruments does the surgeon use to achieve atraumaticity? For atraumatic removal, special instruments are used - thin, neat and elastic elevators that can minimally invasively penetrate and expand the periodontal tissue that connects the tooth root directly to the jaw. Using special instruments, the periodontal ligaments are cut so that the root can be removed as carefully as possible, in its “pure form.”
The vestibular plate that surrounds the bone is very thin. And we work with her carefully when removing teeth. It may also be necessary to saw the root of the tooth so that it can be removed in pieces. Sawing can be carried out with oscillating ultrasonic attachments - ultrasonic knives. Cutting the root of a tooth can be done quite effectively with a high-quality thin surgical dental bur, which has a certain length.
After cutting the root, the medial wall of the root is first removed, and then the vestibular wall of the root is removed. This allows for maximum preservation of surrounding tissue.
Then, after such removal, you can preserve the tooth socket or place an implant so that the bone is preserved as much as possible. Preservation of the tooth socket is carried out if there are no conditions for installing an implant at once, or if the patient undergoes delayed implantation.
If the roots of wisdom teeth are removed, the socket is not preserved; it is enough to remove them as atraumatically as possible. Let's talk about this in a little more detail.
Features of root removal of decayed wisdom teeth
Are there any difficulties when removing the roots of wisdom teeth? Removing the roots of wisdom teeth requires that the surgeon has sufficient experience. Often the roots of these third molars (wisdom teeth) are located close to the mandibular canal. Often the roots of molars are adjacent to the upper or lateral wall of the mandibular canal. The configuration of wisdom tooth roots is extremely diverse and sometimes extremely difficult to remove:
Therefore, when removing the roots of wisdom teeth, it is imperative that the patient undergo a CT scan. And the surgeon, as I said, needs to have some experience in surgical training in order to avoid the risks of removing the roots of such teeth and carry out the manipulation as efficiently as possible.
Like any root teeth, the roots of wisdom teeth are removed by cutting them along the roots. Wisdom teeth do not have problems because they are close to the angle of the lower jaw and there are strong cortical plates there. When I talked about thin vestibular walls, this comparison refers to the aesthetic zone of the smile, to the frontal group of teeth, including the premolars:
.
Methods for restoring damaged teeth
The main criterion for choosing a method for restoring a tooth is the degree of its destruction. If it is small, artistic restoration is used. The method involves the use of composite, that is, filling materials. For this purpose, strengthening with intra-root pins can be used. The disadvantage of this method is some fragility of the structure. To preserve the filling for a long time, it is better to give up the habit of biting candy, nails, and hard foods.
A high-tech alternative to fillings and composite restorations is inlays. The inlay is made in a dental laboratory using an impression taken from the prepared tooth. The advantage of inlays is their strength and exact conformity to the surface on which they are attached. Inlays, unlike conventional composite fillings, do not shrink, making the likelihood of an incomplete fit virtually non-existent.
A method that is often used to restore severely damaged teeth is restoration with crowns. This method can be used for almost any degree of destruction, the main thing is that the root remains strong and motionless. The walls of the tooth should protrude above the edge of the gum.
What the patient needs to understand before root removal
You need to assess the health risks, you need to talk to the attending surgeon, find out about his experience. Quite often, tooth root removal is carried out, unfortunately, with the following negative consequences:
- gums are torn
- fractured bony vestibular plate
Sometimes when visiting such patients, you get the feeling that the tooth was not removed, but knocked out with something. There were cases when a patient’s extraction began in some clinic, and there, in the middle of the patient’s appointment, the doctor announced that he was unable to remove it, and the patients came to us in this form to remove the root of a tooth that was already in the extraction stage.
When removing the roots of wisdom teeth, you may face risks such as jaw fracture. One of the common risks of removing the roots of 3 molars is damage to the mandibular nerve
, leading to cuts and numbness in areas of the jaw. There is a risk of damaging the artery on the lingual side.
If, when a tooth is removed, a root or part of it is left behind, what should you do?
According to Russian treatment standards, the tooth root cannot be left during extraction. That is, if the patient was left with a root or part of it during removal, then this is considered a poorly performed surgical procedure.
In European countries there are doctors who agree that if there is no inflammation on the tooth and if the root part is not infected, and removal of the root leads to trauma, then only the cortical part of the root is removed, and the other part remains in the bone.
If the patient is left with a part of the root that is infected, then this is a problem. A cyst may develop and inflammation may develop. If the apical part was not infected, then everything heals and does not bring any trouble to the patient.
Tooth root without crown part
Can a tooth root without a crown cause inflammation in the gums or bone? Of course it can. There is a canal at the root of the tooth; if this canal is infected, then the problem will develop into a negative prognosis.
Inflammation, suppuration, periostitis, osteomyelitis - diseases can develop due to an infected tooth root. And the source of infection at the root must be removed; if it is impossible to remove the infection and preserve the root, then it must be removed.
Do these measures help stop the factors that destroy the tooth?
Any of the methods of tooth restoration involves preliminary preparation, during which the very cause of destruction is eliminated. In particular, before installing a crown, the doctor removes tissue affected by caries, cleans and seals the canals. If the specialist did it efficiently and conscientiously, as the dentists of the Unident network of clinics work, the recurrence of the disease is practically excluded. Otherwise, the patient may eventually feel pain under the denture, discomfort when chewing - all these are signs of secondary caries. In this situation, you should immediately consult a doctor - and, most likely, you will need to remove the prosthesis. And after the dentist fixes the problem that is destroying the tooth, the prosthesis will have to be made and reinstalled. That is why it is so important to turn to professionals with extensive experience and an impeccable reputation for dental restoration.
Is implantation possible after tooth root removal?
Yes, of course it is possible. And we at the clinics of the German Implantology Center widely use implantation after tooth root removal. Our conditions allow us to carry out implantation in such cases. And if we can achieve primary stability of the implant, then in 90% of cases
After removal, we immediately install the implant. We have rolled out the technology to perfection and gives excellent results.
Of course, with the exception of wisdom teeth, no implant is placed after their removal. But, by the way, wisdom teeth in this situation can be extremely useful, since they... can be transplanted to the place of the problem tooth being removed! Dental transplantation has been practiced in the clinics of the German Implantology Center since 2017, and our specialists have accumulated a wealth of clinical experience. Let's talk about this a little more.
An alternative to implantation is autotransplantation of wisdom teeth
Don't rush to remove your wisdom teeth. Firstly
, there must be clear indicators for their removal.
Secondly
, you don’t need to follow fashion, trends and delete eights just because “a girlfriend or friend deleted them and it’s cool.” There are a number of moments in life when wisdom teeth come to our aid.
It is not for nothing that nature has created a number of organs that duplicate each other in our body, for example, we have two lungs, two kidneys, which in case of problems with one lung/kidney come to our aid. Also with wisdom teeth: if a person (for some reason) has problems with the chewing group of teeth, for example, caries has destroyed the sixth or seventh tooth, then eights can come to the rescue. How so? After all, wisdom teeth are not involved in the chewing process. Yes, you are right here. But a wisdom tooth can serve as a donor, and it can be transplanted into place of a tooth with destroyed roots. Fantastic? No, advanced technologies in dentistry. This is called autotransplantation.
In the following video we show in detail the dental transplant surgery. The roots of two sixths of the patient's teeth had just been destroyed, and they were replaced by the patient's own wisdom teeth. And, by the way, this patient at the end of the video gives a detailed review after 1 year after the operation. Look, this is useful:
Restoring severely damaged teeth with crowns
To install a crown, you need reliable support. If a tooth is destroyed, its tissue is not sufficient to secure the prosthesis firmly. To do this, a stump tab is installed, which is fixed in the root canals. The upper part of such an inlay serves as a support for the future crown.
The prosthesis is made from impressions taken from both jaws. The material for their manufacture may vary.
- The simplest and most inexpensive is metal ceramics. Crowns, strong and durable, are excellent for restoring chewing teeth. Disadvantage: The gums above the crown may darken. For this reason, it is better to install metal ceramics only on chewing teeth.
- Metal-free ceramics and zirconium dioxide are materials that are in the same price category. They are significantly more expensive than metal-ceramics, they allow you to get an excellent aesthetic result and do not cause any negative reactions. Ceramics are installed mainly on the front teeth, as they are quite fragile. Such teeth are practically indistinguishable from natural ones in appearance. Zirconium is a universal material, suitable for both chewing and front teeth.
