Extraction chapter
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Root Fracture

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Root fractures are commonly caused by poor technique. Carnivore teeth taper towards the apex. Over-robust and impatient elevation followed by improper use of forceps will fracture the root.

A fractured fragment containing necrotic pulp or in an infected periodontal pocket will cause bone lysis and must be removed. The operator can delineate the remaining root tissue with a small (e.g. Number ½ round) bur and "walk" down the outside of the root, circumferentially, to isolate it from the bone. This can be described as walking down a spiral staircase with the bur. Use a root tip pick or fine blade luxator to loosen and remove root tip.

Alternatives are:

  • Bur away part of the bone plate to remove root tip

  • Atomise root tip with high speed round bur with water irrigation - so called "Dental Pulverisation"

  • Leave the root tip for a few weeks before a further attempt is made to remove it - but follow the guidelines below regarding litigation.

Beware of the prospect of litigation when root tips are left. It is essential to note broken root tips on the record and, also, to inform the client. Not to do so makes it hard to defend one's position in the event of future litigation. Radiographs at the time and at some appropriate future date, to monitor the root, should also be performed. Consider referral if you are unsure of these techniques.

 

 

Retained root tip of feline maxillary cuspid (canine) tooth after crown lost
Retained root tip of feline maxillary cuspid (canine) tooth after crown lost

Radiograph of retained mandibular roots left after sloppy extraction technique when only crowns were removed
Radiograph of retained mandibular roots left after sloppy extraction technique when only crowns were removed

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