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