Root resection under the surgical field employed for extraction of impacted tooth and management of external resorption

Abstract

This case report illustrates determination of prognosis and immediate resection carried out, before completing the endodontic therapy, during the surgery employed for managing a nonperiodontal problem. This case showed external pressure resorption in the distobuccal root of maxillary second molar caused by the impingement of impacted third molar. Extraction of third molar was decided when healing was not seen, despite initiating endodontic therapy in second molar. Following elevation of flap and extraction of third molar, the poor prognosis due to severe bone loss around the resorbed root was evident. But due to strategic value of second molar, it was found beneficial to employ resection. Therefore, immediate resection was carried out in the same surgical field before the completion of endodontic therapy. This prevented the need for another surgical entry with its associated trauma to carry out resection separately later. Resection followed by the completion of endodontic therapy and full crown assisted in salvaging the remaining functional portion of the tooth and prevented the occurrence of distal extension with its potential drawbacks.

Could the pulp be preserved in tooth with root resorption caused by embedded tooth?

“… 20 The aim of RCT is to stabilize the root resorption and to achieve a hermetic seal, but the poor prognosis due to severe bone loss around the resorbed root was evident. 21 If the resorption processes have progressed severely, both teeth may be not reservable. However, our previous cohort study revealed that, in most cases, this ERR tooth can keep vital pulp by just removing the ET without any other therapy.…”

Correlational study of impacted and non-functional lower third molar position with occurrence of pathologies

“…Root resorption on the second molars is one of the complications associated with the third molar impaction and most of the available data have come from case reports [ 38 – 40 ]. Knutsson et al [ 41 ] evaluated 666 patients before removal of mandibular third molars and found that 548 patients had pathologic conditions (occlusal and/or distal caries, second molar root resorption and pericoronaritis).…”

Review of Approaches to the Management of Vertical Dental Root Fractures and Tooth Preservation

“…For molars with periodontal, endodontic, restorative, or prosthetic problems, root resection therapy is a possible treatment option. Although the most common indications for root resection are periodontal-based, our discussion focuses on endodontic indications, such as an unfillable canal, root fracture, root perforation, root resorption, and root decay [ 22 ]. Root resection therapy can provide good outcomes in cases of incomplete fracture [ 23 ].…”