Human teeth are an organ that is subject to frequent destruction. This happens due to a series of various reasons– from poor care to injury. But when the crown is destroyed as a result of damage to the dental tissue, a root (or several roots) remains in the gum. The question arises - whether to delete it. If the patient cares about maintaining the integrity of the dentition, and immediately after losing a tooth goes to restore it, for example, to install an implant, removal is inevitable. But in most cases, people do not rush to the dentist to extract a root from the gum, which, as they think, does not interfere and does not pose a danger.
Save or delete
During treatment, dentists try to preserve at least one root on multi-rooted teeth as much as possible. If possible, it will serve as a support for the restored crown, and the tooth will perform its functions to a sufficient extent.
But after complete destruction of the dental tissue, if the carious process has reached the roots and completely captured them, it is better to remove the pathogenic source of infection from the gums as soon as possible, before it spreads to a large area, damaging neighboring teeth.
Removing a root with a damaged dental crown is difficult surgical procedure. Patients rightfully consider it one of the most unpleasant. And although today, thanks high level development of anesthesia, the process is not as painful as before, patients remain afraid of this operation.
By the way. Fortunately, in most cases it is not necessary to remove all of the tooth roots. If the carious lesion is not captured last stage, it is enough to treat the remaining roots, and subsequently resort to prosthetics or tooth restoration.
But when the carious process has destroyed the roots to the ground, if they are rotten through and through, it is necessary to part with them as quickly as possible.
A rotten root is a breeding ground for infection. The longer it is present in oral cavity, those big problems generates.
Most often, patients with neglected rotting roots left after a tooth crown falls out or chips come to the surgeon for emergency assistance with the words: “The rotten root didn’t bother me for so long, didn’t hurt, and then suddenly my whole cheek was swollen.” Of course, this does not happen suddenly. A natural fact that will happen 100% at the most inopportune time if you have a damaged root in your mouth.
Important! For a patient with gumboil, it is almost impossible to painlessly remove the root, since anesthesia should take into account the projection of the roots into the gingival tissue, but this place is filled with pus. In some cases, it is necessary to make an incision in the gum to drain the purulent masses, carry out disinfection and send the patient without removing the ill-fated root. And not all patients return on time as prescribed by the doctor in order to undergo the removal operation. Many people leave everything as is, waiting for a new flux.
Indications for removal
If none of the tooth-preserving techniques can be used, the roots of the tooth are removed. There are a number of situations when surgery is unavoidable.
Table. The need for tooth root removal
| Reasons for deletion | Description |
|---|---|
| Complex transverse fracture, lobar fracture, or fracture of a dental crown. |
| Near the root there is a focus of inflammation. This can be a cyst, phlegmon or abscess, as well as in the case of osteomyelitis and periostitis. |
| There are three degrees of root mobility, the last of which, the third, is an indication for its removal. |
| The dental crown is completely destroyed below the level of gum tissue |
| Atypical location of the tooth root to be removed. |
The crown can be destroyed both on a “living” tooth and on a “dead” one. In the first case, the root is not badly damaged and can be saved. A pulpless tooth almost always has a severe degree of damage to the roots, and it cannot be restored using prosthetic techniques by adding a crown part. Root extraction and implant restoration are shown here.
By the way. For the roots of the posterior molars, the situation almost always requires their extraction.
- These are the most complex and problematic teeth, located in the far part of the jaw closure, the care of which is difficult. Therefore, hygiene is not carried out in full, and their destruction occurs faster than others.
- During the process of eruption, posterior molars often cause displacement of the dentition, disrupting the bite.
- They often provoke chronic injury to the mucous membrane, as a result of biting the mucous membrane from the inside of the cheek. This can lead to constant inflammation and the formation of malignant tumors.
Since there is no need to restore the coronal part, which often does not even fully emerge from the gum tissue, on wisdom teeth, in case of their abnormal growth or destructive carious lesions, the rear molars are removed along with the root.
From dental practice
There are many situations in which it is necessary to make a decision to remove or preserve roots. An inexperienced dentist, for example, insisting on preserving a half-rotten root to install a bridge may be wrong if:
- the root has high mobility (the prosthesis will also be mobile along with it);
- the interroot septum is destroyed by necrotic processes;
- the focus of inflammation is localized at the root apex (narrow part);
- the root has low functional value.
The latter means that even if it is therapeutically possible to preserve the root, this is not always advisable. Even if the root is partially restored, the restored coronal portion attached to it may not be fully functional.
Better to extract:
- roots of posterior molars;
- teeth that do not have antagonists (therefore they cannot perform the chewing function);
- roots of teeth emerging from the dentition.
How are roots removed?
There are many methods for removing tooth roots in dentistry. But patients always feel fear when it comes to removing roots when the crown is completely or largely destroyed.
By the way. If the root is quickly removed from the gum before it is completely destroyed, the operation will not be the most difficult. Using forceps with “cheeks”, even without tissue incisions (if the root is not completely covered by the gum), an operation to remove the root of average complexity lasts about ten minutes.
The least difficult is root removal in patients aged forty years and above. In mature and old age, the alveolus atrophies, the height of the interroot septa decreases, and in almost all cases when the crown is destroyed, a inflammatory process fundamentally. Therefore, it is, as it were, pushed out, rejected by the body.
In younger patients, the hilar tissue usually remains healthy. When it is planned to remove two or more roots, the operation is considered complex.
Dental surgeon tools
Once upon a time, the roots were literally gouged out of the jaw with a chisel and a hammer (special dental ones, not construction ones, but it was still painful).
Today, the root is removed by cutting out the gum tissue using a drill and extracting it piece by piece using an elevator.
Cases when the root has to be hollowed out from the gums are recorded in only 2% of patients.
The anesthesia is complete and effective, and pain is minimal, just like when extracting a tooth with a preserved coronal part.
Unbelievable but true
Even today, in the 21st century, and by no means residents of “dense” villages, but completely civilized and educated people They try to remove the root of a damaged or dilapidated tooth on their own using pliers. The fear of going to the dentist is so great that, having taken a glass of vodka as anesthesia, the patient tries to grab the base of the root with this instrument, believing that after this it will not be difficult to pull it out.
Of course, when attempting such a removal, which usually will not be successful:
- the wound becomes infected;
- pain shock occurs;
- part of the root is crushed, filling the wound with fragments, which subsequently rot;
- complications arise.
Complications after removal
It is worth noting that complications are not uncommon after surgery to extract the root by a dentist. True, this doesn’t really concern experienced doctors who do not have much experience in such operations.
Due to inattention, negligence or due to lack of professionalism, root fragments remain in the wound. The doctor reassures the patient, assuring that the non-removed parts will subsequently come out of the gums on their own. Of course, this doesn't happen.
With severe removal, the surgeon may create a situation where the root tip breaks off. This is not always noticeable, because from the wound there's blood coming out. Experienced dentists in such cases, the appointment is postponed and the patient is scheduled for repeated removal.
Important! Leaving a broken root fragment in the wound is unacceptable. Yes, for a long time this fragment can be in the gum without causing concern to the patient. But he will move towards the surface, along fistula channel. And if there was a cyst at the top, then even after several years of “calm” behavior, the remains of the root can provoke gumboil.
The second unpleasant situation can arise with a seemingly successful outcome, when the remainder of the root tissue is covered by the gum and ends up locked in a capsule of gum tissue. Such a “time bomb” will certainly provoke phlegmon or an abscess, and will also cause periostitis and osteomyelitis.
Sometimes a situation arises: the root is removed completely and purely in depth, but fragments are stuck in the gum tissue above. This is the most common surgical negligence that the patient must monitor. If you feel that life has not improved after removing the rotten root, consult another doctor. Listen to the opinion of at least three dentists in order to subsequently avoid alveolitis or other diseases.
Summary
In modern dentistry, everything is not as scary as it seems. For any pain threshold, the patient is given local anesthesia. The anesthetic will remain effective throughout the procedure and for two hours after it.
As the anesthetic begins to take effect, the jaw becomes numb. Modern lever elevators will then remove plaque, food and other foreign organisms quickly enough to allow access to the root. You need to remove it. Therefore, the best thing you can do if you have a root in your mouth is to go to the surgeon and find out whether it is worth carrying out a planned, timely removal so as not to cause serious pathological complications.
Video - Removing tooth roots
Patients often do not seek help in a timely manner when a tooth is severely damaged. Afraid that I will have to cut the gum. The gums are cut in rare cases, and any manipulation in the dentist’s office is carried out under anesthesia, so there is nothing to be afraid of. This article will talk about how to remove a tooth if only the root remains.
The technique for tooth root removal will depend on the clinical situation. Situations may be different:
- The root in the bone was preserved after the destruction of the coronal part of the tooth by the carious process.
- The root in the bone was preserved after the injury.
- The root in the bone was preserved after a complex fracture, accompanied by its fracture.
If a root remains in the bone after a tooth has been destroyed by caries, it is usually highly pigmented and mobile. Removing it is not difficult. It is usually possible to remove it with ordinary dental forceps with elongated jaws. If the forceps cannot cope with the situation, then first loosen the root with an elevator, and then remove it from the hole with forceps. To cut the gums in in this case resort only when the root is already long time is located to the bone and the gum has managed to close the defect.
If the root remains in the bone after an injury or after a complex removal, then the procedure for extracting it will depend on the depth of its location. After numbing the pain, dentists first try to remove it traditional ways: elevator and tongs. As a rule, such roots are not visible to the naked eye; the doctor studies its location on x-ray.
If traditional method removal does not produce results, then they try to remove it using a chisel and hammer. Place the chisel in the space between the bone and the root and tap it lightly with a hammer. This usually causes the root to loosen, and it is easily removed from the hole with forceps.
Surgical tooth root removal
How is a tooth removed if only the root remains, when none of the methods described above helped? In this situation, they resort to surgical intervention.
Can be used as an anesthetic local anesthesia, so general anesthesia. In any case, the patient will not feel pain.
The surgical technique is as follows:
- After the onset of anesthesia, the doctor makes an incision in the mucoperiosteal membrane in the projection of the pathological focus.
- Peels off the flap.
- If the root is not visible to the naked eye, trephine the bone plate under water cooling in order not to damage the bone matrix and prevent bone atrophy in the future.
- If the root is visible, then they simply cut it out of the bone using small dental instruments in the form of burs.
- After the root is extracted, the hole is curetted and all fragments are removed.
- The mucoperiosteal flap is returned to its place and sutured.
- A gauze pad is placed on the wound for half an hour or 40 minutes to stop the bleeding.
- Some doctors place anti-inflammatory powder on the tampon to prevent the development of postoperative complications.
Surgical tooth extraction
Is it necessary to remove the root of a tooth?
Many patients, after tooth extraction, feel that there is something left in the bone, but because of their fears they do not consult a doctor in a timely manner. The remaining root may not bother you for the rest of your life. However, under certain conditions, inflammation can develop, accompanied by terrible pain, so when the question arises; “Do I need to remove the remaining tooth root?” The answer is simple: “Certainly, and the sooner the better.”
After a tooth has been removed and the root remains, what should you do? main question. You should not delay your visit to the doctor. Perhaps there is no root there, and the tongue cuts the sharp edge of the alveolar process. Then the dentist will simply grind it off and all the unpleasant sensations will disappear. However, in order to accurately exclude the presence of a root, you need to take an x-ray and probe the alarm zone.
Tooth root removal can be very simple or very complex. It all depends on the patient’s condition, his teeth and jaw bones. If the bone has partially resolved, then only a first-year student cannot cope with the operation medical school. It’s another matter if the root of the tooth is fractured as a result of mechanical damage, or if it is intact but located deep in the alveolus. Mechanical damage can be caused by trauma (strong impact), or improper previous treatment.
The operation to remove the root of a tooth has its own specifics. upper jaw, procedures vary depending on the type of tooth (incisors, canines, chewing teeth). The surgeon uses various tools to remove the roots of teeth: S-shaped, bayonet-shaped forceps. The latter are especially actively used when removing tooth roots from the upper jaw. In some cases, before the actual removal of the tooth root, it is divided into parts (usually using a drill). Tooth root removal is different from the process of removing an entire tooth and is usually more labor intensive.
Some patients ignore surgery to remove the root of the tooth if the crown part is no longer there. Motivation varies - usually the patient expects that the remaining tooth will come out on its own over time. Indeed, tooth fragments tend to come out on their own, but the root is not a fragment. It is often observed that the patient comes with the root already tightened - then it is necessary to cut the gums to gain access to it. The root of the tooth itself, if not removed in a timely manner, can provoke severe pain, inflammation. Remember: the tooth root does not dissolve!
Many Moscow clinics take on any, even the most complex cases. The experience and qualifications of doctors - specialists with extensive experience - will not allow them to complicate the operation themselves by causing mechanical damage to the tooth root or making mistakes when removing it. But they can correct other people's mistakes. Tooth root removal can be performed with forceps, elevators, or, when previous techniques have failed, by sawing.
Removal of the upper tooth root and lower jaw has technological differences. For different teeth (canines, incisors, chewing teeth), forceps of different shapes (straight, S-shaped, bayonet-shaped) and elevators (working on the principle of a lever) are used. The procedure itself is performed under local or general anesthesia. The dentist will choose a method for removing tooth roots, and anesthesia agents are selected in such a way as to eliminate the possibility of manifestations side effects(individual intolerance, allergic reactions).
If the root of the tooth is already overgrown, you will have to open it by cutting into the gum. This operation is also performed under anesthesia. After surgery, stitches may be placed and special medications may be used to speed up gum healing. Doctors will remove the root of any tooth, regardless of why only the crown was removed. Painless, fast, high quality.
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Procedure for opening a periodontal abscess
IN periodontal pockets always happen pathological processes. Whenever purulent discharge Symptoms characteristic of periodontal abscess occur. The gums become swollen and painful to the touch. Appears sharp pain when biting, in addition, the teeth adjacent to the developing abscess begin to hurt.
Closed sinus lift procedure
During this operation, the doctor creates a small cylindrical hole in the place where the implant will be installed in the future. Then the movement is made maxillary sinus using a special tool - an osteotome, and the freed space is filled with granular osteoplastic material, where it can then be installed in a previously prepared hole.
Hood excision procedure for pericoronitis
Pericoronitis (pericoronitis) is an inflammation of the soft tissue of the gums surrounding an erupting or erupted tooth. Pericoronitis often occurs during the eruption of wisdom teeth, when the tooth remains partially unerupted.
Open sinus lift procedure
A sinus lift is a dental procedure related to bone grafting. In most cases, it is necessary for high-quality installation of dental implants in the lateral sections of the upper jaw in conditions of insufficient bone volume.
Dental cavity opening procedure
Preparation of a carious cavity is performed according to generally accepted methodology with the condition that the volume of the carious cavity corresponds to the expected volume of the coronal part of the pulp. If there are carious cavities on the contact surface, it should be transferred to the lingual or palatal surface, and then the cavity should be opened through the carious cavity.
Seal removal procedure
Dental filling is the most popular service in Moscow dentistry. This is a treatment method that helps restore the shape and function of a damaged tooth using a filling, which is selected individually for each patient. But sometimes, on the contrary, it is necessary to get rid of the filling.
Baby tooth removal procedure
Milk teeth are the first teeth that appear in children from the age of six months, and they are replaced by permanent teeth from the age of five until thirteen. Their difference lies not only in how long they remain in the oral cavity, but also in their susceptibility to various types of deformations.
The question of installing an implant or restoring a tooth is usually decided when the roots of the tooth are healthy - in such cases, the doctor fills the canals, restores the crown with a pin, or together with the patient evaluates the possibility of prosthetics.
If the crown of a tooth is completely destroyed by caries and its restoration is impossible, the roots most often have to be removed - otherwise they become a focus chronic infection, leading to infection of surrounding tissues, and if the process is advanced, of neighboring teeth and the jaw area. In addition, a cyst can develop on the root - this is not only very painful, but also difficult to treat. The occurrence of a cyst is extremely dangerous unpleasant consequences- for example, rupture with the formation of phlegmon or osteomyelitis.
It often becomes necessary to remove even healthy roots if, as a result of an injury, the crown of the tooth is completely broken off - for example, if the chip partially extends under the gum or there is a high probability of infection in the canals.
The tooth roots remaining in the gums after extraction can cause significant discomfort to the patient, continuing to rot, hurt, and become infected. bone tissue. In rare cases, the roots do not cause any sensation at all and are only detected on an x-ray, but more often patients feel that the root has not been completely removed. Usually, after removing a tooth, a dental surgeon immediately checks whether there are any root fragments left in the gum, and, if necessary, performs an operation to remove them.
How are roots removed?
Removal of tooth roots is performed under local anesthesia(if indicated, general anesthesia is possible). This is a less painful operation than is commonly believed, although quite complex.
Typically, tooth roots are removed using special forceps, the shape of which depends on the location of the affected tooth and its structure. Also important role plays a role in the condition of both the actual roots to be removed and the tissues surrounding them.
If the remainder of the root cannot be pulled out with forceps, it can be removed with an elevator - a special tool that is inserted between the wall of the hole and the root. Roots connected to each other sometimes have to be separated using a drill and removed one by one.
Possible complications after removal of tooth roots - inflammation of the socket (alveolitis), bleeding, swelling. To avoid them, the doctor may prescribe antibiotics and anti-inflammatory drugs after removal.
Patients are often frightened by the upcoming procedure, but experienced dental surgeons can handle this operation without difficulty. Difficulties most often arise when removing the roots of “wisdom teeth” due to the peculiarities of their location, but for a qualified specialist this is not a problem.
Why are we afraid to pull out the root of a tooth?
Arsenic and unbearable pain are what patients remember after tooth root removal. The procedure seemed endlessly long, with patients visiting the dentist more than twice. The pain they experienced at this time was not relieved by any anesthetic.
How was a tooth root removed before?
The operation took place in two stages. At the first stage, the dental surgeon expanded the root canal with a drill, inserted arsenic into the pulp, placed a temporary filling and sent the patient home for two days. During the adaptation period the patient experienced toothache due to the effects of arsenic on the nerve and the body as a whole.
At the second stage, the patient had the root removed. It happened that the nerve did not die during this time. Because of this, the procedure was painful.
How do they do it now?
Tooth root removal takes place in one stage. The patient is injected with a thin needle and a modern anesthetic. Ultracaine or imported analogues. Within 10 minutes, the anesthetic begins to act, and the patient does not feel touch to the oral cavity. This is where the surgeon begins his work. It separates the circular ligament from the neck.
If the gum is not inflamed, then it is separated from the edge of the alveoli. To remove the root of a tooth, the surgeon will need forceps or an elevator. He grabs the root with them and pulls it out.
This procedure will take two hours. And the only thing unpleasant feeling The sound that the patient experiences is the sound of the devices.
In what cases will it be necessary to pull out the root of a tooth?
The main reason for tooth root removal is infection. Secondary reasons include excessive tooth mobility due to gum disease, the presence of a cyst, deep caries and chipping of the tooth wall.
Types of operations
Hemisection
Represents modern technology removal of the tooth root along with the crown. With this procedure, the tooth is preserved, as is its functionality.
With hemisection, there is a high probability that the tooth will not withstand the load. Therefore, dentists will not give you guarantees on its service life.
Average price for hemisection: 2500 rubles.
Amputation
In this case, the root is completely removed while preserving the crown. This makes it possible to save the tooth.
During amputation, the dental surgeon makes an incision in the gum, and the root is cut off with a drill and pulled out with forceps. The empty cavity is filled with bone-restoring or bone-plastic material and the gum is sutured.
Amputation has a number of contraindications for which it cannot be performed. These include diabetes, various immune and cardiovascular diseases, elderly age.
Cystectomy
This operation is prescribed if it is possible to remove a cyst on the root. In this case, the tooth is completely preserved. In essence, this is a simple procedure for an experienced surgeon, where the dentist’s main task is to remove the cyst and fill it with bone-forming material.
Average price for cystectomy: 3000 rubles.
How to behave after tooth root removal
After the operation, you should not eat, drink tea or coffee for three hours. It is also not recommended to drink alcohol or smoke cigarettes until the gums are completely healed.
Pain in the postoperative period
Often, patients return to the doctor complaining of tooth pain. This is normal, such pain is a consequence of changes in the structure of the jaw. As a rule, it appears when eating hot or cold food and when closing the jaw. In such cases, it is recommended to take an anesthetic. The pain will go away in a few days.
If the pain persists for a long time, contact your dentist, as it is possible that the root has not been completely removed.
Prices
The average cost of tooth root removal will be 3,500 rubles, in difficult cases the price will increase to 5,000 rubles. Please note: the price depends on many factors. To quickly find a clinic and find out the exact cost of treatment, use our search.
Don't put off visiting the dentist! Remember that it is easier to prevent a disease than to treat it.
