Retained Root ..

Retained Root :
Retained root refers to the partial root structure that remains in the jaw following the extraction or fracture of a natural tooth. If the retained root remains it will either stay frozen in the bone forever or work its way out where it can be removed. Retained root however may cause infection of the jaw or osteitis.

Examinations :
Retained roots are generally discovered during routine ..

Ex: Her we have panoramic radiogrph show retained upper lateral incisor.


Removing of retained root :
Retained root can be removed if it is causing pain to the patient. If the patient feels some type of jaw or facial pain which can either be dull and infrequent or a nagging deep aching pain there is the possibility that the retained roots have caused osteitis to the jaw.

• common symptom of this problem is the presence of a bitter taste or smell emerging from an unknown area in the mouth. The most susceptible regions of the teeth to this problem is the wisdom tooth areas (third molar regions) followed by the first molar areas (six-year molar areas.)


• Retained roots are also used a way to provide support to overdentures. Overdentures can either be a full or partial denture which is designed to fit over retained teeth or roots. The advantage that overdentures have over complete destures is that the retained roots aid in the preservation of the alveolar bone and also provides an established pattern of mastication and height of bone in the alveolar ridge. However in instances of severe tooth decay the roots will have to be removed


Removal of retained root :

Operation :

-Incision
The papilla between the two teeth adjacent to retained root
is released .

- Reflection
The undermining of the flap commences at the relieving
limb, using the curette end of a Mitchell's trimmer. This
makes it easier to insert the broader, blunter Howarth's
periosteal elevator, which is advanced along the bone
and peels off the mucoperiosteal flap.

- Elevation and delivery

The root can be clearly seen, and no overlying bone
removal is necessary. A medium Coupland's chisel is
used to loosen the root from its attachment mesially
and distally, and to define the buccal and palatal margins
prior to the application of forceps.
The root is easily removed, with care taken not to
crush the hollow carious area between the blades.

- The socket
The socket is clean and the margins smooth.

- Closure
The first suture draws the flap into the mesial corner
of the defect, and the second closes the gaping anterior
relieving limb of the incision.

- Follow-up
A week later, the sutures are removed and the area has
healed well. There is some local plaque accumulation,
and the patient needs to be encouraged to brush the
area vigorously and not hold back for fear of damaging
the healing wound.

Refernces :
http://www.dentalfind.com/glossary/retained-root.html
An atlas of minor surgery by David A McGowan second edition