Submucosal root retention. A two-year clinical observation

The Value of a Tooth for Alveolar Ridge Management; Strategies to Manage Ankylosed Maxillary Anterior Teeth in Young Patients

OBJECTIVE

In the young and growing patient, tooth ankylosis impedes alveolar growth and presents a serious dilemma regarding the best treatment approach. Two common treatment approaches, extraction of the ankylosed tooth or a "wait and see" will result in a compromised alveolar ridge that can affect future prosthetic rehabilitation. The purpose of this article is to discuss five treatment strategies that can be utilized in the management of tooth ankylosis in the growing patient: (1) extraction, (2) decoronation or root submergence, (3) socket shield (partial extraction), (4) segmental osteotomy and (5) replacement with tooth autotransplantation.

OVERVIEW

It is important to understand the biologic sequelae of ankylosis and the value of the tooth for alveolar ridge management. Strategies will be discussed with an emphasis on alveolar ridge management using a natural tooth and root. With an interdisciplinary team, treatment options can then be developed, to achieve more favorable long-term outcomes.

CONCLUSIONS

An understanding of each of these procedures and the proper time for implementation will help the clinician achieve the most optimal long-term outcomes for these growing patients.

CLINICAL SIGNIFICANCE

There are several treatment options for traumatized ankylosed incisors in growing patients. This article will describe the details of these treatment strategies, emphasize the value of the tooth for ridge management and present guidelines about selecting the most optimal strategy based on age, rate of growth, condition of the traumatized tooth, and the definitive prosthetic plan.

Clinical parameters that affect performance and patient satisfaction of root-retained overdentures: A systematic review of randomised controlled clinical trials

OBJECTIVE

To evaluate clinical parameters that affect the performance of root-supported overdentures (ROD) and to identify the possible factors that may affect it.

BACKGROUND

ROD still serve as an alternative and successful treatment plan nowadays for partially edentulous patients. Nonetheless, there is not yet conclusive evidence about their clinical evaluation.

MATERIALS AND METHODS

A search strategy was developed following a PIO (Population, Intervention, Outcome) framework including an electronic search in the following databases: PubMed, Cochrane Library and Scopus. The systematic search included only randomised controlled clinical trials (RCTs), published until January 2023 in English language and was performed by two independent reviewers. Quality assessment of the included studies was conducted according to the Cochrane Risk of Bias tool.

RESULTS

The final selection of studies included 11 RCTs. Clinically relevant variables derived from this search were: Complications, with caries being the most frequently reported, periodontal aspects and bone changes around abutment teeth. Additionally, methods and clinical suggestions for the maintenance of these restorations and patient-related outcomes were assessed. According to the risk of bias assessment, nine studies were considered of high risk, whereas only 2 of low risk. A meta-analysis was not feasible.

CONCLUSION

Within the limitations of this systematic review, ROD remain a viable treatment plan, offering better denture stability and bone preservation around abutment teeth and high patient satisfaction. Thorough oral hygiene and regular follow-ups are of utmost importance. Further well-designed RCTs are necessary for firmer conclusions.

Root submergence technique as a partial extraction therapy to preserve the alveolar ridge tissues: A systematic review and appraisal of the literature

STATEMENT OF PROBLEM

As socket grafting with commercially available biomaterials has become popular, reports of the root submergence technique for ridge preservation have decreased. A systematic review of this partial extraction therapy is lacking.

PURPOSE

The purpose of this systematic review was to review the root submergence technique as well as critically appraise the available data.

MATERIAL AND METHODS

A review was carried out that observed the Participant, Intervention, Comparison, Outcomes (PICO) strategy and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The focused question was "What are the outcomes of the different methods to submerge tooth roots for ridge preservation?" Medical subject headings (MeSH) terms that related to the root submergence technique were searched in PubMed/MEDLINE, Scopus, and the Cochrane Library databases.

RESULTS

A total of 7709 abstracts and study titles were individually screened from the initial search results. After reviewing the full-text articles and applying the selection criteria, the final included search results totaled 47 full-text articles for in-depth review. In 10 animal studies, 258 roots were studied in 34 dogs and 7 monkeys. Histological data confirmed that coronal bridging (bone or cementum growth over the cut root) was a common outcome. Of the vital roots submerged, the majority maintained their vitality. In 37 human studies, 475 roots were submerged and reported on. Subjective ridge preservation was often reported. Among the adverse healing outcomes, exposure of the root through the mucosa was the most common. Nonetheless, in animals, 86.8% of roots remained submerged; in humans, 74.7%.

CONCLUSIONS

Root submergence is an established technique for ridge preservation. Exposure is a common complication, and correct technique may be key to its prevention. Further research of this partial extraction therapy is encouraged.