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The root of the cause: a clinical case report of the surgical removal of a retained root via an extra-oral approach Melissa Loh Hamnah Azam David Carl Jones Dental Update 2024 49:2, 707-709.
Authors
MelissaLoh
BDS (Liverpool), MFDS RCS (Glasgow)
PGCert Teaching and Learning in Clinical Education (Edgehill), Speciality Registrar in Oral Surgery, Morcambe Bay Hospitals
Retained roots are commonly seen as an incidental finding in general practice following radiographic examination, many being asymptomatic. However, over time they may migrate, develop pathological change and become symptomatic for the patient. This article illustrates root migration using an interesting clinical case to demonstrate how it can present, and the surgical techniques required in its removal. In this particular case, the retained root of a lower right second molar migrated to below the right side of the inferior alveolar nerve.
CPD/Clinical Relevance: It is important to recognize when referral for a specialist opinion is appropriate.
Article
Retained roots are commonly seen as an incidental finding, with many being asymptomatic. A general dental practioner (GDP) may notice this incidental finding in practice following radiographic examination. Over time the retained root may migrate, develop pathological change and become symptomatic for the patient. Long-term chronic pathology can lead to a cystic change1 and result in dental pain. A surgical extraction is often indicated in order to resolve the problem. In this circumstance, the patient may be referred to an oral and maxillofacial department for further investigation.2
The literature shows that mandibular roots are more likely to be retained than maxillary roots following attempted dental extraction, and that posterior teeth are six times more likely to be retained than anterior teeth.3 It is also known that the clinical experience of the operator is another factor involved with teeth fracturing upon attempted extraction, as more experienced dentists are less likely to have post-extraction complications.3
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