Palatal root resection of compromised maxillary first molars

Seong-Nyum Jeong

doi:10.5051/jkape.2009.39.3.375

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Jeong: Palatal root resection of compromised maxillary first molars

Case Report

The Journal of the Korean Academy of Periodontology

The Journal of the Korean Academy of Periodontology 2009; 39(3): 375-381.

Published online: 30 September 2009

DOI: https://doi.org/10.5051/jkape.2009.39.3.375

Palatal root resection of compromised maxillary first molars

Seong-Nyum Jeong

Department of periodontology, Daejeon Dental Hospital, School of Dentistry, Wonkwang University, Korea.

Correspondence: Dr. Seong-Nyum Jeong. Department of Periodontology, Daejeon Dental Hospital, School of Dentistry, Wonkwang University. 1268 Doonsan-dong, Seo-gu, Daejeon, 302-120, Korea. seongnyum@wonkwang.ac.kr, Tel: 042-366-1128, Fax: 042-366-1115

Received 28 July 2009 Accepted 17 September 2009

Abstract

Purpose

Root resection can be a valuable procedure when the tooth in question has a high strategic value. The prognosis of root resection has been well documented in previous studies, but the results focused on the palatal root resection have not been discussed in depth. I represent here the short term effectiveness of palatal root resection of maxillary first molars.

Methods

Palatal root resection was performed on maxillary first molars of three patients. All the palatal roots were floating state on the radiographic finding and showed full probing depth and purulent exudation at initial examination. Reduction of palatal cusp and occlusal table was performed concomitantly. Endodontic therapy was completed after root resection.

Results

Compromised maxillary first molars were treated successfully by palatal root resection in 3 cases. The mobility of resected tooth was decreased a little bit. The probing pocket depth of remaining buccal roots was not increased compared to initial depth. All the patients satisfied with comfort and cost effective results and the fact they could save their natural teeth.

Conclusions

Within the above results, palatal root resection is an effective procedure treating compromised maxillary first molar showing advanced palatal bone loss to root apex with or without pulp involvement when proper case selection is performed.

Keywords: maxilla, molar, palate, tooth root

Figures and Tables

Figure 1

Preoperative periapical view.

Figure 2

Palatal root was removed.

Figure 3

Apical curettage was done.

Figure 4

Cusp reduction.

Figure 5

Suture.

Figure 6

Post-op 1month.

Figure 7

Post-op 6month.

Figure 8

Post-op 6month.

Figure 9

Preoperative periapical view.

Figure 10

After flap elevation.

Figure 11

Cutting of palatal root.

Figure 12

Resected palatal root.

Figure 13

Odontoplasty was done.

Figure 14

Bone graft on extraction socket.

Figure 15

Suture.

Figure 16

Core build-up.

Figure 17

Post-op 3month.

Figure 18

Preoperative periapical view.

Figure 19

Palatal fistula opening.

Figure 20

Root crack was detected after flap elevation.

Figure 21

Root cutting.

Figure 22

Reverse filling.

Figure 23

Bone graft.

Figure 24

Suture.

Figure 25

Post-op 3week.

Figure 26

Post-op 4month.

Table 1

Probing Pocket Depth Change(mm)

M: Mesial, D: Distal, B: Buccal, P: Palatal

^*There was discrepancies in probing sites between pre-op. and pot-op. due to tooth structure change after root resection procedure.

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