Overview
Retained dental roots occur when the root or roots of a tooth remain embedded in the alveolar bone after the coronal portion of the tooth has been removed or naturally exfoliated, potentially leading to complications such as infection, pain, and impaired healing 2.Diagnosis
Clinical examination and radiographic imaging (X-rays, CBCT) are essential for identifying retained roots 2.
Assessment of symptoms including pain, swelling, and signs of infection aids in diagnosis 2.Management
Surgical removal under local anesthesia or conscious sedation for pain management and patient comfort 1.
Consider conscious sedation in conjunction with local anesthesia to reduce postoperative pain and enhance patient satisfaction 1.
Soft tissue closure techniques, such as the modified palatal pedicle connective tissue flap, may be employed in cases involving grafting to prevent ridge resorption and improve esthetic outcomes 2.Special Populations
Pregnancy: No specific guidance provided in the abstracts.
Pediatrics: No specific guidance provided in the abstracts.
Elderly: Conscious sedation may be particularly beneficial for elderly patients to manage pain and anxiety effectively 1.
Comorbidities: Management should consider the impact of comorbidities on anesthesia and surgical risks; tailored sedation protocols may be necessary 1.Key Recommendations
Utilize conscious sedation combined with local anesthesia to decrease postoperative pain and enhance patient satisfaction following surgical removal of retained dental roots (Evidence: Moderate 1).
Employ advanced soft tissue closure techniques, such as the modified palatal pedicle flap, in cases requiring socket grafting to preserve ridge integrity and esthetics (Evidence: Weak 2).
Tailor anesthesia approaches based on patient age and comorbidities to optimize safety and comfort (Evidence: Expert opinion).References
1 Bedeloğlu E. Evaluation of the effect of conscious sedation on patient satisfaction and pain after wisdom tooth extraction. Journal of stomatology, oral and maxillofacial surgery 2022. link
2 El Chaar E, Oshman S, Cicero G, Castano A, Dinoi C, Soltani L et al.. Soft Tissue Closure of Grafted Extraction Sockets in the Anterior Maxilla: A Modified Palatal Pedicle Connective Tissue Flap Technique. The International journal of periodontics & restorative dentistry 2017. link