implant special

Retained root tip: Recommendations?

Last Updated March 06, 2018
Reviewed By:  OsseoNews Team

I extracted a left maxillary first bicuspid #12 (24) today. The plan was to place an immediate implant after extraction. However, the extraction turned out to be very difficult because the tooth had very slim roots, extremely thin buccal plate that fractured during elevation of the buccal root tip, and a minor oroantral communication was noted on the palatal root. Upon cleaning the socket a third slim root was identified and I luxated the root and decided to graft the area and postpone implant placement after dealing with oroantral communication. I completed the procedure by placing a membrane over the graft and suturing the flap. The final x-ray showed that the root tip of the disto-buccal root remained in the bone. Due to time constraint and patient commitment to a family event, I couldn’t reopen the surgical site today to remove the root tip. The patient will be seen this coming Friday. My questions are as follows:

1. Should I reopen and retrieve the root tip on the next visit and re-graft?
2. Should I leave the root tip and remove it at the time of implant placement?
3. Should leave the root tip in place and deal with complications if they arise?

I am sorry I couldn’t upload x-rays because they were sent in an incompatible format to my email

Your feedback would be most helpful and appreciated. What do you recommend?

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