A minimally invasive technique for primary tooth extraction: a case report

Gabriela Oliveira Borgo,Kelly Maria Silva Moreira,Karina Guedes De Sousa,Regina Maria Puppin-Rontani

doi:10.1590/1981-86372021002020190153

Gabriela Oliveira Borgo, Kelly Maria Silva Moreira + Show 2 more

Open Access

https://doi.org/10.1590/1981-86372021002020190153

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Abstract

ABSTRACT Root resorption is characterized by the loss of cementum and / or dentin from the tooth root as a result of internal or external odontoclastic action. This case reports a premature cervical root resorption of deciduous teeth in an 8-year-old boy. Large root resorption on the mesial faces of the maxillary and mandibular right and left deciduous canines (teeth #53, #63, #73 and #83), with asymptomatic pulp involvement, was detected during routine radiographic examination for orthodontic planning. The patient was managed with extraction of the affected teeth using two different techniques: conventional and alternative. The conventional technique, forceps, was used for the maxillary and mandibular left canines (teeth #63 and #73). And alternative technique using the periotome device, usually required for extraction during dental implant surgery, was used for the maxillary and mandibular right canines (teeth #53 and #83). The periotome device showed to be an alternative to improve pediatric surgery due to better patient behavior and healing, and to reduced procedure length.

Highlights

Root resorption is characterized by the loss of cementum and / or dentin from the tooth root as a result of internal or external odontoclastic action [1]
External root resorption (ERR) diagnosis has become easier with the improvement of radiographic techniques combined with Cone Beam Computer Tomography (CBCT) [7, 8], which has been considered the best approach to diagnose root resorption lesions
There is no consensus in the scientific literature about the best clinical management of root resorption [9], it is important to consider that the residual dental structure should be able to self-restore and self-preserve

Summary

INTRODUCTION

Root resorption is characterized by the loss of cementum and / or dentin from the tooth root as a result of internal or external odontoclastic action [1]. This instrument breaks apart the fibers of the periodontal ligament before tooth extraction, thereby reducing the tissue trauma and maintaining the soft and hard tissue architecture, which is important to prevent root fracture [20] Since this technique is not commonly used in pediatric dentistry, the aim of this case report was to show the usefulness of the periotome for extraction of deciduous teeth due to premature cervical root resorption. All lesions were located on the cervical area, indicating external cervical resorption (ECR) with pulp exposure This same radiograph showed a slight distalization of the germs of the mandibular right and left second premolars (teeth #35 and #45, respectively), possibly interfering in the exfoliation of the mesial roots of the mandibular right and left deciduous molars (teeth #75 and #85, respectively), as shown in figure 1. A minimally invasive extraction technique was used with the periotome device (figure 2)

DISCUSSION

CONCLUSION