Often, when removing a tooth, a dentist hears a familiar cracking sound. He or she hopes that it is just the alveolar bone. However, after removing the tooth, sometimes the dentist discovers that there is a root tip left in place.
This is a tricky and potentially dangerous situation. The root tip can be pushed into the sinus, the mandibular nerve canal or the buccal mucosa. This would cause the need for an additional surgical procedure or a referral for treatment. Following is a description of a procedure that can prevent this situation from arising, it is one I have used for years with success.
THE PROCEDURE
After confirming that the root tip is still in the socket, attempt to see if suction will remove it. If this action does not remove the root tip, rinse the area well to identify the root canal. Then screw a no. 35 Hedström file (only occasionally do I use a different size) in the canal until it is tight, but not so tight that the file breaks off.
Once the file is securely in place, you can feel more confident that you have control of the situation. Gently tug on the file; often, the root tip will slip right out.
If the root is still tight, leave the file in place and proceed with your usual methods of retrieval. When you use various methods to remove bone around the root tip, you will feel more confident that you will not lose the root tip. After each maneuver, gently tug on the file until the root tip comes out (Figure
).
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