Root Resection: An Alternative Treatment Option to Extraction

Root resection is the process by which one or more of the roots of a tooth are removed at the level of the furcation while leaving the crown and remaining roots in function [1]. Indications for root resection therapy include: teeth with periodontal problems, endodontic problems, root fractures, and prosthetic problems [2]. Vertical root fracture (VRF) is an untoward complication to root canal therapy that often calls for tooth extraction. Aetiological factors for VRF include loss of substance due to restorative and endodontic therapy and stress factors associated with root canal debridement and filling [3]. Root canal preparation causes stress in dentin and may initiate dentinal cracks, which can extend to complete fractures under masticatory forces [4]. VRF usually originates from the apical end of the root and propagates coronally or depending on the nature of stresses, originate from the cervical portion of the root with extension in an apical direction [4]. Usually, patients of middle and older age are affected. An overall prevalence of 3% to 5% has been reported in literature [5]. The clinical presentation of VRF is extremely variable and may include fistula and abscess formation, development of a deep, narrow and isolated pocket, radiographically visible bone resorption along the lateral surface of the root and depending the on the angle of the X-ray cone beam, radiographically visible fracture line [6].