Residual Roots

procedures2-15

Sinus closure

All the roots of maxillary back teeth have a relation to the maxillary sinus in the upper jaw. When removing these roots or teeth, the sinus can be exposed resulting in an antro – oral fistula. This means that there is a communication between the mouth and the maxillary sinus resulting in food entrapment in the sinus.

This can lead to a severe sinus infection, complicating the closure of the fistula afterwards. This is why all sinus exposures are treated immediately by means of a sinus closure.

Because nose blowing can expose the sinus again, the patient is asked not to blow the nose for 10 – 14 days after the operation.

Residual Root & Extractions

Most single residual root removal or extractions can be performed under local anaesthetic in the rooms. In most cases we will wait for the socket of the tooth to heal with bone formation, before placing an implant. In the anterior maxillary region, called the esthetic zone, a different approach is sometimes followed, and implants are sometimes placed immediately after tooth removal.
In all cases of tooth removal, the missing tooth must be replaced with an implant to avoid bone loss in the long run.
THE DENTECTOMY AND THE FITTING OF DENTURES WITH IMPLANT PLACEMENT:
The removal of all teeth, and the simultaneous placement of dentures, is called a full dentectomy. This procedure is in most cases, performed under general anesthetic.
When planning a dentectomy, the dentist will discuss all options available to avoid doing a
dentectomy. The financial implications to restore all the remaining teeth might be too high, or the remaining teeth might be in too an advance state of decay to restore them. In these situations the option of a dentectomy and the placement of implants might be the only practical solution.
Once the teeth are removed, bone loss will start. The dento- alveolar bone ( this is the bone supporting the teeth), will rapidly fall away, and it is recognized that all the dento – alveolar bone will be gone in 10 to 15 years after a dentectomy, if implants were not placed. This will result in the lower denture floating on the lower jaw (loose), or in the case of the upper jaw, falling out during speech or chewing. This is why having a dentectomy, can be life changing with detrimental effects on your general health in the long run.
It is universally accepted today, that after a dentectomy, the patient’s jaws will need to be
reconstructed with implant placements afterwards.
Implant placement in the jaw, has the additional benefit, on top of fixation of the denture or bridge in the mouth, to stop the dento – alveolar bone from falling away. The bone is therefore preserved in the long run.
When receiving a dentectomy, or single tooth /residual root removal, planning should already be done to restore the missing teeth / tooth with an implant.
Prior to the dentectomy, the dentist will manufacture an immediate denture for placement immediately after the procedure. Relining and relieving of the denture will be necessary within a week after the dentectomy. This immediate denture will have to be replaced with a new denture after 1 year. If implants are to be placed at the same time as the dentectomy, thorough planning will be done prior to the procedure.

Immediate denture info