ROOT MORPHOLOG Y Medical Assignment Help

ROOT MORPHOLOG Y

.’Just as the root morphology of the erupted tooth has a major influence on the degree of difficulty of a closed extraction, root morphology plays a major role in determining the degree of difficulty of the impacted tooth’s removaL Several factors must be considered when assessing the morphologic structure of the root The first consideration is the length of the root. As discussed earlier, the optimal time for removal of an impacted tooth is when the root is one third to two thirds formed. When this is the case, the ends of the roots are . blunt and almost never fracture (Ffg. 9-29). If the tooth is not removed during the formative stage and the entire length of the root develops, the possibility increa~es for

FIG. 9-29

FIG. 9-29

FIG. 9-29 Roots that are two thirds formed, which are less difficult· to remove abnormal root morphology and for- fracture of the root tips during extraction. If the root development is insufficient (i.e., less than one third complete), the tooth is more difficult to remove; because it tends to roll in its crypt like a bait in a socket, which prevents easy elevation (Fig. 9-30). The next factor to be assessed is whether the roots are fused into a single, conic root (Fig. 9-,31), or if they are separate and distinct roots. The fused, conic roots are eas- . ier to remove than widely separateroots (Fig. 9-32). . The curvature of the tooth roots also plays a role in the difficulty of the  xtraction. Severely curved or dilacerated roots are more.difficult to  emove than straight or slightly curved roots (see Fig. 9-32). The surgeon should carefully examine the apex area of the radiograph to assess FIG, 9-30

FIG, 9-30

FIG, 9-30 Lack of root development If extraction is attempted,
crown will roll around if}crypt, which makes it difficult to remove

FIG. 9-31

FIG. 9-31

FIG. 9-31 Fused roots with conic shape.

the presence of ‘small, abnormal, and sharplj’ hooked
roots that probably fracture if the surgeon does not giYC’
them special consideration.
The direction of the tooth root curvature is also important
to examine preoperatively. During removal of a
mestoangirlar impaction, roots that are curved gently in the
distal direction (following along the pathway of extraction)
can be removed without the force that can cause fracture of
the roots. However, if the roots of a mesioangular
tmpacuen are curved mesially, ‘the roots almost always fracture
or must be sectioned before the tooth can be delivered.
The total width of -the·roots in the mesiodistal direction
should be compared with the width of the tooth at the
cervical line. If the tooth root width is greater, the extrac-

FIG. 9'-32

FIG. 9′-32

FIG. 9-33

FIG. 9-33

FIG. 9-33 Wide periodontal ligament space. Such space makes extraction process less difficult

tion will be more difficult. More bone must be removed or the tooth ‘must be sectioned before extraction. Finally, the surgeon should assess the pcriodontalligament space. Although in: most patients the periodontal
ligament space is of n ormal dimensions, it sometirrres iswider or narrower. The wider the periodontal ligament  space, the easier the tooth is to remove (Fig. 9-33). A third polar that is in the proper stage of development for
removal has a relatively broad periodontal ligament space, which eases’ extraction. However, older patients,  especially those over age 40, tend -to have a much  rower periodontal ltgament space, which thereby lncreases
the difficulty  of the extractionthe presence of ‘small, abnormal, and sharplj’ hooked  roots that probably fracture if the surgeon does not giYC’
them sp ecial consideration.The direction of the tooth root curvature is also important  to examine preoperatively. During removal of amestoangirlar impaction, roots that are curved gently in the distal direction (following along the pathway of extraction) can be removed without the force that can cause fracture of  the roots. However, if the roots of a  esioangulartmpacuen are curved mesially, ‘the roots almost always fracture or must be sectioned before the tooth can be delivered. The total width of -the·roots in the  direction should be compared with the width of the tooth at the cervical line. If the tooth root width is greater, the extractuntitled

tion will be more difficult. More bone must be removed or the tooth ‘must be sectioned before extraction. Finally, the surgeon should assess the pcriod on talligament space. Although in: most patients the periodontal
ligament space is of normal dimensions, it sometirrres iswider or narrower. The wider the periodontal ligament space, the easier the tooth is to remove (Fig. 9-33). A third’ molar that is in the proper stage of development for
removal has a relati vely broad periodontal ligamentspace, which eases’ extraction. However, older patients,  especially those over age 40, tend -to have a much narrow rower periodontal ltgament space, which thereby ncreases the difficulty of the extraction.

 

 

 

 

 

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