Our patient was a 41-year-old male who presented as a non-smoker. He had a family history of dental issues on his mother’s side, who had lost many teeth over the years. Despite having good oral hygiene and reasonable compliance with hygienist maintenance, he had been diagnosed with GAP (old classification) or Stage 3 Gr C periodontal disease.
The patient had undergone numerous rounds of root surface debridement (RSD) over the years, including previous treatment in the USA. His lower right tooth number six (LR6) had been a subject of discussion due to its uncertain prognosis.
Given the severity of his condition, regeneration was not an option. The patient was presented with several treatment alternatives for LR6, and after careful consideration, he decided to try root resection. His occlusion was checked and found favourable for this procedure.
Despite having minimal and stable residual pockets for 20 years and mobility 1, the root resection was successful. The patient was satisfied with the outcome.
The patient was last seen in 2018, four years after the root resection procedure. At that time, the LR6 was still in place, but there were clear signs of failure. Despite this, the patient reported no symptoms.
There were no significant pockets present, and the tooth displayed grade 1-2 mobility. It’s worth noting that despite these issues, the patient had minimal maintenance needs.
In a recent update, it was understood that the LR6 was extracted in 2022. This indicates a 26-year survival period post root resection procedure, with minimal maintenance – a testament to the long-term stability that can be achieved with this treatment approach when executed effectively.
This case demonstrates that root resection can provide long-term stability for patients with periodontal disease. However, it requires multiple factors to be successful, including good periodontal health, endodontic treatment, and favourable occlusion. This approach could be a viable option for general dentists considering referrals to Perio and Implants.
Dentists should be aware that while root resection can be a successful treatment option, it requires careful patient selection and meticulous execution. A comprehensive understanding of the patient’s oral health status, including periodontal, endodontic, and occlusal conditions, is essential to determine the most effective treatment plan.
The success of this case underlines the importance of considering all available treatment options and tailoring the approach to the individual patient’s needs and circumstances. Furthermore, regular follow-ups and maintenance are crucial to ensure the best possible outcome for the patient.