Fixed PRos For Periodontally Compromised Teeth

Question 1

What are some issues for using fixed pros in periodontally compromised teeth?

Answer 1

• Crown root ratio increased
• More apical=closer to pulp
• Limited ability to correct alignment

Question 2

How many mm of attachment loss equates to 50% loss of surface area in first molars?

Answer 2

6mm

Question 3

What are some indications for root resection?

Answer 3

• Tunneling or hemisection (splitting the entire tooth in half) can not improve access to oral care or severe isolated defect exists
• Severe bone loss around roots of the molars but not involving all of them
• Untreatable furcation involvement
• Vertical or horizontally fracturd roots
• Severe caries
• Internal or external root resroption
• Inability to treat one root canal successfully
• Severe dehisence around a root and sensitivity which precludes grafting
• Failure of abutment in long span FPD
• Strategic removal of root to improve adjacent tooth prognosis

Question 4

What are some contraindications for root resection?

Answer 4

Closley approximated or fused roots

• Signficantly decreased osseous support
• Increased crown: root ratio
• SEverely diminished coronal structure
• RCT not possible

Question 5

What are the options for restoring teeth after root resection?

Answer 5

• Remaining root restored as individual tooth
• Used as pros abutment
• Premolarization
• Minimum treatment (e.g. amalgam)

Question 6

What are the surivival rates of root resected teetH?

Answer 6

• 55% failure over 5-7 years
• Failure type restorative, endodontic
• Most common on mandibular roots

Question 7

What factors can improve prognosis for root resected teetH?

Answer 7

-Protective occlusal scheme
-Flattened cusps
Reduced overlap