Learn more about how to properly extract retained roots.

By Dr. Brook Niemiec

Root fracture during extractions is very common in veterinary dentistry.  The removal of retained root tips may seem a daunting task, but with proper technique and training, it can be straightforward.  

The first point is to NEVER attempt to extract a root blind.  Fishing down an alveolus for a retained root is almost never successful and often results in forcing the root into the nose or mandibular canal. (Figure 1). 

This is because there is incomplete apical bone coverage in many cases, especially the premolars and molars of small-breed dogs.

The first step is to obtain radiographs to evaluate the retained roots. This will inform you of the amount of root left, as well as its positioning in relation to the vital structures.   Next, create a mucogingival flap (we generally recommend an envelope flap (Figure 2).

The length of the incision should be determined based on the anticipated amount of exposure required to retrieve the fragments.  Following flap creation, buccal cortical bone is removed with a carbide bur to a point somewhat below the most coronal aspect of the remaining root. (Figure 3) 

 If necessary, the bone can be removed 360 degrees around the tooth; however, this author attempts to avoid this aggressive approach.  Once the root (s) can be visualized (Figure 4), careful elevation with small, sharp elevators is initiated. (Figure 5)

Once the root is mobile, it can be extracted normally.  After the root is extracted (Figure 6), the bone is smoothed and the defect closed. (Figure 7)