Is it possible to save a tooth?

Question

Is it possible to save a broken premolar if only the roots remain. There is only a bit of the tooth. The rest is the gum. No cementum and periodontal membrane. Is it possible to regenerate them? Thanks for your replies

Miller Vieira Paula, DDS · Answer

When only the roots of a tooth remain, and there is minimal visible crown structure above the gum line, options for restoring the tooth become limited. In dental practice, preserving a tooth requires a stable foundation that includes the periodontal ligament, cementum, and an adequate portion of the root structure. Here are key points based on your description:
1.- Structural Integrity of the Root: If the roots are in good condition without significant decay or infection, certain restorative procedures, like root canal treatment followed by a post and core build-up, may still be possible. However, this is contingent on having enough root length and structure to support restoration.
2.- Absence of Cementum and Periodontal Membrane: The cementum and periodontal ligament are essential for attaching the tooth to the surrounding bone, allowing it to function within the mouth. Without these structures, the tooth lacks anchorage, which complicates regenerative efforts. Current dental technology has not yet reached a stage where we can reliably regenerate these specific tissues in clinical settings.
3.- Regenerative Techniques: Although research is underway in dental tissue regeneration, including stem cell therapy and guided tissue regeneration, these methods are largely experimental. At this time, predictable regeneration of cementum and periodontal ligament in clinical practice remains challenging.
4.- Alternative Treatment Options: If restoring the tooth is not feasible, extraction and replacement options, such as dental implants or a bridge, may be considered. Dental implants, in particular, offer a stable and durable solution, closely mimicking the function and aesthetics of natural teeth.
Best Regards,Dr. Miller Vieira Paula

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