Chirurgia radicolare: indicazioni e tecnica

Osseous resective surgery deals with treatment of roots and multirooted teeth affected by different kinds of disease or lesions, mostly of periodontal nature. It involves techniques which enable the clinicial in preserving the stability by sacrifying only part of the compromised roots. In this study, such surgical procedures will be described in relation to simplified definitions:- root separation and extraction; - root separation; - root amputation. With root amputation it is possibile to leave the overlying reconstruction unaltered or perform a modification of the crown (plasty) in order to realize a coronal anatomy compatible with the direction of occlusal loading. Both root separation and amputation require eventually a prosthesis and prostetic appliances, would have to be prepared for easy cleaning, both for home care standards and for professional maintenance, and for proper distribution of occlusal load. Such treatments seem to be a valid alternative when compared to tooth extraction followed by conventional fixed or removable prosthesis, or implant supported, more complex and expensive. The choice for one or the other solution (conservative or extractive) depends upon the evaluation of all the prognosis factors invloved with both procedures, which are mostly patient’s compliance and the presence of anatomical favorable relationships. Once such information are obtained, after proper clinical and radiological exams, the surgical protocol would have to be followed very stringently: endodontically, operatively, surgically and prosthodontically. Only by following all these steps and the right patient selection good results can be obtained, with a long term prognosis.