(TC52) Dental Submergence, A Case Report

Root submergence is an established technique for ridge preservation associated with non-restorable teeth. Indications include teeth under complete dentures, fixed partial dentures, or in cases of incomplete mandibular or maxillary growth prior to future implant placement. Alveolar ridge width decreases by up to 50% one year after extraction, so root submergence is a predictable and desirable technique to avoid significant bone loss.  In this case, a 17-year-old male presented with previously treated tooth #8 with asymptomatic apical periodontitis. Endodontic retreatment was initiated, but between the first and second appointment, the crown broke off at the gingival crest. The tooth was deemed non-restorable, and the patient elected for future implant placement once maxillary growth was complete.  Rather than extract the tooth, endodontic retreat was completed and the tooth obturated with white MTA. Next, the remaining coronal tooth structure was removed such that it was 2mm below the crestal bone.  The gingival tissues were sutured in such a way to allow secondary intention healing around the coronal aspect of the resected tooth, thus encouraging a wider band of keratinized tissue over the tooth root.   At a 2-month follow-up visit the periapical lesion showed evidence of radiographic healing and the soft tissue was completely healed covering the root. This case suggests that root submergence is a favorable treatment option to maintain alveolar bone in otherwise non-restorable teeth.