Window Approach for Simultaneous Root Fragment Removal and Implant Placement: Two Case Reports

Abstract

Introduction: Root fracture during extraction is not uncommon due to the presence of multiple and thin roots, which are often divergent and curved. The retained root fragments (RF) are usually radiographic incidental findings and often asymptomatic without associated pathology. However, careful and conservative surgical strategies for the removal of RF must be incorporated to allow for simultaneous implant placement and to avoid potential complications such as compromised osseointegration or retrograde peri-implantitis. Conventional RF removal techniques may lead to a significant amount of bone removal, involving more trauma and a prolonged healing period. Case Presentation: In these two case reports, the Window Approach for Simultaneous Root Fragment Removal and Implant Placement (WASRIP) technique was used to extract RF in a minimally invasive fashion to preserve both the coronal and apical bone, which are critical components in providing mechanical stability for simultaneously placed implants. All implants presented in both cases showed adequate primary stability and successfully achieved osseointegration at a 3-month follow-up period. Conclusion: Through the buccal window, sufficient access was provided to remove RF atraumatically with maximal retention of surrounding bone that led to predictable implant placement. Key Words: dental implant therapy; peri-implantitis; alveolar ridge; alveolar ridge augmentation; bone regeneration.