TRANS-ALVEOLAR EXTRACTION TECHNIQUE OF RETAINED DENTAL ROOT FIRST LEFT MAXILLARY MOLAR USING LOCAL ANESTHESIA

Abstract

Background: Extraction of retained maxillary molar roots is often complex due to crown loss, deep root position, and morphological variations like trifurcations. These factors limit the effectiveness of intra-alveolar techniques, increasing risks of root fracture and tissue trauma. Trans-alveolar extraction offers wider access and better surgical control. Objective: This case report aims to present the clinical management of a retained root of tooth 26 using the trans-alveolar extraction technique. Case Report: A 58-year-old female patient presented to Soelastri Dental Hospital with a chief complaint of a remaining root fragment in the maxillary left molar region and requested extraction. Clinical intraoral examination revealed retained radices of tooth 26 without signs of inflammation, mobility, or tenderness on percussion and palpation. Panoramic radiographic evaluation confirmed the presence of retained root fragments embedded within the alveolar bone, with no associated periapical pathology. Case Management: The trans-alveolar extraction procedure was carried out under local infiltration anesthesia. A mucoperiosteal flap was elevated, followed by controlled removal of alveolar bone up to the furcation area. Root separation was performed to facilitate the removal of the radices. The socket was thoroughly debrided, sharp bony margins were smoothed, and primary closure was achieved with suturing. Conclusion: Trans-alveolar extraction is a reliable and effective surgical technique for managing retained root fragments associated with severely damaged teeth.