When a patient loses an anterior tooth, root banking is probably not the first thing that comes to mind. However, it is a procedure you may want to familiarize yourself with. If the patient is esthetically concerned, it’s a great treatment option as long as the patient has a biologically healthy root and they don’t have any periodontal problems.
Here are the steps to help guide you through a successful root banking procedure.
- Fill the canal area with resin-modified glass ionomer cement. Also, if the tooth had a previous post present, you’ll need to clean up where the post was located and make sure the area is free of caries before filling the canal with the cement.
- The next step is to reduce the coronal portion of the tooth until it is just below the bone, about .5 mm. Before this part, you want to check to see where the tooth is positioned relative to where the bone is. If you want to chip away parts of the tooth as opposed to grinding down the teeth and gingiva, carefully prep the inside of the tooth to thin out the walls of the tooth structure.
- Finally, make a provisional for the area. It is very important to have the correct contours and emergence profile especially interproximally. There must be 2 mm of space between the pontic of the provisional and the remaining root structure. This ensures optimal tissue health and esthetics.
What makes this often overlooked procedure good to know is that, because there is still a root maintaining the bone, the tissue does not migrate. Therefore, that means less worry for you and your patient.
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Mark J. Fleming, D.D.S., Spear Visiting Faculty and Contributing Author