Putting tooth-roots back in the socket

Summary

Almost three million adult teeth are extracted each year on the NHS. This results in bone resorption in the extraction site. The resultant loss of bone volume affects patient's facial profile and also complicates the future prosthetic restoration, whether it is a conventional bridge, a denture or an implant-supported prosthesis. In order to compensate for the loss of bone volume, patients will usually undergo either alveolar ridge preservation (ARP) procedures at the time of extraction or bone augmentation procedures after extraction socket is healed. ARP can limit, not eliminate, bone resorption following tooth extraction, and high-quality long-term studies supporting their effectiveness are lacking. Bone augmentation procedures are not predictable. Both procedures are technique sensitive, require highly-skilled clinicians, expensive materials and equipment. This will have a significant effect on public's access to these treatments that are not currently provided on the NHS.

We propose using autogenous tooth roots for ARP (ATR-ARP). In this approach, teeth are extracted using minimally invasive techniques. Root surface is prepared, and tooth is decoronated and then the tooth root is replanted in their socket. The ATR-ARP is a minimally-invasive technique, does not incur extra cost, does not require highly skilled clinicians, can be accessible on the NHS, and is environmentally friendly. This technique will enhance patients' profile and future prosthetic restorations whether tooth-, gum- or implant-supported. The present study aims to provide data required for future NIHR grant applications to investigate the feasibility and acceptability as well as the clinical effectiveness of the proposed ATR-ARP technique.