Overcoming Challenges: Minimally Invasive Extraction of a Tooth with Dancing Root on a Diabetic Patient

Tooth extraction is a common dental procedure performed to remove a tooth that has decay, trauma, or any other dental condition that cannot be treated. Tooth extraction can be done by two methods, intra-alveolar, and trans-alveolar extraction. Intra-alveolar extraction is a type of "routine" extraction without any additional surgery. This case report presents an intra-alveolar extraction of a premolar tooth with a curved root on a diabetic patient.

A 20-year-old female patient presented with severe tooth decay in the premolar tooth without any pain. Upon examination, it was found that 3/4 of the premolar tooth crown was gone, and the tooth vitality was negative. The percussion test was positive, and the patient had already lost multiple teeth. The patient wanted to extract the tooth and followed up with a partial denture. The patient maintains regular visits to an internist doctor to manage her diabetes. In addition, permission was obtained from the internist to extract the tooth. A panoramic radiograph was taken, which did not indicate any significant abnormality.

The dental procedure was performed on the patient with local anesthesia administered via infiltration and intra-ligament technique. Initially, a dental elevator was used to loosen the tooth, but despite appearing to be loose and easily pulled from the socket, it was observed to be stuck. As there might be a curved on the apical third, we proceeded carefully and patiently made a deeper loosening with the elevator to provide the curved root space to maneuver. Then, forceps were used to move the tooth until it could be removed without any interference from its socket. The socket was cleaned and packed with gauze to control bleeding, and the patient was prescribed analgesics and antibiotics. The dentist also provided instructions and oral health education to the patient.

One week after the tooth extraction procedure, the patient returned for a follow-up appointment. Upon examination, it was noted that the healing process had progressed well, with no signs of infection. The patient then made plans for the fabrication of a partial denture. This indicates that the procedure was successful in addressing the patient's concerns and providing a positive outcome.

In order to perform a successful tooth extraction procedure, it is crucial to have a comprehensive understanding of the patient's condition as well as the tooth morphology before and during the procedure. This enables the dental practitioner to determine the most suitable techniques. The complexity of the tooth extraction, in this case, was managed without the need for any additional surgery, which spared the patient from extensive damage. This highlights the importance of careful consideration of the patient's needs and careful execution of the extraction procedure.

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