Is tooth extraction or root retention before dental implantation?

With the aging of society, there are more and more patients with missing or bad teeth. However, a common misunderstanding in the treatment of defective teeth is to pull out all the teeth that can't be filled, thinking that these defective teeth will affect the effect of dental implants. In fact, the determination of the retention or removal of residual roots should be based on the damage range of root defects, the health status of periapical tissues, and the relationship between treatment effect and repair. If the residual root injury is large, the defect reaches below the gum, the periapical tissue lesions are extensive, and the treatment effect is not good, you can consider excision; If the residual root is stable, the periapical tissue has no obvious lesion or the lesion range is small, which is helpful to support and fix the denture, it should be preserved after root canal treatment. According to the degree of tooth (column) defect, the logical order of the following restoration methods should be: inlay-high inlay-partial crown-full crown-post crown-fixed bridge-removable partial denture/overdenture-removable partial denture with magnetic attachment-complete denture. One idea contained therein is to protect and preserve tooth tissue and/or root as much as possible. If the root length of the bad tooth can meet the retention requirements, post-crown restoration can be carried out after root canal treatment; When the root is short and a single restoration can not meet the requirements of reasonable crown-root ratio, it can be combined with adjacent teeth to increase its support and retention. If the root is too short to be repaired with post-core crown, overdenture can be repaired after root canal treatment. (Some patients cannot have their teeth extracted due to other diseases, such as severe hypertension, coronary heart disease and diabetes. However, root calcification can not be treated by root canal therapy, but can also be repaired by overdenture. If the root is tender, the tissue surface of the denture corresponding to the root can be buffered to make it gently contact. The fundamental difference between overdenture and conventional denture is that the denture base is covered with mucosa and natural teeth or treated roots, which delays the absorption of alveolar bone, increases the stability of denture, enhances the physiological discrimination ability and improves the chewing efficiency. Because the root is preserved, the proprioception of periodontal ligament is also preserved, so that denture can not only distinguish the size and direction of occlusal force, but also judge the size and thickness of food between occlusal surfaces. The adaptation period of patients to dentures is also greatly shortened.