Root submergence technique as a partial extraction therapy to preserve the alveolar ridge tissues: A systematic review and appraisal of the literature

• Published in: The Journal of prosthetic dentistry 2023-08, Vol.130 (2), p.187-201
• Main Authors: Du Toit, Jonathan, Salama, Maurice, Gluckman, Howard, Nagy, Katalin
• Format: Article
• Language: English
• ISSN: 0022-3913; 1097-6841
• DOI: 10.1016/j.prosdent.2021.08.009

As socket grafting with commercially available biomaterials has become popular, reports of the root submergence technique for ridge preservation have decreased. A systematic review of this partial extraction therapy is lacking. The purpose of this systematic review was to review the root submergence technique as well as critically appraise the available data. A review was carried out that observed the Participant, Intervention, Comparison, Outcomes (PICO) strategy and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The focused question was “What are the outcomes of the different methods to submerge tooth roots for ridge preservation?” Medical subject headings (MeSH) terms that related to the root submergence technique were searched in PubMed/MEDLINE, Scopus, and the Cochrane Library databases. A total of 7709 abstracts and study titles were individually screened from the initial search results. After reviewing the full-text articles and applying the selection criteria, the final included search results totaled 47 full-text articles for in-depth review. In 10 animal studies, 258 roots were studied in 34 dogs and 7 monkeys. Histological data confirmed that coronal bridging (bone or cementum growth over the cut root) was a common outcome. Of the vital roots submerged, the majority maintained their vitality. In 37 human studies, 475 roots were submerged and reported on. Subjective ridge preservation was often reported. Among the adverse healing outcomes, exposure of the root through the mucosa was the most common. Nonetheless, in animals, 86.8% of roots remained submerged; in humans, 74.7%. Root submergence is an established technique for ridge preservation. Exposure is a common complication, and correct technique may be key to its prevention. Further research of this partial extraction therapy is encouraged.