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Supporting Your Practice

Saving a Tooth Using Root Resection

Dr. Joel Fransen
Endodontist, Richmond BC

In this episode of CDA Oasis Live, Dr. John O’Keefe, Director of Knowledge Networks CDA, invites Dr. Joel Fransen, endodontist from Richmond BC, to present a case study of a patient where a root resection was successfully used to save the tooth from extraction.

Dr. Fransen walks through the clinical details of the case and, citing evidence from a recent meta-analysis published in the Journal of Endodontics, argues that although such a procedure is often overlooked in favour of implants, there is enough evidence to suggest it is a rational treatment planning choice in certain cases.

“Implants are great if you can’t save a tooth, but nothing is better than the real thing. But it has to be the right patient  and you have to be comfortable doing the procedure.”

Here are some of the clinical scenarios where Dr. Fransen considers a crown resection or a root resection as a valid option:

  • Class III furcation
  • Deep class II furcal involvement
  • Bone loss on one root – most commonly brought about by a vertical root fracture
  • Sub gingival caries that are out of control and it is difficult to restore the area
  • Apical root radiolucency that persists despite root canal treatment
  • Perforations
  • Large separated instruments or posts
  • Resorption/resorptive defect
  • If an implant or bridge is not an option for the patient

We hope you find the conversation useful. We welcome your thoughts, questions and/or suggestions about this post and other topics. Leave a comment in the box below or send us your feedback by email.

Until next time!
CDA Oasis Team


Full Conversation (23.15")


  1. Vasant Ramlaggan July 9, 2021

    Great case! Thanks for the explanation. Brings it back to the forefront of our options.

  2. William Liang July 15, 2021

    Great case. Thank you for sharing. All those who aspire to be a good dentist need to understand the many treatment options and when they are appropriate.


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