This case report examines a rare presentation of multiple rootless teeth, highlighting diagnostic challenges and multidisciplinary management strategies. The patient exhibited several congenitally absent root structures, requiring detailed imaging and coordinated care to plan functional rehabilitation.
Clinicians must recognize variations in tooth development to avoid misdiagnosis and to implement timely interventions. This report emphasizes the integration of clinical, radiographic, and laboratory findings in defining an evidence-based treatment plan.
| Case Identifier | Age at Presentation | Number of Affteced Teeth | Key Radiographic Finding |
|---|---|---|---|
| MRC-2023-08 | 28 years | 4 | Absent radicular structures with retained primary predecessors |
| Specialty | Referral Pathway | Imaging Modality | Final Diagnosis |
| Oral Surgery & Prosthodontics | Secondary Referral from General Dentistry | Cone Beam CT | Multiple Rootless Teeth Syndrome |
Clinical Presentation and Imaging Findings
The patient reported mild masticatory discomfort and aesthetic concerns related to posterior segments. Clinical examination revealed tooth numbers 14, 15, 24, and 25 missing, with stable but heavily restored primary molars in place.
Cone beam CT demonstrated minimal alveolar bone over the intended prosthetic sites, while confirming the absence of permanent successors. These radiographic details guided bone preservation planning and informed future implant or prosthetic options.
Diagnostic Challenges in Rootless Teeth
Differential Diagnosis
Distinguishing true agenesis from embedded or ectopic permanent teeth required correlating panoramic and CBCT findings. Early misinterpretation could lead to inappropriate space closure or delayed referral.
Role of Advanced Imaging
Three-dimensional imaging clarified the relationship between residual primary roots and adjacent anatomical structures, supporting precise surgical documentation and patient counseling.
Multidisciplinary Management Approach
A coordinated team comprising oral surgery, orthodontics, and prosthodontics defined a staged protocol. Initial orthodontic alignment created optimal space distribution, followed by ridge preservation and definitive rehabilitation planning.
Soft tissue health and occlusal force distribution were continuously monitored to ensure long-term stability of the final restoration方案.
Treatment Planning for Function and Aesthetics
Short-Term Objectives
Immediate priorities included maintaining arch length, preserving alveolar bone volume, and controlling local inflammation through targeted hygiene protocols.
Long-Term Rehabilitation Strategy
The definitive plan combined implant-supported crowns and adhesive bridgework, tailored to biomechanical load expectations and patient esthetic preferences.
Key Takeaways for Clinical Practice
- Early recognition of rootless teeth prevents misdiagnosis and unnecessary tooth extraction.
- CBCT is essential for accurate surgical planning and patient counseling.
- Multidisciplinary coordination improves functional and aesthetic outcomes.
- Ridge preservation should be considered when immediate implant placement is not feasible.
- Long-term success relies on structured maintenance and occlusal management.
FAQ
Reader questions
What clinical signs suggest multiple rootless teeth rather than severe agenesis?
Retained primary molars with minimal occlusal wear, absence of follicular remnants on CBCT, and family history of hypodontia support the diagnosis of rootless teeth rather than generalized agenesis.
How does CBCT change management compared to conventional panoramic imaging?
CBCT provides three-dimensional visualization of bone quantity, root morphology, and proximity to vital structures, enabling more predictable surgical and prosthetic decision-making in complex cases.
Can orthodontic treatment be safely initiated before surgical intervention?
Yes, phased orthodontics can optimize space and reduce impaction risk, but coordination with surgical timing is essential to avoid compromising ridge preservation or future implant positioning.
What are the long-term success factors for rehabilitation with implants in such cases?
Consistent oral hygiene, regular professional maintenance, adequate bone volume maintenance, and occlusal control contribute significantly to the longevity of implant-supported reconstructions.