The DTR Technique © for Rehabilitation of Non-Restorable Teeth: A Case Report
DOI:
https://doi.org/10.53274/IJCRD.2026.7105Keywords:
- Direct Through Root (DTR), Dental Implants, Non-Restorable Teeth, Ridge Preservation, Implant Rehabilitation
Abstract
The rehabilitation of non-restorable teeth in implant dentistry presents a significant clinical challenge, particularly in cases associated with thin buccal cortical plates and a high risk of post-extraction ridge resorption. Direct Through Root (DTR) implant placement is an emerging technique that utilizes the retained root as a guide for implant osteotomy, followed by atraumatic root removal, thereby facilitating precise implant positioning while minimizing surgical trauma.
This case report describes the management of a mandibular posterior region involving non-restorable first and second molars with severe attrition and compromised crown structure. A DTR approach was employed to preserve alveolar ridge architecture and ensure optimal implant positioning. Following decoronation, osteotomy was initiated through the retained root structure, and the remaining root fragments were atraumatically extracted. A Bioner implant (5 × 10 mm) was placed with satisfactory primary stability. The peri-implant gap was grafted using Regeneross to enhance bone regeneration.
After a healing period of three months, prosthetic rehabilitation was completed using a screw-retained PFM crown. The case demonstrated favorable functional outcomes with stable peri-implant tissues.
Within the limitations of a single case, the DTR technique appears to be a minimally invasive and effective approach for the rehabilitation of non-restorable teeth. Further long-term clinical studies are required to establish its predictability and broader clinical applicability.
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References
1. Hürzeler MB, Zuhr O, Schupbach P, et al. The socket-shield technique: a proof-of-principle report. J Clin Periodontol. 2010;37(9):855–862.
2. Buser D, Martin W, Belser UC. Optimizing esthetics for implant restorations. Int J Oral Maxillofac Implants. 2004;19 Suppl:43–61.
3. Araújo MG, Lindhe J. Dimensional ridge alterations following tooth extraction. J Clin Periodontol. 2005;32(2):212–218.
4. Araújo MG, Sukekava F, Wennström JL, Lindhe J. Ridge alterations following implant placement. J Clin Periodontol. 2005;32(6):645–652.
5. Chen ST, Buser D. Esthetic outcomes following implant placement. Int J Oral Maxillofac Implants. 2014;29 Suppl:186–215.
6. Kan JY, Rungcharassaeng K, Lozada JL, et al. Gingival tissue stability following implant placement. J Prosthet Dent. 2011;105(2):82–90.
7. Urban IA, Montero E, Monje A, Sanz-Sánchez I. Effectiveness of ridge augmentation. J Clin Periodontol. 2019;46 Suppl 21:319–339.
8. Troiano G, Lo Muzio L, Laino L, et al. Bone substitutes in implant dentistry. J Biol Regul Homeost Agents. 2019;33(1 Suppl 1):87–95.
9. Esposito M, Grusovin MG, Polyzos IP, et al. Timing of implant placement. Eur J Oral Implantol. 2010;3(3):189–205.
10. Lang NP, Pun L, Lau KY, Li KY, Wong MC. A systematic review on survival and success rates of implants. Clin Oral Implants Res. 2012;23 Suppl 6:39–66.
11. Lanka Mahesh, gregori M.kurtzman, David schwartz, sagrika Shukla , residual roots as an anatomical guide for implant placement , DOI: 10.1563/aaid-joi-D-15-00101
12. Lazzara RJ. Immediate implant placement into extraction site : surgical and restorative advantages . int j periodontics restorative dent . 1998; 9:332-343
13. Werbitt MJ, Goldberg PV. The immediate implant: bone preserva-tion and bone regeneration. Int J Periodontics Restorative Dent. 1992;12:207-217.
14. Schultz AJ. Guided tissue regeneration (GTR) of nonsubmerged implants in immediate extraction sites. Pract Periodontics Aesthet Dent. 1993;52:59–65.
15. Wilson TG, Weber HP. Classification of and therapy for areas of deficient bony housing prior to dental implant placement. Int J periodontics Restorative Dent. 1993; 13:451-459
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