Retained deciduous root fragment

Definition: A root fragment of a primary tooth that has not been resorbed and remains within the jawbone after the crown has exfoliated.

Radiographic Features:

  • Location:
    • Most common: Mesial and/or distal to second premolar
    • More frequent in mandible than maxilla
    • Can occur throughout maxilla and mandible
  • Edge: Well-defined, may show remnant periodontal ligament space
  • Shape: Typically linear or curved
  • Internal structure: Radiopaque, density similar to dentin
  • Other: None specific
  • Number: May be single or multiple

Key points:

  • Most commonly affected tooth: Deciduous second molar
  • Can persist for years without symptoms
  • May interfere with eruption of permanent successor
  • Difficult to differentiate from enostosis if periodontal ligament space is absent

Clinical significance:

  • Usually an incidental finding
  • Generally doesn’t require treatment if asymptomatic
  • May cause delayed eruption of permanent teeth
  • Could potentially lead to cyst formation (rare)

Note: If no periodontal ligament space is visible, differentiate from enostosis based on shape. Linear shape suggests retained root fragment. Neither typically requires treatment if asymptomatic.