Root Resection: Key Updates and a Review of the Literature

Root resective therapy remains a valuable but technique-sensitive treatment modality aimed at preserving multi-rooted teeth with severe periodontal or endodontic involvement. This review summarizes key updates in root resection, including its historical context, indications and contraindications, and evolving clinical approaches. Evidence demonstrates that both conventional root resection, often preceded by endodontic therapy, and vital root resection, performed prior to or without root canal treatment, can achieve favourable outcomes under specific conditions. Surgical techniques such as presurgical crown contouring and the vertical cut method offer distinct advantages, though direct comparative studies remain limited. Diagnostic challenges, such as assessing furcation involvement, have prompted refinement of classification systems and integration of advanced imaging modalities such as cone-beam computed tomography, which improve accuracy but carry higher costs and radiation exposure. Long-term survival rates of resected teeth vary widely, reflecting the importance of case selection, surgical proficiency, and supportive care. While extraction and implant placement are the most common treatments today, with the given indications, root resection provides the unique benefit of preserving natural dentition, underscoring its role as a last-resort but meaningful option in modern dentistry. Further standardized, long-term clinical trials are needed to clarify prognostic factors and optimize outcomes.