How to Root Bank

Root banking is not a very common procedure when treating patients that have lost an anterior tooth. In a really esthetically-concerned patient, it's a great treatment option as long as the patient has a biologically healthy root and they don't have any periodontal problems. Below are a few steps to help guide you through a successful root banking procedure.

Step 1: Fill canal with resin-modified glass ionomer cement. You'll need to clean up where the post was located and make sure the area is free of caries before filling the endodontic portion with the glass ionomer cement.

Step 2: Reduce tooth structure. With a burr, prep the tooth until it's .5mm below bone. It may be helpful to probe to the bone and look at where the tooth is positioned relative to where the bone is. You can then prep the inside of the tooth and thin the walls out allowing you to chip away parts of the tooth as opposed to grinding down the teeth and gingiva.

Step 3: Make provisional. The provisional needs to have the contours and the emergence profile interproximally. It's critical to leave 2mm of space between the pontic and the remaining root to maintain optimal tissue health and esthetics.

The great thing about this uncommon procedure is that you and your patient won't ever have to worry about the tissue migrating. Since there is still a root maintaining the bone, that tissue isn't going anywhere.