The DTR technique© for rehabilitation of non-restorable teeth: A case report

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, fol-lowed 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 pri-mary stability while maintaining an appropriate peri-implant distance from the adjacent natural tooth. The peri-implant gap was grafted using Regeneross to enhance bone regener-ation. 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.