Diagnosis and Treatment of Endodontically Treated Teeth with Vertical Root Fracture: Three Case Reports with Two-year Follow-up

Teeth with vertical root fracture (VRF) have complete or incomplete fractures that begin in the root and extend toward the occlusal surface. The most frequent causes of VRF originate from physical trauma, occlusal prematurity, inadequate endodontic treatment, and iatrogenic causes. Diagnose is difficult and delay can cause stomatognathic system problem. The purpose of this case report was to evaluate immediate implant placement after extraction of teeth with vertical root fracture. For the 1st case, the VRF in 1st left lower molar was confirmed during surgical flap and at the same time, the tooth was removed and immediate implant was placed. For the 2nd case, the VRF 1st left lower molar was confirmed during endodontic access and at the same appointment, the tooth was removed and the immediate implant is placed. Several studies have shown that immediate implants have similar success rates when compared with late implants. Consider that this approach is a safe procedure with favorable prognosis. In cases of VRF, the main factor to be considered is the presence of adequate bone support and immediate implants can preserve the vertical bone height, adding the fact that good patient compliance reduces the number of surgical interventions and promotes the functionality of stomatognathic system.

Section: Discussionmentioning

confidence: 99%

“…Occasionally signs and symptoms and radiographic findings may promote confusion and be interpreted wrongly [8]. There is a difficulty in diagnosing the fracture and delay can lead to bone loss, pain, and problems in the stomatognathic system [9]. …”

Section: Introductionmentioning

confidence: 99%

Vertical Root Fracture: Preservation of the Alveolar Ridge Using Immediate Implants

Oya

Pallos

Schwartz-Filho

et al. 2014

“…In order to produce a root surface that is conductive to cellular adhesion and growth, several solutions such as using tetracycline, citric acid, and ethylenediaminetetraacetic acid (EDTA) have been suggested [19]. In addition, in the previous studies [9, 20] tetracycline was used to treat the subjected teeth for thirty seconds just before the replantation. On the basis of these findings, in this case, tetracycline was applied to the root surfaces to enhance periodontal ligament fiber attachment and prevent ankylosis.…”

Section: Discussionmentioning

confidence: 99%

Treatment of Necrotic Calcified Tooth Using Intentional Replantation Procedure

Majd

Arvin

Darvish

et al. 2014

Introduction. If the teeth are impacted by a chronic irritant, the pulp space possibly will undergo calcific changes that may impede access opening during root canal treatment. In such cases that conventional endodontic treatment is impossible or impractical, intentional replantation may be considered as a last solution to preserve the tooth. Methods. After failing to perform conventional root canal therapy for a necrotic calcified right mandibular second premolar, the tooth was gently extracted. The root apex was resected and the root end cavity was prepared and filled with calcium enriched mixture (CEM) cement. Then, the extracted tooth was replanted in its original position. Results. After a year the tooth was asymptomatic, and the size of periapical radiolucency was remarkably reduced and no clinical sign of ankylosis was observed. Conclusion. Intentional replantation of the necrotic calcified teeth could be considered as an alternative to teeth extraction, especially for the single-rooted teeth and when nonsurgical and surgical endodontic procedures seem impossible.

“…Although several solutions have been suggested for managing VRF cases, such as tooth extraction and implant replacement [6], root resection using a surgical method [7], and utilizing CO 2 laser to fuse VRF [8], no specific treatment modality has been established [9]. VRF reconstruction with adhesive resin cement has shown successful outcome in several studies [9–13].…”

Section: Introductionmentioning

confidence: 99%

“…VRF reconstruction with adhesive resin cement has shown successful outcome in several studies [9–13]. According to long-term clinical results, bonding of fractured segments after tooth extraction with an adhesive resin cement and then replantation of the tooth could be an alternative approach to extraction [12, 13].…”

Section: Introductionmentioning

confidence: 99%

Treatment of a Vertical Root Fracture Using Dual-Curing Resin Cement: A Case Report

Majd

Akhtari

Araghi

et al. 2012

Introduction. Vertical root fracture (VRF) is one of the most frustrating complications of root canal treatment. The prognosis of the root with VRF is poor therefore tooth extraction and root amputation are usually the only treatment options. However, bonding of the fracture line with adhesive resin cement during the intentional replantation procedure was recently suggested as an alternative to tooth extraction. Methods. A vertically fractured left maxillary incisor was carefully extracted, fracture line was treated with adhesive resin cement, a retrograde cavity was produced and filled with calcium-enriched mixture (CEM) cement, and tooth was replanted. Results. After 12 months the tooth was asymptomatic. The size of periapical radiolucency was noticeably reduced and there was no clinical sign of ankylosis. Conclusion. Using adhesive resin cement to bond the fracture lines extraorally in roots with VRF and intentional replantation of the reconstructed teeth could be considered as an alternative to tooth extraction, especially for anterior teeth.