Microsurgical re-treatment of an endodontically treated tooth with an apically located incomplete vertical root fracture: a clinical case report

Taschieri, Silvio; Fabbro, Massimo Del; Kabbaney, Ahmed El; Tsesis, Igor; Rosen, Eyal; Corbella, Stefano

doi:10.5395/rde.2016.41.4.316

Cited by 5 publications

(6 citation statements)

References 25 publications

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“…Although the most common indications for root resection are periodontal-based, our discussion focuses on endodontic indications, such as an unfillable canal, root fracture, root perforation, root resorption, and root decay [ 22 ]. Root resection therapy can provide good outcomes in cases of incomplete fracture [ 23 ]. In a protocol for the treatment of incomplete VRFs, Taschieri [ 24 ] proposed removing the fractured apical segment of the root via resection.…”

Section: Root Amputation Root Resection or Hemisectionmentioning

confidence: 99%

Review of Approaches to the Management of Vertical Dental Root Fractures and Tooth Preservation

Salihu,

Stavileci

2024

Med Sci Monit

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A vertical root fracture (VRF) is a complex condition in which the fracture lines can be partial or complete and extend along the long axis of the tooth. Considering the nature of the damage and the low likelihood of a successful outcome, such fractures can be difficult to manage. Their management typically involves complex endodontic or surgical procedures, which can be technically challenging for general dentists. Recent advancements introduce promising techniques, such as intentional replantation, adhesive methodologies, and regenerative procedures, showcasing potential in salvaging teeth affected by VRFs. Nonetheless, the imprecise nature of symptoms necessitates meticulous case evaluation by clinicians. Comprehensive patient counseling regarding diverse treatment options and potential ramifications remains crucial to preserving the affected tooth. Preserving a vertically fractured tooth aids in improving both function and aesthetics while safeguarding the arch’s integrity by maintaining the height of the alveolar bone. It is important to note that the success of the treatment procedures depends on the extent and location of the fracture, the condition of the tooth and fragment, and the skill of the dental professional performing the treatment. This review highlights the complexity of VRF management, emphasizing the necessity for precise evaluation, patient education, and the exploration of innovative techniques. It aims to review the treatment of VRFs, ranging from classical to contemporary methods, with a focus on tooth preservation. The establishment of standardized protocols and conduct of further research to ascertain long-term efficacy are imperative in optimizing outcomes and retaining natural dentition in cases of VRFs.

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Section: Root Amputation Root Resection or Hemisectionmentioning

confidence: 99%

Review of Approaches to the Management of Vertical Dental Root Fractures and Tooth Preservation

Salihu,

Stavileci

2024

Med Sci Monit

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“…Recently, Taschieri et al 2016 reported on a treatment of a maxillary left central incisor suspected with an incomplete ROF. Following an exploratory flap procedure, the fracture was confirmed.…”

Section: Cementation Of the Root Fracture Following Flap Elevationmentioning

confidence: 99%

“…In the context of ROF teeth, in recent years, new reports suggested promising treatment alternatives aimed to preserve ROF teeth (Tsesis et al 2010a;Taschieri et al 2010;Floratos and Kratchman 2012;Taschieri et al 2016) which were traditionally condemned to extraction (Tsesis et al 2015;Tsesis et al 2010a;Taschieri et al 2010;Floratos and Kratchman 2012;Tsesis et al 2006;Fabbro et al 2009;Plotino et al 2007). These unique treatment attempts are in their preliminary stages of development and are based mostly on case reports (Tsesis et al 2010a;Taschieri et al 2010;Floratos and Kratchman 2012).…”

Section: Introductionmentioning

confidence: 99%

“…These unique treatment attempts are in their preliminary stages of development and are based mostly on case reports (Tsesis et al 2010a;Taschieri et al 2010;Floratos and Kratchman 2012). Still, it seems that modern endodontics offers technical means such as magnification and illumination devices (Tsesis et al 2015;Fabbro et al 2009;Kim and Baek 2004), and the use of modern materials such as bioceramic cements (Torabinejad and Chivian 1999) for the repair of ROFs (Tsesis et al 2010a;Taschieri et al 2010;Floratos and Kratchman 2012), that with proper case selection, may allow the treatment and preservation of some ROF teeth (Tsesis et al 2015;Taschieri et al 2016).…”

Section: Introductionmentioning

confidence: 99%

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The preservation of teeth with root-originated fractures

2018

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Traditionally, when a root-originated fracture (ROF) was diagnosed in an endodontically treated tooth, the tooth was scheduled for extraction. However, modern endodontics offers new treatment options to manage and maintain certain ROF teeth. The decision of whether to extract a ROF tooth and substitute it with a dental implant, or to implement a more conservative management approach by attempting an additional endodontic treatment aimed to preserve the natural tooth, is complicated and multifactorial. The management alternatives of ROF teeth range from a traditional root amputation in multi-rooted teeth to modern endodontic surgical modalities that may enable the preservation of a fractured tooth. This required decision-making process includes prosthetic, periodontal, esthetic, endodontic, and patient value concerns.

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“…Vertical root fractures (VRFs) refer to fractures of the tooth root along the longitudinal axis, through the medullary cavity and the pericementum space [1]. These fractures may originate anywhere on or within the root, may extend coronally toward the cervical margin in the facial or lingual aspects, and are extremely challenging to diagnose in dental practice [2,3]. In fact, the mandibular rst molar, which is possibly exposed to the maximum biting force, commonly suffers from VRFs because of severe tooth abrasion [4].…”

Section: Introductionmentioning

confidence: 99%

Biomechanical Evaluation of the Mandibular First Molar After Simulated Occlusal Wear Using 3D Finite Element Analysis

Guo

Sun

Shi

et al. 2022

Preprint

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PURPOSE：This study aimed to investigate the biomechanical basis of vertical tooth fracture occurring in the mesial root of the mandibular first molar. METHODS：We used 3D finite elements to analyze the stress distribution and transient displacement of the mandibular first molar after occlusal surface wear and tooth tilt. Based on four degrees of wear within each of the surface wear and tooth tilt groups, eight models were established in addition to the control model. A simulated bite force of 200 N was loaded on the occlusal surface, and nonlinear finite element analysis was used to explore the biomechanical basis of vertical root fracture. RESULTS：When the distal tipping angle of the abrasion plane of the mandibular first molar increased from 5° to 15°, the angle between the instantaneous displacement contours and the long axis of the tooth decreased. Meanwhile, the mesial root was found to suffer the highest stress concentration, and the possibility of longitudinal root fracture was increased. CONCLUSION: By evaluating the biomechanical effect of tooth wear and occlusal loading, we are able to identify some clinical interventions that may prevent vertical tooth fracture.

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Microsurgical re-treatment of an endodontically treated tooth with an apically located incomplete vertical root fracture: a clinical case report

Cited by 5 publications

References 25 publications

Review of Approaches to the Management of Vertical Dental Root Fractures and Tooth Preservation

Review of Approaches to the Management of Vertical Dental Root Fractures and Tooth Preservation

The preservation of teeth with root-originated fractures

Biomechanical Evaluation of the Mandibular First Molar After Simulated Occlusal Wear Using 3D Finite Element Analysis

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