Abstract
Trauma may result in craze lines on the enamel surface, one or more fractured cusps of posterior teeth, cracked tooth syndrome, splitting of posterior teeth, and vertical fracture of root. Out of these, management of some fractures is of great challenge and such teeth are generally recommended for extraction. Literature search reveals attempts to manage such fractures by full cast crown, orthodontic wires, and so forth, in which consideration was given to extracoronal splinting only. However, due to advancement in materials and technologies, intracoronal splinting can be achieved as well. In this case report, longitudinal fractures in tooth #27, tooth #37, and tooth #46 had occurred. In #27, fracture line was running mesiodistally involving the pulpal floor resulting in a split tooth. In teeth 37 and 46, fractures of the mesiobuccal cusp and mesiolingual cusp were observed, respectively. They were restored with cast gold inlay and full cast crown, respectively. Longitudinal fracture of 27 was treated with an innovative approach using intracanal reinforced composite with Ribbond, external reinforcement with an orthodontic band, and full cast metal crown to splint the split tooth.
Highlights
Conservation is becoming the basis of dentistry due to advancements in adhesive materials and technologies [1]
Direction, extent, prognosis, and treatment modalities, they can be classified as craze lines on the enamel surface, one or more fractured cusps of posterior teeth, cracked tooth syndrome, splitting of posterior tooth, and vertical fracture of root [3]
The fracture line involving the pulpal floor was sealed with adhesive restorations, which is not a bioactive material and cannot promote cementogenesis at fracture site in the furcation area
Summary
Conservation is becoming the basis of dentistry due to advancements in adhesive materials and technologies [1]. A literature search for the management of split tooth reveals that if the fracture extends to a root surface, the mobile segment can be removed followed by surgical crown lengthening and orthodontic extrusion of the retained segment [2]. For reinforcement-ligature wires [6], composite resin [7], adhesives [8], full coverage crowns, intentional reimplantation [9], and lasers like CO2 and Nd-YAG, used to fuse the fracture segments [10, 11], have been successfully tried In all these cases, the fracture line involving the pulpal floor was sealed with adhesive restorations, which is not a bioactive material and cannot promote cementogenesis at fracture site in the furcation area. In the same patient, fractured cusps of teeth 37 and 46 were successfully managed by cast gold inlay and full cast crown, respectively
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