Abstract
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.
Highlights
Vertical root fracture (VRF) is one of the most frustrating complications of root canal treatment
Bonding of the fracture line with adhesive resin cement during the intentional replantation procedure was recently suggested as an alternative to tooth extraction
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
Summary
An obliquely or longitudinally oriented breakage of the root that originates from the apex and propagates coronally is called vertical root fracture (VRF) [1]. VRF is one of the most infuriating undesirable consequences of root canal therapy, because it results in the tooth or root extraction [2]. It was reported that the prevalence of VRF lies in the range of 11%–20% in extracted endodontically treated teeth [3, 4]. As described previously [5] the most important risk factors for VRFs include overpreparation of root canal and post space, excessive lateral and vertical compaction forces during obturation, moisture loss in endodontically treated teeth, and superfluous pressure during post placement. The present case report describes a successful treatment of a VRF using adhesive resin cement to fill the outer space of the fracture line
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