Abstract
Introduction
Vertical root fracture (VRF) is an important threat to the tooth’s prognosis during
and after root canal treatment. Often the detection of these fractures occurs years
later by using conventional periapical radiographs. However, recent studies have addressed
the benefits of computed tomography to diagnose these problems earlier. Accurately
diagnosed VRFs have been treated by extraction of teeth, with minimal damage to the
periodontal ligament, extraoral bonding of fractured segments with an adhesive resin
cement, and intentional replantation of teeth after reconstruction.
Methods
The 3 case reports presented here describe the diagnosis and treatment of vertically
fractured teeth that had been previously treated endodontically. Cone-beam computed
tomography (CBCT) was used for diagnostic imaging to detect VRFs. Vertically fractured
roots were carefully extracted and extraorally treated by using a self-etching dual-cure
adhesive resin cement, and intentional replantations were performed after reconstruction.
Results
After a mean follow-up period of 2 years, the teeth were asymptomatic. There was no
clinical ankylosis, and diagnosis by using CBCT scans showed reduced periapical radiolucency.
Conclusions
Extraoral bonding of fractured segments and intentional replantation of teeth after
reconstruction provide an alternative treatment to extraction, especially for anterior
teeth. Computed tomography–assisted VRF diagnosis is helpful in detecting fractures;
however, higher-resolution tomography units providing better image quality would be
a better choice for improved visualization of these fractures.
Key Words
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Article info
Publication history
Published online: November 15, 2010
Identification
Copyright
© 2011 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.
