2019 Volume 62 Issue 1 Pages 54-64
Purpose: Due to the poor prognosis for vertical root fracture (VRF), the affected tooth is usually extracted. Recently, however, good clinical progress has been reported when adhesive materials are used to bond the fractured fragments (adhesive therapy). The weaknesses of adhesive therapy are technical difficulty, and occasional inflammation and infection causing persistent deep periodontal pockets. In the present study, a combination method of internal adhesive therapy using resin, and external adhesive therapy using mineral trioxide aggregate (MTA) and intentional replantation was applied to two VRF cases.
Materials and methods: First, the VRF tooth was extracted, and the infected tooth substance was extensively resected leaving a thin layer of the fracture line on the root surface. Subsequently, the disinfected root canal of the tooth was filled with dual-cure type core resin along with a reinforcing fiber core or metal wire to consolidate the tooth into one piece. A linear-shaped cavity was formed on the fracture line of the root surface, and filled with MTA before replantation. Finally, the treated tooth was replanted in the extraction socket after curettage and irrigation.
Results: The two VRF cases treated with this method did not show any inflammation or the formation of a residual periodontal pocket, indicating a good prognosis.
Conclusion: In the two VRF cases treated with the combination method of adhesive therapy with MTA and intentional replantation, greater eradication of the infection source was attained, resulting in the reconstruction of good periodontal tissue. This method is proposed as an innovative treatment for vertical root fracture without acute pain or periodontal pockets.
