ORIGINAL ARTICLES   

Minerva Stomatologica 2009 September;58(9):399-413

Copyright © 2009 EDIZIONI MINERVA MEDICA

language: English, Italian

Surgical decision making in coronally located vertical root fracture

Taschieri S. ¹, Laster Z. ², Rosano G. ¹, Weinstein T. ¹, Del Fabbro M. ¹ ✉

¹ Department of Health Technologies, Galeazzi Orthopedic Institute, University of Milan Milan, Italy; ² Department of Oral and Maxillofacial Surgery The Baruch Padeh Medical Center, Poriya, Israel

Aim. The purpose of this study was to present an intrasurgical decision making in teeth showing clinical signs and symptoms of incomplete vertical root fracture.
Methods. Sixteen patients with one tooth in which an incomplete vertical root fracture was diagnosed, involving only the buccal side, underwent a flap elevation procedure to visualize the pattern of bone loss and assess the type of root fracture. If the intraoperative diagnosis confirmed the presurgical one, a new root fracture repair technique was used. If the intraoperative diagnosis consisted of a complete or multiple fracture, the tooth was extracted and a postextraction implant insertion procedure was performed, in combination with the use of plasma rich in growth factors in order to enhance implant osseointegration.
Results. A total of nine vertical root fracture repair procedures were performed. The mean patient follow-up was 22.5 months. All patients reported full satisfaction for mastication function and phonetics. One patient was not satisfied for the esthetic result. A total of seven implants were immediately inserted in fresh postextraction sockets, and loaded four months later. The mean patient follow-up was 25.2 months. Overall implant success and survival was 100% after one year of functional loading. All patients reported full satisfaction for mastication function, phonetics and esthetics.
Conclusion. Intraoperative diagnosis allowed to choose an appropriate surgical approach that led to excellent results in terms of clinical outcomes and patient satisfaction.