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• Diagnostic Performance of Iterative Reconstruction of Cone-beam Computed Tomography for Detecting Vertical Root Fractures in the Presence of Metal Artifacts
  Matheus Barros-Costa, Gustavo Santaella, Christiano Oliveira-Santos, Deborah Queiroz Freitas, William C. Scarfe, Francisco Carlos Groppo
  Journal of Endodontics.2025;[Epub]     CrossRef
• Vertical root fracture diagnosis in teeth with metallic posts: Impact of metal artifact reduction and sharpening filters
  Débora Costa Ruiz, Lucas P. Lopes Rosado, Rocharles Cavalcante Fontenele, Amanda Farias-Gomes, Deborah Queiroz Freitas
  Imaging Science in Dentistry.2024; 54(2): 139.     CrossRef
• Comparing standard- and low-dose CBCT in diagnosis and treatment decisions for impacted mandibular third molars: a non-inferiority randomised clinical study
  Kuo Feng Hung, Andy Wai Kan Yeung, May Chun Mei Wong, Michael M. Bornstein, Yiu Yan Leung
  Clinical Oral Investigations.2024;[Epub]     CrossRef

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• Evaluation of dentinal crack formation during post space preparation using different fiber post systems with micro-computed tomography
  Ayşe Nur Kuşuçar, Damla Kırıcı
  BMC Oral Health.2025;[Epub]     CrossRef
• Selecting drill size for post space preparation based on final endodontic radiographs: An in vitro study
  Farzaneh Farid, Julfikar Haider, Marjan Sadeghpour Shahab, Nika Rezaeikalantari
  Technology and Health Care.2024; 32(4): 2575.     CrossRef
• Cone Beam Computed Tomography Analysis of Post Space in Bifurcated Premolars Using ParaPost and Peeso Reamer Drills
  Abdulaziz Saleh Alqahtani, Omar Nasser Almonabhi, Abdulmajeed Moh. Almutairi, Reem R. Alnatsha
  The Open Dentistry Journal.2024;[Epub]     CrossRef
• A Comparative Evaluation of Real-Time Guided Dynamic Navigation and Conventional Techniques for Post Space Preparation During Post Endodontic Management: An In Vitro Study
  Sherifa Shervani, Sihivahanan Dhanasekaran, Vijay Venkatesh
  Cureus.2024;[Epub]     CrossRef
• The effect of ultrasonic vibration protocols for cast post removal on the incidence of root dentin defects
  Giulliano C. Serpa, Orlando A. Guedes, Neurinelma S. S. Freitas, Julio A. Silva, Carlos Estrela, Daniel A. Decurcio
  Journal of Oral Science.2023; 65(3): 190.     CrossRef

The replacement of missing teeth, especially in the anterior region, is an essential part of dental practice. Fiber-reinforced composite resin bridges are a conservative alternative to conventional fixed dental prostheses or implants. It is a minimally invasive, reversible technique that can be completed in a single visit. The two cases presented herein exemplify the treatment of root-fractured anterior teeth with a natural pontic immediately after extraction.

Citations

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• Current Evidence on the Fiber-reinforced Composite Bridges
  Ramesh Chowdhary, Sunil Kumar Mishra
  International Journal of Prosthodontics and Restorative Dentistry.2023; 12(4): 159.     CrossRef
• Bridging the Gap: A Case Report of Tooth Replacement using Resin-Bonded Fiber- Reinforced Composite Resin
  Vineet Sharma, Sumit Bhansali, Sonal Priya Bhansali
  Journal of Pierre Fauchard Academy (India Section).2023; : 66.     CrossRef
• Reconstruction of Natural Smile and Splinting with Natural Tooth Pontic Fiber‐Reinforced Composite Bridge
  Maryam S. Tavangar, Fatemeh Aghaei, Massoumeh Nowrouzi, Andrea Scribante
  Case Reports in Dentistry.2022;[Epub]     CrossRef

Although it is challenging, the early diagnosis of a vertical root fracture (VRF) is crucial in order to ensure tooth preservation. The purpose of this clinical case report was to describe reparative surgery performed to treat a tooth affected by an incomplete VRF. A 26 year old male patient was suspected to have a VRF in a maxillary left central incisor, and an exploratory flap was performed in order to confirm the diagnosis. After detecting the fracture, the lesion was surgically treated, the fracture and the infected root-end were removed, and a platelet-rich plasma membrane was used to cover the defect in order to prevent bacterial migration. A 24 month clinical and radiological follow-up examination showed that the tooth was asymptomatic and that the healing process was in progress. The surgical approach described here may be considered an effective treatment for a combined endodontic-periodontal lesion originating from an incomplete VRF and a recurrent periapical lesion.

Citations

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• Biomechanical perspectives on dentine cracks and fractures: Implications in their clinical management
  Sishi Chen, Dwayne Arola, Domenico Ricucci, Brian E. Bergeron, John A. Branton, Li-sha Gu, Franklin R. Tay
  Journal of Dentistry.2023; 130: 104424.     CrossRef
• Efficacy of Autologous Platelet Concentrates in Regenerative Endodontic Treatment: A Systematic Review of Human Studies
  Joanna Metlerska, Irini Fagogeni, Alicja Nowicka
  Journal of Endodontics.2019; 45(1): 20.     CrossRef
• The preservation of teeth with root-originated fractures
  Eyal Rosen, Ilan Beitlitum, Igor Tsesis
  Evidence-Based Endodontics.2018;[Epub]     CrossRef

Exposing sound structure of a subgingivally fractured tooth using orthodontic extrusion is considered to be a conservative way to re-establish biologic width without sacrificing esthetics or jeopardizing periodontal support of neighboring teeth. When a misaligned tooth is traumatically involved, a more comprehensive approach combining tooth extrusion and re-alignment may be necessary for a successful restorative outcome. This case report describes a successful esthetic management of a patient with complicated crown-root fracture on the maxillary right central incisor and pre-existing malocclusion in the maxillary anterior region. Forced eruption along with re-alignment of teeth by orthodontic movement seems to allow re-positioning of the fracture line to a favorable position and correction of crowding, providing a better esthetic result.

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• Effects of systematic bisphosphonate use in patients under orthodontic treatment: a systematic review
  Vasileios F Zymperdikas, Maria P Yavropoulou, Eleftherios G Kaklamanos, Moschos A Papadopoulos
  European Journal of Orthodontics.2020; 42(1): 60.     CrossRef
• In vitro retention efficiency of temporary type zinc oxide cement for orthodontic forced eruption
  Renato Nieto-Aguilar, Deyanira Serrato-Ochoa, Rafael Medina-Navarro, Asdrúbal Aguilera-Méndez, Karina Denisse Morales-Soto, Juan Pablo Loyola-Rodriguez, Antonio Campos, Miguel Alaminos
  International Orthodontics.2019; 17(1): 96.     CrossRef

Traumatic injuries of the face often involve root fractures especially in anterior teeth. The prognosis and the treatment of the root fracture depend on the extent of the fracture line, general health and patient compliance. This case report outlines a new conservative trial treatment modality to stabilize the maxillary central incisors with horizontal root fracture on the cervical to middle third by fabricating canine guidance to remove loading on the traumatized maxillary central incisors during eccentric movements and thus inducing spontaneous healing of the fractured line between the fragments. Radiographs after thirty months showed adequate healing with no signs of pathological changes including root resorption, ankylosis or displacement. Long term follow-up revealed that vitality, stability and aesthetics were maintained and the patient was satisfied with the outcome.

Citations

Citations to this article as recorded by  

• Healing after horizontal root fractures: 3 cases with 2-year follow-up
  Yoorina Choi, Sung-Ok Hong, Seok-Ryun Lee, Kyung-San Min, Su-Jung Park
  Restorative Dentistry & Endodontics.2014; 39(2): 126.     CrossRef

The development of adhesive dentistry has allowed that the crown fragment reattachment can be another option in the treatment of crown fracture. However, additional crown lengthening procedure or extrusion of the tooth may be necessary in the treatment of crown root fracture because subgingival fracture line in close proximity to the alveolar bone leads to challenges for restorative procedure and the violation of the biologic width. This case report presents a modified crown fragment reattachment technique of crown root fracture with pulp exposure, which was done without additional crown lengthening procedures. After the endodontic treatment, the patient was treated using a post insertion and the fragment reattachment technique, which made it possible to preserve the space for the biologic width and maintain a dry surgical field for adequate adhesion through the modification of the fractured coronal fragment. Since a coronal fracture was occurred and reattached afterward, it was observed that the coronal fragment was well maintained without the additional loss of periodontal attachment through 2-year follow up.

The purpose of this study was to investigate the fracture resistance of crown-root fractured teeth repaired with dual-cured composite resin and horizontal posts. 48 extracted human premolars were assigned to control group and three experimental groups. Complete crown-root fractures were experimentally induced in all control and experimental teeth. In the control group, the teeth (n=12) were bonded with resin cement and endodontically treated. Thereafter, the access cavities were sealed with dual-cured composite resin. In composite resin core - post group (n=12), the teeth were endodontically treated and access cavities were sealed with dual-cured composite resin. In addition, the fractured segments in this group were fixed using horizontal posts. In composite resin core group (n=12), the teeth were endodontically treated and the access cavities were filled with dual-cured composite resin without horizontal posts. In bonded amalgam group (n=12), the teeth were endodontically treated and the access cavities were sealed with bonded amalgam. Experimental complete crown-root fractures were induced again on repaired control and experimental teeth. The ratio of fracture resistance to original fracture resistance was analyzed with Kruskal-Wallis test. The results showed that teeth in control and composite resin core - post group showed significantly higher resistance to re-fracture than those in amalgam core group (p < 0.05). The resistance to refracture was high in the order of composite resin - post group, control group, composite resin group and bonded amalgam group. Within the scope of this study, the use of horizontal post could be beneficial in increasing the fracture resistance of previously fractured teeth.

The treatment of esthetic areas with single-tooth implants represents a new challenge for the clinician. In 1993, a modification of the forced eruption technique, called "orthodontic extrusive remodelling," was proposed as a way to augment both soft- and hard-tissue profiles at potential implant sites. This case report describes augmentation of the coronal soft and hard tissues around a fractured maxillary lateral incisor associated with alveolar bone loss, which was achieved by forced orthodontic extrusion before implant placement. Through these procedures we could reconstruct esthetics and function in a hopeless tooth diagnosed with subgingival root fracture by trauma.