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Research Article
Retrospective study of fracture survival in endodontically treated molars: the effect of single-unit crowns versus direct-resin composite restorations
Kanet Chotvorrarak, Warattama Suksaphar, Danuchit Banomyong
Restor Dent Endod 2021;46(2):e29.   Published online May 6, 2021
DOI: https://doi.org/10.5395/rde.2021.46.e29
AbstractAbstract PDFPubReaderePub
Objectives

This study was conducted to compare the post-fracture survival rate of endodontically treated molar endodontically treated teeth (molar ETT) restored with resin composites or crowns and to identify potential risk factors, using a retrospective cohort design.

Materials and Methods

Dental records of molar ETT with crowns or composite restorations (recall period, 2015–2019) were collected based on inclusion and exclusion criteria. The incidence of unrestorable fractures was identified, and molar ETT were classified according to survival. Information on potential risk factors was collected. Survival rates and potential risk factors were analyzed using the Kaplan-Meier log-rank test and Cox regression model.

Results

The overall survival rate of molar ETT was 87% (mean recall period, 31.73 ± 17.56 months). The survival rates of molar ETT restored with composites and crowns were 81.6% and 92.7%, reflecting a significant difference (p < 0.05). However, ETT restored with composites showed a 100% survival rate if only 1 surface was lost, which was comparable to the survival rate of ETT with crowns. The survival rates of ETT with composites and crowns were significantly different (97.6% vs. 83.7%) in the short-term (12–24 months), but not in the long-term (> 24 months) (87.8% vs. 79.5%).

Conclusions

The survival rate from fracture was higher for molar ETT restored with crowns was higher than for ETT restored with composites, especially in the first 2 years after restoration. Molar ETT with limited tooth structure loss only on the occlusal surface could be successfully restored with composite restorations.

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Case Report
Pulp revascularization with and without platelet-rich plasma in two anterior teeth with horizontal radicular fractures: a case report
Edison Arango-Gómez, Javier Laureano Nino-Barrera, Gustavo Nino, Freddy Jordan, Henry Sossa-Rojas
Restor Dent Endod 2019;44(4):e35.   Published online August 20, 2019
DOI: https://doi.org/10.5395/rde.2019.44.e35
AbstractAbstract PDFPubReaderePub

Pulp revascularization is an alternative treatment in immature traumatized teeth with necrotic pulp. However, this procedure has not been reported in horizontal root fractures. This is a case report of a 9-year-old patient with multiple horizontal root fractures in 2 upper central incisors that were successfully treated with pulp revascularization. The patient presented for treatment 2 years after the initial trauma, and revascularization was attempted after the initial treatment with calcium hydroxide had failed. Prior to pulp revascularization, cone-beam computed tomography and autoradiograms demonstrated multiple horizontal fractures in the middle and apical thirds of the roots of the 2 affected teeth. Revascularization was performed in both teeth; platelet-rich plasma (PRP) was used in one tooth (#11) and the conventional method (blood clot) was used in the other tooth (#21). Clinical and radiographic follow-up over 4 years demonstrated pulp calcification in the PRP-treated tooth. Neither of the 2 teeth were lost, and the root canal calcification of tooth #11 was greater than that of tooth #21. This case suggests that PRP-based pulp revascularization may be an alternative for horizontal root fractures.

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Review Article
Survival rates against fracture of endodontically treated posterior teeth restored with full-coverage crowns or resin composite restorations: a systematic review
Warattama Suksaphar, Danuchit Banomyong, Titalee Jirathanyanatt, Yaowaluk Ngoenwiwatkul
Restor Dent Endod 2017;42(3):157-167.   Published online July 31, 2017
DOI: https://doi.org/10.5395/rde.2017.42.3.157
AbstractAbstract PDFPubReaderePub

This systematic review aims to summarize the current clinical studies that investigated survival rates against fracture of endodontically treated posterior teeth restored with crowns or resin composite restorations. Literature search were performed using keywords. Publications from 1980 to 2016 were searched in PubMed, ScienceDirect, Web of Science, MEDLINE, and SCOPUS. Included studies were selected based on inclusion and exclusion criteria. Three clinical studies were included: 1 randomized controlled trial and 1 prospective and 1 retrospective cohort studies. Pooled survival rates ranged from 94%–100% and 91.9%–100% for crowns and resin composite, respectively. The majority of teeth had no more than 3 surface loss of tooth structure. The studies included were heterogeneous, and were not appropriate for further meta-analysis. Current evidence suggested that the survival rates against the fracture of endodontically treated posterior teeth restored with crowns or resin composites were not significantly different in the teeth with minimum to moderate loss of tooth structure.

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Case Report
Microsurgical re-treatment of an endodontically treated tooth with an apically located incomplete vertical root fracture: a clinical case report
Silvio Taschieri, Massimo Del Fabbro, Ahmed El Kabbaney, Igor Tsesis, Eyal Rosen, Stefano Corbella
Restor Dent Endod 2016;41(4):316-321.   Published online June 21, 2016
DOI: https://doi.org/10.5395/rde.2016.41.4.316
AbstractAbstract PDFPubReaderePub

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.

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