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25 February 2024: Review Articles

Review of Approaches to the Management of Vertical Dental Root Fractures and Tooth Preservation

Besir Salihu 1ABDEF , Miranda Stavileci 2EF*

DOI: 10.12659/MSM.943100

Med Sci Monit 2024; 30:e943100

Table 1 Treatment approaches for vertical root fractures.

Treatment modalityDescriptionAdvantagesDisadvantages
No treatment, just observation with monitoringFollowing the actual clinical condition without taking any step in the treatmentLeast invasive option, allows assessment of the fracture’s stabilityTooth may become symptomatic or fail. Typically leads to tooth loss due to infection or complications
Root resection and root amputationRemoving apex of a tooth’s root, or the whole root of multi-rooted teethTooth preservation, maintains the bone density, restores the function and is an alternative to extractionComplex procedure, risk of residual infection which leads to limited success. Requires surgical skills
HemisectionThe surgical removal of one-half of a tooth, typically in multi-rooted teethCan save one portion of the tooth, cost-effective, conservation of healthy rootsMay result in a gap if one portion is extracted, also it is a complex procedure
Laser fusion of vertical root fractureSealing the fracture line while generating thermal energyBetter alternative than extraction and no treatmentIs not a widely recognized or established dental procedure
Re-cementing, bonding or sealing the fractured fragmentClosing the fracture line with different approaches, with the aim of saving the tooth and sealing the fracture line so the bacteria does not enterMinimally invasive, compared with resection and hemisection, even though it is often combined with these procedures. Cost-effective and preserves the toothComplex procedure, Requires good surgical skills and healthy periradicular tissues, some bacteria can remain within the fracture lines
Intentional replantationTooth is intentionally removed from its socket, treated or repaired, and then replanted back into its original position in the patient’s mouthPreservation of natural tooth, less invasive than dental implants and requires fewer dental appointmentsRisk of complications, success rates vary, potential for reinfection, risk of root resorption, not suitable for all cases
Prosthodontic rehabilitation (partial denture or bridge)Focused on restoring or replacing missing teeth and associated oral structures to enhance oral function, aesthetics, and overall well-beingProvides a functional and aesthetic replacement of the lost tooth as a result of vertical root fractureAlteration of adjacent healthy teeth, not suitable for single-tooth replacements, potential for discomfort or instability
Tooth extraction and implant placementThe most common treatment in vertical root fracture casesRemoves the source of infection and brings back the tooth functionLoss of the natural tooth and extra cost for the implant

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Medical Science Monitor eISSN: 1643-3750
Medical Science Monitor eISSN: 1643-3750