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Surgical decision making in coronally located vertical root fracture
S Taschieri1, Z Laster, G Rosano
1Department of Health Technologies, Galeazzi Orthopedic Institute, University of Milan, Milan, Italy.
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.
Conclusions:
Intraoperative diagnosis allowed to choose an appropriate surgical approach that led to excellent results in terms of clinical outcomes and patient satisfaction.
