ABSTRACT
Vertical root fractures lead to advanced periodontal breakdown with deep periodontal pockets and vertical bone defects. The purpose of this study is to evaluate clinically the periodontal healing of root fracture treatment using adhesive resin cement. In 22 patients, 23 teeth with vertical root fractures were treated with 4-META/MMA-TBB resin cement. Eleven fractured roots were bonded through the root canal (group A) and 12 fractured roots were bonded extra-orally and replanted (group B). All teeth were then restored with full cast crowns (n=20) or coping (n=3). Mean probing depth was 6.6 mm at pre-treatment and 4.4 mm 6 months after the treatment in group A, and 7.4 mm and 4.6 mm, respectively, in group B. Bleeding scores were 100% at pre-treatment and 36.4% after 6 months in group A and 91.7% and 8.3%, respectively in group B. Radiographic bone level was 56.8% at pretreatment and 59.1% after 6 months in group A, and 18.8% and 29.2%, respectively, in group B. Two roots of group A and three roots of group B were extracted due to refracture, deterioration of periodontal inflammation, mobility, and luxation. The remaining roots (n=18) presented no discomfort to the patients and there was no deterioration of periodontal conditions over a mean period of 33 months (range 14-74 months) in group A and over a mean period of 22 months (range 6-48 months) in group B. There was no ankylosed teeth nor was any root resorption detected. The results suggested that the treatment of vertical root fracture using 4-META/MMA-TBB resin has good prognostic possibilities.
Subject(s)
Dental Bonding/methods , Tooth Fractures/therapy , Tooth Root/injuries , Adult , Aged , Alveolar Bone Loss/etiology , Boron Compounds/therapeutic use , Chi-Square Distribution , Female , Humans , Male , Methacrylates/therapeutic use , Methylmethacrylates/therapeutic use , Middle Aged , Periodontal Pocket/etiology , Post and Core Technique , Resin Cements/therapeutic use , Root Canal Therapy , Statistics, Nonparametric , Tooth Extraction , Tooth Fractures/complications , Tooth Replantation , Wound HealingABSTRACT
Resin adhesive systems capable of bonding conventional amalgam to dentin, enamel, and cast restorations are now available. This article describes a case in which bonded amalgam was used to create a "vital core," permitting preservation of vitality during restoration of a molar where deep caries had encroached on the pulp. Without use of adhesive resin, the restoration would have required devitalization of the tooth, endodontic therapy, and fabrication of a crown retained by a post and core.
