Surgical decision making in coronally located vertical root fracture.
OBJECTIVE
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.
Taschieri
S
S
Department of Health Technologies, Galeazzi Orthopedic Institute, University of Milan, Milan, Italy.
Laster
Z
Z
Rosano
G
G
Weinstein
T
T
Del Fabbro
M
M
D000328:Adult; D000368:Aged; D003657:Decision Making; D003758:Dental Implantation, Endosseous / Q000379:methods*; D015921:Dental Implants; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D036341:Intercellular Signaling Peptides and Proteins / Q000008:administration & dosage / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D010949:Plasma; D011182:Postoperative Care; D014081:Tooth Extraction; D014082:Tooth Fractures / Q000601:surgery*; D014092:Tooth Root / Q000293:injuries*; D016896:Treatment Outcome
D015921:Dental Implants; D036341:Intercellular Signaling Peptides and Proteins