title: Implant treatment choice after extraction of a vertically fractured tooth. A proposal for a clinical classification of bony defects based on a systematic review of literature.
abstract: OBJECTIVE
  The objectives of this study were to propose a classification for the bone defects resulting after extraction of a vertically fractured tooth and to review the existing literature about the treatment of such kind of defects by means of dental implants in combination with regenerative procedures.
  
  
  METHODS
  An electronic search was performed on biomedical databases using a combination of appropriated search terms combined through the use of Boolean operators. All articles concerning the treatment of peri-implant bone dehiscences and fenestrations through guided bone regeneration (GBR) with at least 6 months follow-up were eligible. Outcomes data extracted from the selected articles were summarized using descriptive tables. A classification of the bone defects associated with vertical root fracture (VRF) was also proposed.
  
  
  RESULTS
  A total of 33 articles were included in the review. Twenty-three articles (814 implants) were about bone dehiscence treatment, ten articles presented the treatment of fenestrations, and ten (429 implants) adopted vertical bone augmentation. The percentage of bone filling was variable among different procedures and defect classification. The use of resorbable membrane was associated with better outcomes than the use of non-resorbable ones.
  
  
  CONCLUSIONS
  Guided bone regeneration for the management of bone defects in the presence of a VRF of the extracted tooth is a viable treatment option. The assessment of bone defect geometry prior to a tooth extraction could be clinically relevant for evaluating the feasibility and the success of immediate implant placement as well as the need of GBR.
authors.affiliation: Dental Clinic, Department of Biomedical, Surgical and Dental Sciences, IRCCS Istituto Ortopedico Galeazzi, Università degli Studi di Milano, Milan, Italy.
authors.forename: Stefano
authors.initials: S
authors.lastname: Corbella
authors.forename: Silvio
authors.initials: S
authors.lastname: Taschieri
authors.forename: Lakshman
authors.initials: L
authors.lastname: Samaranayake
authors.forename: Igor
authors.initials: I
authors.lastname: Tsesis
authors.forename: Carlos
authors.initials: C
authors.lastname: Nemcovsky
authors.forename: Massimo
authors.initials: M
authors.lastname: Del Fabbro
mesh_terms: D016301:Alveolar Bone Loss / Q000145:classification* / Q000209:etiology / Q000601:surgery*; D000540:Alveolar Ridge Augmentation / Q000379:methods*; D001861:Bone Regeneration; D003757:Dental Implantation / Q000379:methods*; D015921:Dental Implants; D006801:Humans; D013529:Surgical Wound Dehiscence / Q000209:etiology / Q000601:surgery*; D014081:Tooth Extraction; D014082:Tooth Fractures / Q000601:surgery*
chemical_list: D015921:Dental Implants
keywords: classification; guided bone regeneration; post-extraction implant; vertical root fracture