• Journal of the korean academy of Pediatric Dentistry
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• v.37 no.3
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• pp.381-386
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• 2010

As the vertical fracture occurs at the various locations following the long axis of a root, treatment method of crown-root fractured anterior teeth is decided according to the depth. If the fracture line is close to the crown, gingivectomy, orthodontic - forced eruption or surgical extrusion of apical fragment could be done. If the line is over 1/3 length of the root, the prognosis is poor and extraction is usually undertaken. However, extraction of maxillary incisor at growing children causes many complications such as esthetic, phonetic problem and alveolar bone resorption. Therefore, preservation of tooth is the highest priority. Recently, intentional replantation with composite resin could be considered as alternative treatment of crown-root fractured anterior tooth. This report presents a patient in mixed dentition with deep vertical crown-root fracture of the maxillary permanent central incisors by trauma. Intentional replantation of the fractured teeth was performed using composite resin. After 2 years, specific clinical symptom has not been found and the patient was satisfied of esthetic result. This method suggests the new technique to preserve a tooth as an alternative to extraction, although it is technically sensitive and the reports of long-term prognosis is insufficient.

• Journal of the korean academy of Pediatric Dentistry
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• v.31 no.2
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• pp.267-272
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• 2004

This case report describes an uncommon treatment method for crown-root fractured incisor with immature root. A 7-year-old girl was referred for treatment of crown-root fractured maxillary central incisor. The fracture line extended to 1/2 of the total tooth length with incomplete root formation. The prognosis of crown-root fracture is usually poor and extraction is usually undertaken. But, in the mixed dentition, extraction of maxillary permanent incisor results in many complications, such as resorption of alveolar bone, poor esthetics, pronunciation and mastication. Conservative therapy in the permanent dentition comprises of few treatment modalities; supragingival restoration, gingivectomy, orthodontic extraction of apical fragment, surgical extrusion of apical fragment with or without rotational replantation. However, in this case, these indications are not applicable, so intentional replantation with adhesive resin system is the treatment of choice. The tooth was followed-up for 12 months. Currently, there are no symptoms. Since this modality adopts the respective advantages of both intentional replantation and adhesive treatment, it might be the treatment of choice in cases of vertical crown-root fracture.

• Journal of the korean academy of Pediatric Dentistry
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• v.36 no.2
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• pp.288-292
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• 2009

A crown-root fracture is defined as a fracture involving enamel, dentin, and cementum. The fractures may be grouped according to pulpal involvement into uncomplicated and complicated. Generally a vertically crown-root fractured tooth must be extracted. However, it should be mentioned that the cases have been reported where bonding of the coronal fragment has led to consolidation of the intraalveolar part of the fracture. Definitive conservative therapy comprises one of four treatment alternatives; fragment removal only, fragment removal with gingivectomy, orthodontic extrusion of apical fragment, and surgical extrusion of apical fragment. The choice is primarily determined by the exact information on the site and the type of fracture, but the cost and the complexity of treatment can also be decisional factors. On the other hand, intentional replantation of the teeth with vertical root facture reconstructed with resin bonding has emerged as a new promising method in recent years. This case presents an intentional replantation of the crown-root fractured maxillary central incisor reconstructed with resin bonding. However, an obvious increase of radiolucency was observed after 4 months and the tooth was re-fractured after 16 months.

• Journal of the korean academy of Pediatric Dentistry
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• v.30 no.3
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• pp.465-470
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• 2003

Transverse and oblique crown-root fractures constitute a major therapeutic problem, particularly in young dentitions. Because crown-root fracture may involve enamel, dentin, pulp, and periodontal tissues, management of the injuries must be modified accordingly. When the fracture line was located under the alveolar crest. there are several methods for crown-root fractured teeth with pulp exposure, such as extruding the root fragment with orthodontic force and restoring it, or intentionally extracting the tooth and replanting it to a position which it can be restored. This case, the fractured tooth is intentionally extracted atraumatically, and replanted by rotating approximately 180 degree into the original socket and fixing with an orthodontic wire. At the 8-month recall examination, the root still showed normal mobility and there was not observed any inflammatory or replacement root resorption in the periapical radiograph.

• Journal of the korean academy of Pediatric Dentistry
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• v.31 no.1
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• pp.92-97
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• 2004

Traumatic injuries in the young peranent dentition are common, but root fractures, defined as fractures in volving dentin, cementum and pulp, are relatively uncommon. Case 1 is a 9-year-old boy who had a horizontal root fracture of his maxillary right central incisor in the apical third. Root canal therapy was performed in coronal segment and calcium hydroxide therapy was initiated. Six months after treatment, a periapical radiograph showed calcific tissue formation and normal root development. 1 year and 3 months later, the canal was permanently obturated with gutta-percha. Case 2 is a 7-year-old girl who had a vertical root fracture of her maxillary right central incisor. Fractured tooth was intentionally extracted atraumatically, and then the separated fragments are bonded with resin cement. the restored tooth was replanted into the original socket. Recalls up to 8 months showed normal mobility and no periapical pathosis. In these cases, we performed conservative treatment. Clinical and radiographic examination showed no pathosis or abnormality of the teeth and periodontal tissue.

• Restorative Dentistry and Endodontics
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• v.34 no.5
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• pp.383-389
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• 2009

The purpose of this study was to investigate the fracture resistance of crown-root fractured teeth repaired with dual-cured composite resin and horizontal posts. 48 extracted human premolars were assigned to control group and three experimental groups. Complete crown-root fractures were experimentally induced in all control and experimental teeth. In the control group. the teeth (n=12) were bonded with resin cement and endodontically treated. Thereafter, the access cavities were sealed with dual-cured composite resin. In composite resin core-post group (n=12), the teeth were endodontically treated and access cavities were sealed with dual-cured composite resin. In addition, the fractured segments in this group were fixed using horizontal posts. In composite resin core group (n=12), the teeth were endodontically treated and the access cavities were filled with dual-cured composite resin without horizontal posts. In bonded amalgam group (n = 12), the teeth were endodontically treated and the access cavities were sealed with bonded amalgam. Experimental complete crown-root fractures were induced again on repaired control and experimental teeth. The ratio of fracture resistance to original fracture resistance was analyzed with Kruskal-Wallis test. The results showed that teeth in control and composite resin core-post group showed significantly higher resistance to re-fracture than those in amalgam core group (p < 0.05). The resistance to refracture was high in the order of composite resin - post group, control group, composite resin group and bonded amalgam group. Within the scope of this study, the use of horizontal post could be beneficial in increasing the fracture resistance of previously fractured teeth.

• Journal of Dental Rehabilitation and Applied Science
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• v.25 no.3
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• pp.225-235
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• 2009

A common procedure of restoration of endodonticlly treated tooth with fiber-reinforced post is followed by core build-up after post cementation. However, this technique is complex and time-consuming. The aim of this study was to compare fracture strength of premolar, restored with various methods of core fabrications on fiber-reinforced posts and casting metal restoration. Forty five freshly extracted human mandibular premolars were obtained and devided into 5 groups acconding to the type of post and methods of core build-up. In Group A, D.T. $Light-post^{(R)}$ were cemented with $DUO-LINK^{TM}$ and then $LIGHT-CORE^{TM}$ was used for core restoration. In Group B, D.T. $Light-post^{(R)}$ and $DUO-LINK^{TM}$ were used for cementing in the postspace, and $DUO-LINK^{TM}$ was used again for core restoration. In Group C, $Light-post^{(R)}$ bonding and the core build-up were performed simultaneously by using $DUO-LINK^{TM}$. In Group D, $LuxaPost^{(R)}$ was bonded by using $LuxaCore^{(R)}-Dual$. Again, $LuxaCore^{(R)}-Dual$ was used for core restoration. In Group E, $LuxaPost^{(R)}$ bonding and the core build-up were performed simultaneously by using $LuxaCore^{(R)}-Dual$. Axial reduction was formed parallelly as possible and 45 degree bevel was made at buccal occlusal surface. Crowns were fabricated and cemented. Each tooth was embedded in self-curing acrylic resin to the level of 2mm below the CEJ. Specimens were fixed on universal testing machin such that the axis of the tooth was at 45 degree inclination to the horizontal plane, and compressive force was applied at a crosshead speed of 1mm/min until failure occurred. The mean fracture strength was the highest in group A followed by descending order in group B, D, E and C. However, there were no statistically significant differences between groups with regard to the fracture strength. The type of the post or build-up methods of the core does not seem to influence the fracture strength.