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Sealing the Gap of Vertical Root Fracture through the Root Canal

Tsutomu Sugaya*,Megumi Natatsuka,Youji Motoki,Kana Inoue,Saori Tanaka,Hirofumi Miyaji,Masamitsu Kawanami,Ryuji Sakagami

Objective: The objective of this retrospective study was to investigate whether preparing the fracture line through the root canal before bonding a vertically fractured root would result in improvement of periodontal inflammation.

Methods: A total of 83 teeth from 81 patients, who had been diagnosed with vertically fractured roots, and in whom the fracture gap was sealed through the root canal, were used. The fracture line was prepared using an ultrasonic tip under a microscope in the preparation group (n=60) and 4-META/MMA-TBB resin was used to bond the fractured gap. In the non-preparation group (n=23), the fracture line was not prepared. Reevaluation was done 1 to 2 months later. Patients were clinically examined for probing depth and presence or absence of sinus tract and abscesses, and radiographs were taken to gauge improvement of bone defects.

Results: Comparing the probing depth in the non-preparation group before and after treatment, there was no significant difference (p=0.13), but in the preparation group, the probing depth was significantly shallower following treatment (p<0.001). In teeth where pre-treatment bone defect occurred, disappearance or decrease of bone defect was seen in 8 out of 13 teeth (61.5%) in the non-preparation group and 33 out of 41 teeth (80.5%) in the preparation group. There was significant improvement in the preparation group compared with non-preparation group (p=0.008).

Conclusion: The results suggest that preparing the fracture line through the root canal before sealing a vertically fractured root may be effective in resolving periodontal inflammation.