Surgical Management of Vertical Root Fractures for Posterior Teeth: Report of Four Cases

Introduction: The objective of this article was to present a surgical treatment option for teeth with incomplete vertical root fracture in maxillary and mandibular posterior teeth. Methods: Four cases are presented in which 1 endodontically treated maxillary or mandibular molar had an incomplete vertical root fracture involving 1 of the roots. The tooth underwent a flap elevation procedure to visualize the pattern of bone loss and assess the extent of root fracture. The fracture line was eliminated by resecting the root in a beveled manner, after which root-end preparation and root-end filling were performed by using mineral trioxide aggregate. The osteotomy was covered with an absorbable collagen membrane. Cases were followed up for 8-24 months after surgery. Results: The procedure was shown to be predictable and successful in this series. Root length was preserved, and tooth extraction was avoided. Conclusions: The microsurgical treatment option for multirooted teeth with incomplete vertical root fracture resulted in long-term clinical success. (J Endod 2012;38:550-555)