Preservation of a Split Tooth: Nonsurgical Clinical Management

J Endod. 2020 Jul;46(7):1002-1008. doi: 10.1016/j.joen.2020.03.007. Epub 2020 May 4.

Abstract

A tooth is considered to be a split tooth if it contains a fracture line extending from the occlusal surface through both marginal ridges. Currently, the only treatment option for a split tooth is extraction. The present case report describes a novel therapeutic strategy for the preservation of a split tooth (first maxillary premolar) with a fracture in the mesiodistal direction. A systematic nonsurgical procedure involving visualization and slight widening of the fracture line is described. This procedure facilitates sealing of the fracture gap with a biocompatible calcium silicate cement (mineral trioxide aggregate) as well as internal composite resin stabilization and cuspal coverage restoration of the tooth. A 3-year follow-up showed a promising clinical and radiographic outcome. The concept presented here is an alternative treatment option for a split tooth, which allows preservation of the tooth rather than its extraction.

Keywords: Longitudinal fracture; mineral trioxide aggregate; nonsurgical fracture repair; split tooth; treatment concept.

Publication types

  • Case Reports

MeSH terms

  • Bicuspid
  • Composite Resins
  • Dental Cements
  • Dental Materials
  • Humans
  • Tooth Fractures*

Substances

  • Composite Resins
  • Dental Cements
  • Dental Materials