PMC7657428_01
(a) Preoperative clinical picture. (b) Preoperative radiograph showing cervical root fracture with respect to 12, crown/root fracture with respect to 11. (c) Rootcanal treatment performed with respect to 11. (d) Clinical picture after extraction of 12. (e) Post space preparation done with respect to 11. (f) Dentin post prepared from extracted 12. (g) Intermittent trial fit verification of dentin post. (h) Flap elevation with respect to 11 to expose fracture line. (i) Postoperative radiograph. (j) Suturing done with respect to 11. (k) Postoperative clinical picture. (l) 1-year follow-up radiograph
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F1
Clinical examination revealed crown fracture extending below the level of the gingiva with respect to 11, crown loss with only a small mobile fragment of crown attached to the soft tissue with respect to 12 [Figure 1a], and crown fracture involving pulp with respect to 21. Cervical third root fracture was observed in relation to tooth #12 [Figure 1b]. Based on clinical and radiographic findings, diagnosis of crown/root fracture (WHO 873.64) with respect to 11, root fracture (WHO 873.63) with respect to 12 [Figure 1a], and crown fracture with pulp exposure (WHO 873.62) with respect to 21 was made. A master cone of size 70/2 was verified, and cold lateral condensation was done using gutta-percha, AH Plus sealer (Dentsply, DeTrey, Konstanz, Germany) [Figure 1c]. In the next appointment, 12 was extracted [Figure 1d], adequately cleaned, and sterilized by autoclaving at 121 C for 15 min. Meanwhile, the root canal of 11 was prepared until size 2 peeso reamer (MANI, INC Japan) [Figure 1e]. The sterilized extracted tooth was then split into two halves vertically, and one half is shaped into dentin post [Figure 1f]. Fit of the post to the canal was checked intermittently after minor adjustments [Figure 1g]. Local anesthesia was administered and internal bevel, crevicular, interdental incisions were given with a 15c blade, and a full-thickness conventional flap was raised to expose the fracture line of 11 [Figure 1h]. The crown form was shaped with composite material, an X-ray was taken to verify the adaptation of composite material, and the flap was sutured back [Figure 1i and j]. Fixed prosthesis was given for rehabilitation of these teeth [Figure 1k]. On 1-year follow-up, radiograph revealed no significant changes, and the patient was asymptomatic [Figure 1l].