Preservation of a Split Tooth: Nonsurgical Clinical Management

CE Hours: 0

Description:  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.

At the conclusion, participants should be able to:

• Describe important diagnostic criteria for a split tooth.
• Describe a step by step procedure for the sufficient restoration of a split first upper premolar.
• Discuss factors which influence the long-term success after repair of a split tooth.