Restoration of a vertical tooth fracture

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    Anonymous
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    Management of vertically fractured tooth or a perforation frequently poses problem during endodontic management. Such teeth often need a pre-endodontic restoration prior to initiation of root canal therapy to aid in the placement of rubber dam clamp.

    Canal projection technique using the ‘projector endodontic instrument guidance system’ (CJM Engineering, Santa Barbara, CA) provides pre-endodontic reconstruction of debilitated coronal and radicular tooth structure while preserving individualized access to the canals. This technique suggested the use of tapered plastic sleeves that mimics the canal shape.In our technique, though the exact taper could not be obtained due to use of a parallel core needle, efforts were made to widen the orifices. Badly mutilated teeth often pose a problem during rubber dam clamp placement. Though techniques have been suggested for isolation of badly broken down teeth, such as: using split dam technique, gingivectomy and crown lengthening procedures, customized splint with rubber dam or clamp placed on the attached gingiva, these techniques will not provide the same level of safety and moisture control as individual tooth isolation. Further, the chamber acts as a reservoir for the irrigant during instrumentation within the canals. Once the crown buildup was done, using canal projection, further endodontic treatment could be done with rubber dam isolation and adequate irrigation.This technique also offers another advantage of immediate post-endodontic restoration.

     

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