Comparative analysis of the fracture resistance of reattached vertical root fractures using different techniques: An in vitro study

Introduction: The management of vertical root fractures (VRFs) is complex and challenging. Various reattachment techniques have been tried, but there is a need to improve the fracture resistance of reattached VRFs. This study assessed the fracture resistance of reattached VRFs with different treatment approaches using resin cement (RC), polyethylene fibers (F), horizontal slot (HS) preparation, and bioceramic material (BC). Materials and Methods: Roots in the control group ( n = 10) were obturated but VRFs were not induced. After instrumentation, vertical fractures were induced in 50 roots, splitting them into two separate fragments. These fractured roots were randomly allocated to 5 experimental groups for reattachment: RC, RC + F, RC + BC, RC + F + BC, and RC + F + HS + BC. Following reattachment of the VRFs, the universal testing machine was used to calculate the maximum fracture load of the specimens. The type of fractures observed was recorded as original site or new site. One-way analysis of variance and Tukey’s post hoc analysis were used for statistical analysis. Results: Among the four experimental groups, the RC + F + HS + BC group showed the highest fracture resistance (477.1 ± 132.12 N), whereas the RC group showed the lowest (177.4 ± 67.87 N). The fracture resistance of the RC + F + HS + BC group was significantly higher than RC ( P < 0.001), RC + F ( P = 0.001), RC + BC ( P < 0.001), and RC + F + BC ( P 0.02). The majority of RC specimens showed original fracture sites, whereas RC + F + HS + BC groups showed the least number of original fracture sites. Conclusion: The RC + F + HS + BC reattachment technique significantly increased the fracture resistance of the reattached VRFs.