Prosthetic rehabilitation using a 2-unit splinted fixed dental prosthesis in a patient with short root anomaly: A case report

Abstract

Background: Short root anomaly (SRA) is a condition in which it is observed a normal-size crown with a small or short root, mainly in the maxillary incisors. Its etiology is varied, meaning it can be a genetic origin, trauma, a developmental disorder, or orthodontic movements. There is still no specific treatment for SRA, therefore, this case aims to demonstrate rehabilitation in teeth affected with SRA. 

Clinical presentation: 57-year-old patient, female. Consults for grayish upper front teeth and maxillary prosthesis in poor condition. Partially edentulous maxilla and mandible with occlusal instability. Stage III Grade B, generalized periodontitis. Grade II mobility in 1.1, 2.1; multiple restorations present. SRA in central incisors and maxillary and mandibular premolars. Pulp necrosis in both teeth 1.1 and 2.1. Necropulpectomy was conducted on both teeth, followed by individualization and cementation of fiberglass posts (PFV) and zirconia-based fixed dental prosthesis (FDP) with medial splinting.

Clinical relevance: SRA is an infrequent pathology, more prevalent in the female gender, generally asymptomatic, and it is usually a radiographic finding.  It has been established that the use of PFV conserves dental tissue, preserves teeth aesthetics and biomechanical behavior, and its elastic modulus is similar to the dentin's, avoiding excessive forces to the biological remnant. Within ceramics, zirconia has better mechanical resistance, supporting occlusal stability and providing necessary aesthetics in the anterior-superior sector. The purpose of splinting is to compensate for the presence of short abutments with poor retention, dissipate occlusal forces, and neutralize abutment tooth mobility. 

Conclusion: Faced with patients with SRA, the treatment preparation and study should be multidimensional to benefit from the best available approach. Periodontal stability and an adequate occlusal adjustment in conjunction with splinting will provide mechanical stabilization, improving the prognosis and survival of the rehabilitation.