Case Report

Apicoectomy in Maxillary Central Incisors Ellis fracture Class VI

Viera Ananda Duatri Seantiga*, Ryan Mahardiansyah*, Raphael Tri Endra Untara**

*Residents, Conservative Dentistry, Universitas Gadjah Mada, Yogyakarta

**Lecturer, Conservative Dentistry, Universitas Gadjah Mada, Yogyakarta
*Jl Denta No 1 Sekip Utara, Yogyakarta, Indonesia; Correspondent: viera.ananda2493@mail.ugm.ac.id

ABSTRACT

Class VI Ellis fracture is a root fracture. The aim of apicoectomy is to prevent the entry of bacteria from periapical into root canal by
placing sealing material after root resection. MTA has good biocompatibility, good adhesion to cavity walls, and induce periapical
healing. A 40-year-old female patient came to RSGM Prof. Soedomo complaints of pain in upper front teeth. The patient had
accident on her teeth 3 months prior. Clinical examination revealed a dentin-deep cavity on palate tooth 11 and tooth 21 was intact.
Both teeth 11 and 21 had pain on percussion and palpation, negative vitality tests, and second-degree tooth mobility. Radiograph
shows horizontal fracture in apical third of teeth 11 and 21. Treatments performed were RCT, splinting, apicoectomy with MTA, and
direct composite restoration. 1.5 months after procedure, no complaints in subjective and objective examination. RCT was
performed with working length up to the limit of root fracture. Wire splinting was done to overcome teeth mobility. Apicoectomy to
remove broken fragments and retrograde filling with MTA was performed. Root fragments in apical third can be removed by
apicoectomy. MTA induces periapical healing, and good marginal adaptation.

Keywords: Apicoectomy, Ellis fracture class VI, MTA