Restor Dent Endod.  2012 Aug;37(3):180-184. 10.5395/rde.2012.37.3.180.

Management of horizontal root fractures by fabrication of canine protected occlusion using composite resin

• Shin JH
• Kim RJ

• KMID: 1995660
• DOI: http://doi.org/10.5395/rde.2012.37.3.180

Abstract

Traumatic injuries of the face often involve root fractures especially in anterior teeth. The prognosis and the treatment of the root fracture depend on the extent of the fracture line, general health and patient compliance. This case report outlines a new conservative trial treatment modality to stabilize the maxillary central incisors with horizontal root fracture on the cervical to middle third by fabricating canine guidance to remove loading on the traumatized maxillary central incisors during eccentric movements and thus inducing spontaneous healing of the fractured line between the fragments. Radiographs after thirty months showed adequate healing with no signs of pathological changes including root resorption, ankylosis or displacement. Long term follow-up revealed that vitality, stability and aesthetics were maintained and the patient was satisfied with the outcome.

Keyword

Canine guided occlusion; Root fracture; Spontaneous healing

MeSH Terms

Ankylosis
Dental Occlusion
Displacement (Psychology)
Esthetics
Follow-Up Studies
Humans
Incisor
Patient Compliance
Prognosis
Root Resorption
Tooth

Figure

• 

  Figure 1 Periapical radiograph showing horizontal root fractures of both maxillary central incisors. Note visible gap between middle and cervical third of the maxillary central incisors.

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  Figure 2 Radiographs showing crown fractures of the maxillary right lateral incisor and canine. (a) initial; (b) after composite resin build-up.

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  Figure 3 After restoration of the maxillary right lateral incisor, and compostie resin overlay on both maxillary canines. (a) anterior view; (b) articulating paper marking of eccentric movements after fabrication of canine protected occlusion using composite showing no contact on the traumatized central incisors.

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  Figure 4 Thirty-months follow-up. (a) anterior view showing good aesthetics; (b) occlusal view showing functional composite overlay on the maxillary canines.

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  Figure 5 Periapical radiograph after 30 months showing healing and reduced gap between the fracture lines.

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  Figure 6 Coronal and cross-sectional CBCT images of spontaneously healed root fractures of the central incisors without any signs of periradicular pathology or root resorption. (a) Coronal image; (b) Cross-sectional image of the maxillary right central incisor; (c) Crosssectional image of the maxillary left central incisor. CBCT, Cone-beam computed tomography.

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