Restor Dent Endod.  2014 May;39(2):126-131.

Healing after horizontal root fractures: 3 cases with 2-year follow-up

• Choi Y
• Hong SO
• Lee SR
• Min KS
• Park SJ

Abstract

Among dental traumas, horizontal root fractures are relatively uncommon injuries. Proper initial management and periodical evaluation is essential for the successful treatment of a root-fractured tooth. If pulpal necrosis develops, endodontic treatment is indicated, exclusively for the coronal fragment. Fragment diastases exert a great influence on healing at the fracture line and on pulpal necrosis. An adequately treated root-fractured tooth has a good prognosis. This case report describes the treatment and 2-yr follow up of 3 maxillary central incisors, first with horizontal root fracture, second with horizontal root fracture and avulsion, and third with horizontal root fracture and lateral luxation. All three cases were treated with mineral trioxide aggregate (ProRoot, Dentsply). During 2 yr of follow-up evaluation, the root-fractured teeth of the present patients were well retained in the arch, showing periodontal healing, even after endodontic treatment.

Keyword

Diastasis; Mineral trioxide aggregate; Tooth fracture

MeSH Terms

Follow-Up Studies*
Humans
Incisor
Necrosis
Prognosis
Tooth
Tooth Fractures

Figure

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  Figure 1 (a) The radiograph of the initial visit shows a horizontal root fracture line on the maxillary right central incisor; (b) The 4-week follow-up radiograph shows internal resorption around the fracture line; (c) The 6-week follow-up radiograph shows that the internal resorption site is larger and more distinct.

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  Figure 2 Radiograph of the tooth. (a) After root canal treatment; (b) At the 1-year follow-up evaluation; (c) At the 2-year follow-up evaluation. 2-year follow-up radiograph reveals healing with the interposition of hard tissue between the fragments.

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  Figure 3 Radiograph of the right maxillary central incisor with horizontal root fracture. (a) After repositioning and applying a resin-wire splint; (b) After root canal treatment; (c) At the 2-year follow-up evaluation. 2-year follow-up radiograph reveals healing with the interposition of hard and soft tissue between the fragments.

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  Figure 4 Radiographs of the emergency visit shows the teeth. (a) Before the application of the resin-wire splint; (b) After repositioning and the application of the resin-wire splint.

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  Figure 5 Images were obtained 3 weeks after the trauma. (a) The periapical radiograph shows a radiolucent lesion around the fracture line on tooth #21; (b) The clinical photograph shows narrow and deep pocket depth and gingival swelling on tooth #21.

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  Figure 6 Radiograph of the teeth. (a) After the root canal treatment; (b) At the 1-year follow-up evaluation; (c) at the 2-year follow-up evaluation. The radiolucent lesion has disappeared on tooth #21. 2-year follow-up radiograph reveals healing with interposition of soft tissue between the fragments.

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