Abstract
In cases where permanent teeth have closed apices and completely erupted roots, the probability of root fractures is increased due to the stable support given by the adjacent bone and periodontal tissues. Fractures have the potential to affect several dental structures, including the pulp, dentin, cementum, bone, and periodontal tissues. In cases of horizontal root fractures (HRF), the apical section typically maintains vitality; however, the present case presented an unusual apex necrosis. Given the patient's age and tooth stability, traditional apical surgery was deemed inappropriate. Instead, a conservative treatment approach was chosen to preserve the tooth. This case report details the management and a 2-year follow-up of a maxillary central incisor exhibiting a HRF and apical necrosis, successfully addressed through the application of Mineral Trioxide Aggregate (MTA) in the both apical and coronal segments. Using MTA prevented apical surgery in cases of apex necrosis accompanied by HRF.
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