Abstract
ABSTRACT This article presents a clinical case of horizontal root fracture, in an adult patient, male, in the apical third, due to the practice of sports, which, along with other factors, has led to pulp necrosis. Initially, the patient sought emergency care, and then he underwent treatment by endodontics, using calcium hydroxide between sessions. After a monitoring period, root canal obturation was performed and the tooth is clinically and radiographically stable 2 years after the trauma. In this case, monitoring is long-lasting, divided into 12-month periods for 10 years, with clinical and radiographic evaluation. Dental fracture in children and teenagers from 10 to 14 years is very common, especially during the practice of sports and recreation activities. It is expected that young male individuals have greater propensity to damage their teeth than young female individuals. Maxillary central incisor is the tooth most commonly involved, and it often evolves to pulp necrosis after trauma.
Highlights
The incidence of oral and dental trauma affecting anterior teeth increases significantly, upper central incisors are mentioned by researchers as the most likely[1] and cases usually fall within the age group from 10 to 14 years[2,3]
According to Andreasen & Andreasen[1] and Caprioglio & lavagnoli[7], root fractures in permanent teeth predominantly affect the upper central incisors in individuals aged between 11 and 20 years and 20 to 44% of cases evolve to pulp necrosis
The patient had already been provided with care, but he showed symptoms and, after diagnosis and treatment planning, access surgery was undertaken and the diagnosis of pulp necrosis could be confirmed
Summary
The incidence of oral and dental trauma affecting anterior teeth increases significantly, upper central incisors are mentioned by researchers as the most likely[1] and cases usually fall within the age group from 10 to 14 years[2,3]. This article presents a case of horizontal root fracture in the apical third treated by endodontic procedures, using calcium hydroxide between sessions. According to Andreasen & Andreasen[1] and Caprioglio & lavagnoli[7], root fractures in permanent teeth predominantly affect the upper central incisors in individuals aged between 11 and 20 years and 20 to 44% of cases evolve to pulp necrosis. Teeth with viable pulp should be maintained without endodontic therapy, while, given the negative test for vitality, the canal must be immediately opened, cleaned, and filled with calcium hydroxide. Apical resistance to an endodontic instrument (K-file type) number 60 and absence of signs and symptoms added to radiographic data enabled root canal obturation close to the fracture line; apical fragment was kept (Figure 2). A third control was performed without evidence of changes
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