Abstract
Introduction. Root fractures, defined as fractures involving dentine, cementum, and pulpal and supportive tissues, constitute only 0.5–7% of all dental injuries. Horizontal root fractures are commonly observed in the maxillary anterior region and 75% of these fractures occur in the maxillary central incisors. Methods. A 14-year-old female patient was referred to our clinic three days after a traffic accident. In radiographic examination, the right maxillary central incisor was fractured horizontally in apical thirds. Initially, following local infiltrative anesthetics, the coronal fragment was repositioned and this was radiographically confirmed. Then the stabilization splint was applied and remained for three months. After three weeks, according to the results of the vitality tests, the right and left central incisors were nonvital. For the right central incisor, both the coronal and apical fragments were involved in the endodontic preparation. Results. For the right central tooth, both the coronal and apical root fragments were endodontically treated and obturated at a single visit with white mineral trioxide aggregate whilst the fragments were stabilized internally by insertion of a size 40 Hedstrom stainless-steel endodontic file into the canal. Conclusion. Four-year follow-up examination revealed satisfactory clinical and radiographic findings with hard tissue repair of the fracture line.
Highlights
Root fractures, defined as fractures involving dentine, cementum, and pulpal and supportive tissues, constitute only 0.5–7% of all dental injuries
Horizontal root fractures are commonly observed in the maxillary anterior region and 75% of these fractures occur in the maxillary central incisors [1]
A 14-year-old female patient was referred to our clinic three days after a traffic accident
Summary
Root fractures, defined as fractures involving dentine, cementum, and pulpal and supportive tissues (e.g., the periodontal ligament and alveolar bone), constitute only 0.5–7% of all dental injuries. In case of total necrosis, the root canal treatment of both fragments, the root canal treatment of the coronal fragment, and the surgical removal of the apical fragment and extraction of the coronal fragment and the root canal treatment and orthodontic extrusion of the apical fragment are the other treatment options [4] Several factors such as degree of dislocation, stage of root formation, location of the fracture, time period between trauma and treatment, and type of trauma (displacement of the coronal fragment compared with no displacement of the coronal fragment) may affect the treatment success of horizontally fractured teeth [5]. In the teeth with a horizontal fracture, the treatment principle is to prevent the movement of the coronal part and to protect the vitality of the pulp For this purpose, splint application is recommended. Splinting with the orthodontic wire and composite resin for 1–3 months is preferred in the teeth with a root fracture
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