Spontaneous healing response of oblique root fracture: case report with 4-year follow-up

Root fractures can involve the dentin, cementum, and pulp and commonly can occur as oblique fractures with varying orientations. The aim of this study was to demonstrate the maintenance of pulp health in a tooth with a fractured root without any endodontic treatment and to discuss the advantage of cone-bean computed tomography (CBCT) compared with traditional radiographs in the diagnosis of oblique root fractures. Intra-oral radiography of tooth 11 revealed a horizontal root fracture at the level of the apical third, while the sagittal CBCT slice reveals a complete fracture line running obliquely from the apical third on the buccal aspect through the cervical third on the palatal aspect. Four years follow-up, the tooth has kept its pulp vitality, no tooth discoloration or discrepancy in arch position, without endodontic treatment. This result illustrates spontaneous healing of root fracture including preservation of pulp health. In addition, it confirms the importance of exams in 3 dimensions to correctly locate the fracture and assist in the treatment decision.

Ten-year follow-up after immediate management of multiple sports‐related dental injuries: a case report

This case report aims to describe a long-term follow-up after the immediate treatment of multiple dental injuries. A 15-year-old female patient was admitted to a private clinic 30 minutes after an accident at school. After clinical and radiographic examinations, tooth 21 was diagnosed with enamel fracture and horizontal root fracture, tooth 22 was diagnosed with lateral luxation, and teeth 12, 11, and 23 were diagnosed with subluxation. Teeth 21 and 22 presented pulp necrosis resulting in root canal treatment. Moreover, tooth 21 was filled with a paste composed of calcium hydroxide, 2% chlorhexidine gel, and zinc oxide, and tooth 22 was filled conventionally. After a 10-year follow-up, her teeth 21 and 22 showed no root resorption or periapical lesion, while her teeth 12, 11, and 23 still presented pulpal vitality

Ten-year follow-up after immediate management of multiple sports‐related dental injuries: a case report

This case report aims to describe a long-term follow-up after the immediate treatment of multiple dental injuries. A 15-year-old female patient was admitted to a private clinic 30 minutes after an accident at school. After clinical and radiographic examinations, tooth 21 was diagnosed with enamel fracture and horizontal root fracture, tooth 22 was diagnosed with lateral luxation, and teeth 12, 11, and 23 were diagnosed with subluxation. Teeth 21 and 22 presented pulp necrosis resulting in root canal treatment. Moreover, tooth 21 was filled with a paste composed of calcium hydroxide, 2% chlorhexidine gel, and zinc oxide, and tooth 22 was filled conventionally. After a 10-year follow-up, her teeth 21 and 22 showed no root resorption or periapical lesion, while her teeth 12, 11, and 23 still presented pulpal vitality.

Conservative Management of the Horizontal Root Fracture in the Middle Third using Fiber Post as an Intraradicular Splint

BACKGROUND: Root fractures are uncommon injuries in permanent teeth and account for only 0.5–7% of dental trauma. It occurs more frequently in fully erupted permanent teeth, in which the completely formed root with closed apices is solidly supported in the bone and periodontium. This may lead to complex consequences due to the combined damage to the pulp, dentine, cementum, bone, and periodontium. They are transverse to oblique in direction and result from a horizontal impact. Their incidence is more in the middle third of the root than at the cervical and apical thirds. CASE REPORT: This paper describes a case of complicated horizontal root fracture at the middle third of the maxillary right central incisor. After receiving an endodontic treatment, the fractured root fragments of the maxillary right central incisors were united with the help of a glass fibre post. Eventually, the incisor was restored with a zirconia crown. CONCLUSION: Follow-up after a year revealed a well-stabilized assembly of the root fragments and the post.

Conhecimento do cirurgião-dentista sobre o manejo e tratamento de fratura radicular horizontal em Curitiba, Brasil Knowledge of dental practitioners on the management and treatment of horizontal root fracture in Curitiba, Brazil

Introdução: A fratura radicular ocorre em uma frequência que varia de 2,5 a 8,7% dos traumas dentários. Objetivo: Avaliar o conhecimento do cirurgião dentista clínico geral da rede municipal de saúde de Curitiba (PR) a respeito de fratura radicular horizontal e comparar os resultados obtidos nesta investigação (grupo 2) com um estudo desenvolvido em 2009 (grupo 1). Material e métodos: Para a realização deste trabalho, um questionário (utilizado no estudo de 2009) sobre conduta e manejo da fratura radicular horizontal foi aplicado aos cirurgiões-dentistas. Os dados foram analisados por meio do teste χ2 e teste Z de diferença entre duas proporções. A amostra foi composta de 81 cirurgiões-dentistas (grupo 2) e 59 cirurgiões-dentistas (grupo 1). Resultados: Houve maior porcentagem de acerto para o grupo 1 quando comparado ao grupo 2, em relação à conduta na fratura radicular horizontal com ou sem deslocamento do terço coronário e quanto ao prognóstico do dente no que tange à posição da fratura. Não houve diferença estatisticamente significante entre grupos a respeito do tecido pulpar, com ou sem deslocamento dos terços. Sobre a permanência da contenção, houve maior acerto entre o grupo 2. AbstractIntroduction: The frequency of tooth fractures ranges from 2.5 to 8.7% in dental injuries. Objective: The objectives of this study were to evaluated the knowledge of general dental practitioners (GD), at the public dental care system, about the correct management of horizontal tooth fractures, in Curitiba (PR, Brazil) (group 2), and to compare the results with a preview study (group 1). Material and methods: The same questionnaire was applied to GD: in 2009 (group 1) and in the actual study (group 2). The data was analyzed using the χ2 test and the Z test for different proportions. The samples were 81 GDs (group 2) and 59 GDs (group 1). Results: Group 1 had more correct answers than group 2, concerning horizontal root fracture with or without crowded displacement, and prognosis related to the position of the fracture line. About the pulp tissue, with our without displacement, there was no statistic significant difference between both groups. When it comes to the splint permanence, group 2 had more correct answers.