Repair characteristics of root fractures in permanent anterior teeth

A follow-up study was made of repaired root fractures in 51 permanent anterior teeth, with a mean observation period of 6 years. The material was subdivided into three repair types (Figs. 1-3): Type 1 - invisible or hardly discernible fracture line (15 teeth), Type 2 - fragments separated by a narrow radiolucent line and peripheral rounding of the fracture edges (33 teeth), and Type 3 - fragments separated by a distinct bony bridge (3 teeth). The majority of repaired teeth gave a normal or slightly decreased response to electric pulp tests and the mobility was physiologic or slightly increased. Reduced transparency or slight yellowish discoloration was observed in 14 teeth. The most conspicuous radiographic finding was pulp obliteration which occurred in 86%. Two different patterns were observed: (1) partial obliteration located in the apical fragments and the fracture area, and extending 0.5-4 mm into the coronal fragment, and (2) progressive obliteration of the entire pulp cavity ending with almost total obliteration. Pulp necrosis did not develop as a sequel to progressive obliteration in any case. Several different characteristics of the fracture influenced the repair pattern, the most important being the degree of fragment dislocation and mobility, stage of root development and localization of the fracture. Correlation between type of repair and various treatment procedures was observed only with regard to reduction.