Management of a horizontal root fracture after previous root canal therapy

This case report concerns a 9-year-old girl who had a horizontal root fracture of her maxillary left central incisor and had root canal therapy performed by her family dentist immediately after the injury. Because of the incomplete canal obturation, the root canal filling material was removed, and calcium hydroxide therapy was initiated. Healing at the fracture site occurred, with hard tissue forming between the root segments. The coronal segment of the root was then obturated with gutta-percha. The patient later had orthodontic treatment with some movement of the coronal segment. Six-year post-treatment follow-up shows apparent clinical and radiographic success. This case illustrates the potential for repair of a horizontal root fracture after endodontic retreatment of the coronal segment and long-term splinting.