Outcomes for root-fractured permanent incisors: a retrospective study

Area of Science:

• Endodontics
• Dental Traumatology
• Restorative Dentistry

Background:

• Root fractures in permanent incisors are complex dental injuries.
• Assessing outcomes requires understanding factors influencing pulp vitality, root union, and survival.
• Clinical and radiographic parameters, along with splinting methods, are crucial considerations.

Purpose of the Study:

• To evaluate outcomes of treated root-fractured permanent incisors.
• To assess pulp vitality, hard root tissue union, and tooth survival.
• To examine the influence of clinical/radiographic factors and rigid splinting on outcomes.

Main Methods:

• Retrospective analysis of 84 treated root-fractured permanent incisors.
• Data extracted from case notes and analyzed using SPSS.
• Odds ratios, Cox regression, and Kaplan-Meier survival curves used to identify risk factors.

Main Results:

• Fracture location varied: apical (17%), middle (56%), gingival (27%).
• Crown fractures (29%) significantly impacted pulp vitality.
• Gingival third fractures had the poorest survival rate (61% tooth loss).
• Pulp vitality loss and coronal fragment displacement negatively affected root union.
• Rigid splinting did not significantly influence pulp vitality or root healing.

Conclusions:

• Enamel-dentine crown fractures are linked to pulp vitality loss.
• Pulp necrosis and coronal fragment luxation affect hard root tissue union.
• Gingival third root fractures present the worst prognosis for tooth survival.
• Rigid fixation does not improve pulp vitality or root tissue union outcomes.