Integrated treatment to resolve a horizontal root fracture

Area of Science:

• Dentistry
• Oral Surgery
• Endodontics

Background:

• Root fractures affect 0.5–7% of permanent dentition injuries, involving cementum, dentin, and pulp.
• Diagnosis relies on clinical and radiographic examinations, though fracture location can limit radiographic accuracy.
• Treatment strategies for root fractures depend on fragment displacement and vitality.

Observation:

• A clinical case details recurrent trauma to tooth 21, resulting in a horizontal root fracture in the middle third.
• Multiple endodontic treatment attempts were performed without success.
• Surgical intervention was chosen to remove the fractured apical segment.

Findings:

• Postoperative follow-up over 4 years demonstrated highly satisfactory wound healing.
• The tooth exhibited minimal mobility, indicating successful management.
• The coronal segment remained viable and stable, suggesting successful preservation.

Implications:

• Surgical fragment removal can be a viable treatment option for complex root fractures when endodontic therapy fails.
• This approach can lead to long-term functional and esthetic outcomes.
• Further research into surgical management of root fractures is warranted.