[Long-term splinting of a traumatic upper permanent incisor with root fracture: report of a case]

Splinting was administered in a case of a traumatic upper right permanent incisor with root fracture. The patient was a boy, 11 years and 10 months old. The radiographical examination indicated that the injured tooth, that had already completed the apical growth, fractured horizontally at the middle 1/3 part of root. Clinical findings showed severe mobility of the coronal fragment of the injured tooth and a small amount of bleeding from the gingival sulcus, but there was almost no disposition of the coronal fragment and it was found to be vital in the electric pulp test. Immobilizing the coronal fragment of the injured tooth with the resin splint bonded directly to the tooth surfaces was prescribed. After 31 months, the pulp of the injured tooth remained vital, and after the elimination of the line of fracture and no symptoms of ankylosis were radiographically confirmed, the splint was then removed. From the case reported above the following implications were obtained: Although the previous investigators reported that the term of splinting teeth with root fractures was for 2-3 months, and prognosis of the injured teeth with root fractures having severe mobility of the coronal segments might be unfavorable, it was also indicated that the healing process by calcification might be possible with the use of long term splinting, as the pulp remained vital. In this case, it was found that the repair by calcification appeared initially on the proximate portion of the pulp at the fractured line, and slowly proceeded into the direction of the site of the outer surface of the root along the fractured line.