Conservative Management of Horizontal Root Fracture: A Case Report

Area of Science:

• Endodontics
• Dental Traumatology
• Restorative Dentistry

Background:

• Horizontal root fractures (HRF) in permanent teeth with closed apices and erupted roots have increased incidence due to stable bone and periodontal support.
• HRF can compromise dental structures, including pulp, dentin, cementum, bone, and periodontal tissues.
• Apical necrosis is an uncommon complication of HRF, particularly when the apical segment typically maintains vitality.

Purpose of the Study:

• To report the management and 2-year follow-up of a maxillary central incisor with HRF and apical necrosis.
• To evaluate the efficacy of Mineral Trioxide Aggregate (MTA) as a conservative treatment option.
• To demonstrate the avoidance of apical surgery in complex HRF cases with apical necrosis.

Main Methods:

• A conservative treatment approach was selected for a maxillary central incisor with HRF and apical necrosis.
• Mineral Trioxide Aggregate (MTA) was applied to both the apical and coronal segments of the fractured root.
• The patient underwent a 2-year follow-up to assess treatment outcomes.

Main Results:

• The conservative treatment using MTA in both segments successfully managed the HRF and apical necrosis.
• The tooth remained stable and vital throughout the 2-year follow-up period.
• Apical surgery was successfully avoided, preserving the natural tooth.

Conclusions:

• Mineral Trioxide Aggregate (MTA) is an effective material for treating horizontal root fractures (HRF) complicated by apical necrosis.
• Conservative management with MTA can prevent the need for apical surgery in such cases.
• This approach offers a viable alternative for preserving teeth with complex root fracture injuries.