Long-term prognosis of 66 permanent anterior teeth with root fracture

A longitudinal clinical and radiographic follow-up study was made of all permanent teeth with root fractures referred to the Oslo University Department of Pedodontics between 1953 and 1972 (n = 66). The material included 51 patients aged 6-21 years. The mean observation period was 5.2 years, ranging from 1 to 19 years. The present report documents background data and the long-term results. Two teeth with exarticulation of the coronal fragments (3%) were immediately extracted. Repair of the fracture area occurred in 51 teeth (77%). Pulp necrosis was found in 13 teeth (20%), nine of which were successfully treated endodontically; only four teeth had to be extracted. Several factors were found to influence the prognosis, most notably the degree of dislocation of the coronal fragment. The localization of the fracture influenced repair only slightly. Despite somewhat increased mobility in some cases, the longevity of teeth with fractures even in the coronal third of the root was not significantly shortened. It is concluded that when optimally treated by repositioning, fixation and relief of occlusion, anterior teeth with root fracture have a favorable prognosis. Even when pulp necrosis occurs, the long-term prognosis is good.