Document Type : Case Report
Authors
1 Postgraduate Student of Endodontics, Dept. of Endodontics, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran.
2 Dept. of Endodontics, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran.
Abstract
While traumatic injuries in the young permanent dentition are frequent, root fractures are relatively rare, particularly in immature teeth. This study reports the case of a 7-year-old boy who fell off a bicycle. Radiographic examination showed an immature right upper central incisor with fractures in the middle and along the root in an oblique and horizontal direction. Furthermore, there was an extrusion of the coronal segment from its original position. At the first appointment, the right central incisor was repositioned, and a semi-rigid splint was applied for four weeks. The patient was examined periodically for the following two years. After two months, the injured tooth was asymptomatic, with a reduction in probing depth from 8 mm to 2 mm along the tooth surface and a physiologic mobility. Although the injured tooth responded to the electric pulp test after nine months, it had no response to the cold test even after two years. The injured tooth showed continued root maturation of both coronal and apical fragments, although metamorphosis calcification and root canal narrowing were observed in conjunction with mild yellow crown discoloration. This report highlights the ability of Hertwig’s epithelial root sheath and immature pulp to continue root development in fractured immature teeth.
Highlights
Safoora Sahebi (Google Scholar)
Keywords
- Andersson L. Epidemiology of Traumatic Dental Injuries. J of Endod. 2013; 39 (3, Supplement): S2-S5.
- Bastone EB, Freer TJ, McNamara JR. Epidemiology of dental trauma: a review of the literature. Aust Dent J. 2000; 45: 2-9.
- Choi SH, Yoon JH, Lee BN, Chang HS, Hwang IN, Oh WM, et al. Treatment of horizontal root-fractured maxillary incisors. Oral Biol Res. 2019; 43: 236-242.
- Bourguignon C, Cohenca N, Lauridsen E, Flores MT, O'Connell AC, Day PF, et al. International Association of Dental Traumatology guidelines for the management of traumatic dental injuries: 1. Fractures and luxations. Dent Traumatol. 2020; 36: 314-330.
- Cvek M AP, Baklan L, Heithersay G. Management of Trauma-Related Pulp Disease and Tooth Resorption. In: Andreasen J AF, Andersson L, editor. Textbook and Color Atlas of Traumatic injuries to the Teeth. 5th ed. Denmark: Wiley-Blackwell; 2019. p. 648-717.
- Belobrov I, Weis MV, Parashos P. Conservative treatment of a cervical horizontal root fracture and a complicated crown fracture: a case report. Aust Dent J. 2008; 53: 260-264.
- Rechenberg DK. Management of Root Fractures. Management of Dental Emergencies in Children and Adolescents. 1st ed. John Wiley & Sons Ltd: United States of America; p. 91-102.
- Andreasen FM. Root Fractures. In: Andreasen J AF, Andersson L, editor. Textbook and Color Atlas of Traumatic injuries to the Teeth. 5th ed. Denmark: Wiley-Blackwell; 2019. p. 377-412.
- Abbott PV. Diagnosis and management of transverse root fractures. J Endod. 2019; 45(12, Supplement): S13-S27.
- Sheikhnezami M, Shahmohammadi R, Jafarzadeh H, Azarpazhooh A. Long-Term Outcome of Horizontal Root Fractures in Permanent Teeth: A Retrospective Cohort Study. J Endod. 2024; 50: 579-589.
- Bakkari A, Bin Salamah F. Updated Guidelines for the Orthodontic Management of Traumatized and Endodontically Treated Teeth: A Review Study. Cureus. 2022; 14: e28943.
- Andreasen FM. Pulpal healing after luxation injuries and root fracture in the permanent dentition. Endod Dent Traumatol. 1989; 5: 111-131.
)