Spontaneously healed horizontal root fracture: a case report

Authors

DOI:

https://doi.org/10.33448/rsd-v10i12.19988

Keywords:

Regenerative Endodontics; Tooth Injuries; Prognosis; Wound Healing; Cone- Beam Computed Tomography.

Abstract

Root fractures are defined as those that involve cement, dentin and pulp, comprising from 1,2 to 7% of injuries in permanent dentition. Usually affects the maxillary anterior region, and generally heals spontaneously, depeding on the vitality of the pulp. Diagnosis is made by clinical findings, sensitivity tests and radiographic examination. Futhermore, cone-beam computed tomography (CBCT) has been used for diagnosis and prognosis, due to the reproduction of three-dimensional images, the location and the path of the fracture line can be accurately visualized. This study reports a case of dental trauma caused by fall from own height. The patient suffered horizontal root fracture in maxillary left central incisor, wich was confirmed from radiographic examination, positioned at the end of the middle third. As immediate treatment, it was performed the repositioning and spliting. To confirm the exact location of the fracture and if healing occurred, CT images of the were performed 30 days after the trauma and the fracture with an oblique path healed by calcified tissue could be visualized. In this way, it was decided to follow-up the horizontal radicular fracture with the control time of:15 days, 30 days, 60 days, 2 years and 5 years. It alllowed the tooh to be preserved in the arch, with normal function.

References

Abbott, P.V. (2019). Diagnosis and management of transverse root fractures. Dent Traumatol. 00, 1–15.

Andrade, E. S., Campos Sobrinho, A. L. de, Andrade, M. G. & Matos, J. L. (2008). Root healing after horizontal fracture: a case report with a 13-year follow up. Dent Traumatology, 8 (24), e1-3.

Andreasen, F. M. (1986). Transient apical breakdown and its relation to color and sensibility changes. Endod Dent Traumatol. 2, 9–19.

Andreasen, F. M., Andreasen, J. O. & Bayer, T. (1989). Prognosis of root-fractured permanent incisors – prediction of healing modalities. Endod Dent Traumatol. 5, 11–22.

Andreasen, F. M., Andreasen, J. O. & Cvek, M. (2007) Root fractures. In:Andreasen, J.O.; Andreasen, F.M.; Andersson, L. editors. Textbook and color atlas of traumatic injuries to the teeth. 4th edn. Kopenhagen: Blackwell Munksgaard. 337–7.

Andreasen, F. M., Andreasen, J. O. & Tsilingaridis, G. (2018). Root fractures. In: Andreasen JO, Andreasen FM, Andersson L, eds. Textbook and Color Atlas of Traumatic Injuries to the Teeth. 5th ed. Oxford, UK: Wiley Blackwell. 377–412.

Andreasen, J. O.(1979). Etiology and pathogenesis of traumatic dental injuries. A clinical study of 1,298 cases. Scand J Dent Res.78, 329–42.

Andreasen, J. O. & Andreasen, F. M. (2001). Fundamentos de traumatismo dental: guia de tratamento passo-a-passo. Porto Alegre: Artmed Editora. 188.

Andreasen, J. O. & Hjording – Hansen, E. (1967). Intra-alveolar root fractures: radiographic and histologic study of 50 cases. J Oral Surg. 25, 414-26.

Andreasen, J. O, Andreasen, F. M., Mejare, J. & Cvek, M. I. (2004). Healing of 400 intra-alveolar root fractures. 1. Effect of pre-injury and injury factors such as sex, age, stage of root development, fracture type, location of fracture and severity of dislocation. Dent traumatol. 20, 192–202.

Bernardes, R. A., Moraes, I. G. de, Duarte, M. A., Azevedo, B. C., Azevedo, J. R. de & Bramante, C. M. (2009). Use of cone-beam volumetric tomography in the diagnosis of root fractures. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 108, 270–7.

Bornstein, M. M., Wolner- Hanssen, A. B., Sendi, P. & Arx, V. T. (2009). Comparison of intraoral radiography and limited cone beam computed tomography for the assessment of root-fractured permanent teeth. Dent Traumatol.25, 571–7.

Bourguignon, C., Cohenca, N. & Lauridsen, E. et al. (2020). International Association of Dental Traumatology guidelines for the management of traumatic dental injuries: 1. Fractures and luxations. Dent Traumatol. 36,314–330.

Caliskan, M. K. & Pehlivan, Y. (1996). Prognosis of root-fractured permanent incisors. Endod Dent Traumatol . 12, 129–36.

Camp, J. H. (2000). Management of sports-related root fractures. Dent Clin North Am. 44,95-109.

Cohenca, N., Simon, J. H., Roges, R., Morag, Y. & Malfaz, J. M. (2007). Clinical indications for digital imaging in dento-alveolar trauma. Part 1: traumatic injuries. Dent Traumatol. 23(2), 95-104.

Costa, F. F., Pinheiro, L. R., Umetsubo, O. S., Santos Junior, O. de, Gaia, B. F. & Cava, M. G. (2014). Influence of cone-beam computed tomographic scan mode for detection of horizontal root fracture. Journal of Endodontics. 40, 1472-6.

Cvek, M., Andreasen, J. O. & Borum, M. K. (2001). Healing of 208 intraalveolar root fractures in patients aged 7–17 years. Dent Traumatol. 17,53–62.

Cvek, M., Mejare, I. & Andreasen, J. O. (2002). Healing and prognosis of teeth with intra-alveolar fractures involving the cervical part of the root. Dent Traumatol. 18, 57–65.

Diangelis, A. J., Andreasen, J. O. & Ebeleseder, K. A. (2012). International Association of Dental Traumatology guidelines for the management of traumatic dental injuries: 1. Fractures and luxations of permanent teeth. Dent Traumatol. 28, 2–12.

Fagundes, D., Mendonça, I., Albuquerque, T. & Jacinto, I. (2014). Spontaneous healing responses detected by cone-beam computed tomography of horizontal root fractures: a report of two cases. Dent Traumatol. 30, 484–7.

Feiglin, B. (1995). Clinical management of transverse root fractures. Dent Clin North Am. 39, 53–78.

Flores, M. T., Andersson, L., Andreasen, J. O., Bakland, L. K., Malmgren, B. & Barnett, F. (2007). Guidelines for the management of traumatic dental injuries.1. Fractures and luxations of permanent teeth. Dent Traumatology. 23,66-71.

Lenzi, R. & Trope, M. (2012). Revitalization procedures in two traumatized incisors with diferente biological outcomes. J Endod. 38,411-4.

Likubo, M., Kobayashi, K., Mishma, A., Shimoda, S., Daimaruya, T. & Igashi, C. et al. (2009). Accuracy of intraoral radiography, multidetector helical CT, and limitedcone-beam CT for the detection of horizontal root fracture. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 108, e70-4.

Lindahl, B. (1963). Transverse intra‐alveolar root fractures: Roentgen diagnosis and prognosis. Odont Revy. 1963;9:10–24.

Mata, E., Gross, M. A. & Koren, L.Z. (1985). Divergent types of repair associated with root fractures in maxillary incisors. Endod Dent Traumatology. 1,150-3.

Neeraj, M., Kundabala, M. & Acharaya, S. (2011). A review of root fractures: diagnosis, treatment and prognosis. Dent Update. 38, 615 – 628.

Ohman, A. (1965). Healing and sensitivity to pain in young replanted human teeth. An experimental, clinical and experimental study. Odontol Tidskr. 73, 166 – 227.

Ozbek, M., Serper, A. & Semra, Ç. (2003). Repair of untreated horizontal root fracture: a case report. Dent Traumatol. 19, 296-7.

Oztan, M. D. & Sonat, B.( 2001). Repair of untreated horizontal root fractures: two case reports. Dent Traumatol. 17(5),240-3.

Pereira, A. J. A., Araújo, C. Y. T., Almeida, C. C. N. & Souza, C. (1997). Conseqüência do diagnóstico equivocado no prognóstico das fraturas radiculares. Rev Assoc Paul Cir Dent. 51(6),579-582.

Soares, J. J. & Goldberg, F. (2001). Endodontia: técnica e fundamentos. Porto Alegre: Artes Médicas Sul. 376.

Wolner-Hanssen, A. B. & Von Arx, T. (2010). Permanent teeth with horizontal root fractures after dental trauma. A retrospective study. Schweiz Monatsschr Zahnmed. 120, 200-212.

Published

13/09/2021

How to Cite

LIMA, A. A. .; PEREIRA, P. L. R. .; BUENO, C. S. P. .; OLIVEIRA, D. P. de .; SILVA, L. C. .; FAGUNDES, D. dos S. . Spontaneously healed horizontal root fracture: a case report . Research, Society and Development, [S. l.], v. 10, n. 12, p. e59101219988, 2021. DOI: 10.33448/rsd-v10i12.19988. Disponível em: https://rsdjournal.org/index.php/rsd/article/view/19988. Acesso em: 16 apr. 2024.

Issue

Section

Health Sciences