Horizontal root fracture – anterior teeth
Horizontal root fracture treatment protocol
Horizontal root fracture of the anterior tooth has pretty good survival rates. The treatment options for a horizontal root fracture depend on where the fracture occurs.
Horizontal fractures can last for a long time with a high success rate
The general treatment should be to save the tooth. Apical fractures have great long term survivial rates without any type of treatment at all. Even coronal fractures can do very well if we place a splint. Sheridan JADA 2019 shows a couple of cervical fractures that are decades old.
Horizontal root fracture of the anterior teeth research
10 year survival rates of anterior teeth with a horizontal root fracture correspond to area of fracture Andreasen 2012
- 89% for apical fracture
- 78% mid root
- 67% oblique mid root cervical
- 33% cervical
Horizontal root fracture causes necrosis of coronal portion and apical portion remains vital Andreasen 1967 and Hitchcock 1985 and Cvek 2004
Treatment is done JUST to the fractured coronal tooth segment leaving the apical alone since usually remains vital Cvek 2004 and Cvek 2008
Treatment is completed with MTA NOT gutta percha. Many articles on this look at page 25 for list article implantpracticeus.com/continuing-education/ce-articles/415-multi-disciplinary-approach-to-the-treatment-of-traumatic-root-fracture-a-case-study
Horizontal root fracture of primary teeth
Due to relatively high survival rates RCT is NOT done as a prophylactic measure for PRIMARY teeth. Flores 2007 IADT guidlines
Detecting a horizontal root fracture
Typically these are not as difficult to detect as the vertical root fracture. A normal PA x-ray can usually see a horizontal fracture. Below is an example of one that was a tricky diagnosis that without a CBCT, we could not have found.
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