Root Fracture
Root Fracture
• Clinical findings: Coronal segment may be
mobile/displaced. Percussion positive. Bleeding from
the sulcus
• Radiographic findings: horizontal fractures detected with
90 degree film. Oblique fracture ( often in apical third)
require occlusal view or varying horizontal radiographs.
• Treatment: Reposition coronal segment promptly.
Confirm reposition radiographically. Splint for 4 weeks.
Fractures in cervical third require stabilization up to 4
months. Monitor pulpal status for one year. If necrotic
endodontic therapy on the coronal segment to the
fracture line.
Root Fracture follow up
• Follow up: 4 weeks remove splint, clinical and
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radiographic exam. 8 weeks clinical and
radiographic exam. 4 months remove splint on
fractures in the cervical third. Then clinical and
radiographic exam at 6 months, 1 year and 5
years.
Favorable outcome: positive pulp test at 3
months. Signs of repair of the fractured
segments.
Negative outcome: Symptomatic, negative pulp
test, extrusion of coronal segment, radiolucency
at fracture line. Need for endodontic therapy.
Alveolar Fracture
Alveolar Fracture
• Clinical findings: fracture involves the alveolar bone and
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may extend to adjacent bone. Segment mobility and
dislocation with several teeth moving together. Drastic
change in occlusion.
Radiographic findings: Several PA angulations, occlusal
film and panoramic radiograph needed to determine the
course and position of fracture lines.
Treatment: Reposition segment and splint, suture
gingival lacerations. Stabilize segment for 4 weeks
Alveolar Fracture: follow up
• Follow up: 4 weeks remove splint do clinical and
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radiographic exam. Follow closely with clinical
and radiographic exam at 8 weeks, 4 months, 6
months, 1 year and 5 years.
Favorable outcome: positive pulp tests after 3
months. No signs of PA pathology
Unfavorable outcome: Symptomatic negative
pulp test after 3 months. PA lesion or external
inflammatory root resorption. Endodontic
therapy needed.