Horizontal Fractures - A Silent Finding: A Case Series.

Incisors are common teeth to suff er dental trauma, with root fracture occurring in <3% of injuries. Horizontal root fractures occur mainly in the middle third of root mostly aff ect upper central incisors. Nevertheless, apical and coronal 3rd fracture is also sometimes reported. Th e fracture may go undiagnosed for many years until the patient reports with discolored, mobile tooth which on radiograph reveals a break in continuity of the root. Th is paper reports the management of three horizontal root fractures (delayed and immediate) in upper incisors; two treated with mineral trioxide aggregate and calamus (Dentsply) for warm vertical obturation and one with fi ber post.

A novel approach in treating horizontally fractured canine using RIBBOND splint and MTA as an obturating material and intra-radicular splint: A case report.

Radicular fractures in permanent teeth are uncommon injuries among dental traumas, being only 0.5-7% of the cases. Management of horizontal root fractures presents a formidable challenge for clinicians because of the difficulty of achieving a stable reunion of fracture fragments. This case report presents the management of horizontally fractured canine by approximation of fracture fragments, fiber splinting, and use of MTA - both as an obturating material and intra-radicular splint. Short-term follow-up of the case showed promising results both clinically and radiographically.

Diagnosis of a horizontal root fracture during retreatment of a maxillary canine utilizing an electronic apex locator and monitoring with CBCT: a case report / Diagnóstico de fratura horizontal durante retratamento de um canino superior com auxílio de localizador apical e tomografia de feixe cônico (Cone Beam): relato de caso

Introduction: The aim of this case report is to demonstrate the retreatment of a maxillary canine diagnosed with a horizontal root fracture utilizing an electronic apex locator and monitored with cone beam computed tomography. Case Report: A 35 year old African American male was referred for root canal retreatment of a maxillary right canine prior to prosthetic rehabilitation. Following removal of gutta percha, an apex locator was utilized to determine the length of the root canal. After a more comprehensive dental history, the patient confirmed a previously unreported history of dental trauma at this time, leading to the suspicion of a horizontal root fracture. Clinical microscopy detected a connective tissue in the apical third of the root canal and multiple periapical and occlusal radiographs enhanced visualization of a horizontal root fracture. The coronal segment was filled with an MTA apical plug and the apical segment remained stable. A recall after 1.5 years was performed with CBCT, which showed no apical radiolucency. Discussion: The present case report reinforces the precept that detailed dental history and careful observation of radiographs are critical factors for obtaining an accurate diagnosis. Fundamental adjuncts, such as microscopy, apex locators and CBCT imaging, can potentially aid in the diagnosis and the subsequent treatment plan of horizontal root fracture

Introdução: O objetivo deste estudo foi mostrar o passo-a-passo do diagnóstico de uma fratura horizontal durante um retratamento, utilizando o localizador apical e a tomografia de feixe cônico como auxiliares do diagnóstico clínico. Relato de caso: Um paciente de 35 anos do gênero masculino afro-americano foi encaminhado com necessidade de retratamento no canino superior direito para posterior reabilitação protética. Seguida da remoção da guta-percha, foi utilizado o localizador apical para determinar o comprimento real do dente. Após uma melhor investigação sobre a história dental do paciente, o paciente confirmou uma história de trauma dental até então não comentada durante a anamnese, levando a suspeita de fratura horizontal no comprimento onde o localizador marcava a posição 0,0. Com o microscópio clínico detectou-se a presença de tecido granulomatoso no terço apical e, através de múltiplas radiografias periapical e uma oclusal foi possível visualizar a fratura horizontal. O segmento coronário instrumentado foi selado com um plug de MTA e, mantido o segmento apical sem tratamento. A proservação após um ano e meio foi realizada com CBCT, não presentando quaisquer alterações periapicais. Discussão: O presente relato de caso reforça ainda mais a necessidade de uma anamnese e história dental detalhada e cuidadosa observação radiográfica como fatores críticos para um diagnóstico preciso. Ferramentas auxiliares, como o microscópio, localizador apical e tomografia podem adicionar ao diagnóstico e consequentemente ao planejamento de fraturas horizontais.

Cicatrización exitosa en un caso de fractura radicular horizontal, ferulado por un periodo de tiempo inusual: seguimiento a 10 años / Successful healing in a case of horizontal root fracture, splinting for inusual time: 10 years follow-up

En el contexto de los dientes con diagnóstico de fractura radicular horizontal después de un trauma, una adecuada ferulización hace referencia tanto al diseño y al tiempo de permanencia de la férula. Esto puede influenciar positivamente, aumentando así las posibilidades de una óptima cicatrización y permanencia de estos dientes a largo plazo. Este artículo reporta un caso de fractura radicular horizontal, en donde los dientes involucrados permanecieron ferulados de manera inadecuada por un largo periodo de tiempo. Sin embargo, una evaluación hecha 10 años después, mostró una óptima cicatrización de los fragmentos.

In the context of the teeth with diagnosis of horizontal root fracture after trauma, adequate splinting is based on design and splinting time. This may influence favorably, increasing all possibilities of an optimal healing and permanence said teeth in the long term. This article reports a case of horizontal root fracture, where teeth involved remained splinted in inappropriate form for a long period of me. However, one evaluation made after 10 years, shows optimal healing of the fragments.