Horizontal root fracture

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Horizontal root fracture

  1. 1. Horizontal root fracture du jour Dr. Christian DiegritzFreitag, 25. Mai 12
  2. 2. Anamnesis • Patient 26 years old • medical history: non contributory • special anamnesis: „direct contact with a ellbow“ • referral slip from the omfs: horizontal root fracture tooth no. 8, TTS for 4 weeks, please NSRTFreitag, 25. Mai 12
  3. 3. PA from yesterday • Perc: +, Vit: - • TST wnl, mobility: 1-2 (TTS in place!) • Diagnosis: pulp necrosis due to horizontal root fracture middle third • double contour may mean 2 fracture lines or deep buccal and high palatal fracture lineFreitag, 25. Mai 12
  4. 4. CBCT yesterdayFreitag, 25. Mai 12
  5. 5. Freitag, 25. Mai 12
  6. 6. Freitag, 25. Mai 12
  7. 7. Freitag, 25. Mai 12
  8. 8. Freitag, 25. Mai 12
  9. 9. Reconstruction facial lateral palatalFreitag, 25. Mai 12
  10. 10. Problems • since the fracture line is very close to the cej palatal I decided to leave the splint for 3 months (Dental Trauma Guide: cervical root fractures 4 months, mid 4 weeks) • how should this case be treated: mid root fracture or cervical fracture? • are the double fracture lines compromising the prognosis of this tooth?Freitag, 25. Mai 12
  11. 11. Treatment plan 1 • splint for 4 months • wait and control closely for 1 year (vitality)Freitag, 25. Mai 12
  12. 12. Treatment plan 2 • Access cavity • clean and shape to the fracture line and leave the apical part „intact“ • placement of MTA • follow up 2 months 6 months 1 year 2 yearsFreitag, 25. Mai 12
  13. 13. Treatment plan 3 • fracture line compromises the predictability of the case • extraction and implantationFreitag, 25. Mai 12
  14. 14. Any advice is greatly appreciatedFreitag, 25. Mai 12

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