Root Fracture

1
Root Fracture
2
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.

3
Root Fracture follow up

• Follow up 4 weeks remove splint, clinical and
  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.

4
Alveolar Fracture
5
Alveolar Fracture

• Clinical findings fracture involves the
  alveolar bone and 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

6
Alveolar Fracture follow up

• Follow up 4 weeks remove splint do clinical and
  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.