Healing after horizontal root fractures: 3 cases with 2-year follow-up
A 33-year-old man presented to the Department of Conservative Dentistry at the Wonkwang University Dental Hospital (Iksan, Korea) with a complaint of discomfort of the maxillary right central incisor during mastication. Two days before, the tooth had impacted against a rigid object. The patient's medical history was noncontributory. Radiographic examination showed a horizontal fracture in the middle third of the root of the tooth and a slight displacement of the apex (). Intraoral examination revealed that all maxillary teeth had normal responses to pulp vitality tests, no mobility, and no discolored crown. Since the maxillary central incisor showed no signs of mobility or pathology, the patient was followed up without any splint appliances. His occlusion was checked and adjusted to eliminate loading on the traumatized tooth during function.\nFour weeks after the trauma, a radiolucent area appeared intra-canally on the apical portion of the coronal fragment and it continued to progress until 6 weeks of observation (). Root canal treatment was initiated on the coronal fragment with K-file and irrigated with 5% sodium hypochlorite. Working length was established with an apex locator (DentaPort ZX, Morita, Kyoto, Japan). Special care was taken to instrument within the coronal fragment. After 2 months of intracanal calcium hydroxide dressing, the canal was obturated with mineral trioxide aggregate (MTA, ProRoot, Dentsply, Tulsa, OK, USA) ().\nAt the 2-year follow-up evaluation, the patient did not report any clinical symptoms. Complete healing of the root fracture with the interposition of hard tissue between the fragments was observed on the periapical radiographs ().