Horizontal root fracture du jourDr. Christian Diegritz

Freitag, 25. Mai 12

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 NSRT

Freitag, 25. Mai 12

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 linesor deep buccal and high palatal fracture line

Freitag, 25. Mai 12

CBCT yesterday

Freitag, 25. Mai 12

Freitag, 25. Mai 12

Freitag, 25. Mai 12

Freitag, 25. Mai 12

Freitag, 25. Mai 12

Reconstructionfacial lateral palatal

Freitag, 25. Mai 12

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

Treatment plan 1

• splint for 4 months

• wait and control closely for 1 year (vitality)

Freitag, 25. Mai 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 years

Freitag, 25. Mai 12

Treatment plan 3

• fracture line compromises the predictability of the case

• extraction and implantation

Freitag, 25. Mai 12

Any advice is greatly appreciated

Freitag, 25. Mai 12