Conservative management of root-fractured primary incisor – case report

Abstract

Most frequent trauma to primary dentitions are injures to the supporting tissue i.e. luxations, but root fractures are relatively uncommon. The difference in the trauma pattern favoring luxation rather than fracture has been found to be typical for the primary dentition, since the elasticity of the alveolar bone surrounding the primary teeth is high and primary tooth held in alveolar socket is less strong. Incidence of foot fractures increases at the age of 3-4 years where physiologic root resorption has begun, thereweakening the root. Traumatic injuries to the primary dentition present special problems and the management is often different as compared with the permanent dentition. Because of potential sequelae of trauma to primary teeth, a treatment method that minimizes any additional risks of further damage to the permanent successors should be selected. The report presents a case of 3.5 year-old boy after traumatic injury – extrusion of tooth 51, which required surgical treatment, and apical third horizontal root fracture of tooth 61 treated conservatively. Written consent from subject’s parents/subject’s legal guardians was obtained. Root-fractured primary tooth has been followed clinically and radiographically for 3.5 year, till advanced root resorption. Presented case and cases described in cited literature demonstrate that conservative treatment of root-fractured primary teeth is a favorable method of the treatment that allows the teeth to function naturally until the term of physiological resorption and exfoliation.

Conservative management of a horizontal root fracture in a primary maxillary central incisor: Case report

“…This report is based on eight years of clinical and radiographic reviews, which showed spontaneous healing of the traumatized tooth and normal eruption of the permanent successor. Traumatic dental injuries such as horizontal root fractures are rare in the primary dentition and they may be a challenge for clinicians as they usually remain asymptomatic 16 . Their incidence increases at the age of 3–4 years due to the beginning of physiologic root resorption which weakens the root 17 .…”

“…such as horizontal root fractures are rare in the primary dentition and they may be a challenge for clinicians as they usually remain asymptomatic. 16 Their incidence increases at the age of 3-4 years due to the beginning of physiologic root resorption which weakens the root. 17 They are generally located in the middle or apical third of the root, with radiolucent lines separating the fragments.…”

Root Fractures in the Primary Teeth and Their Management: A Scoping Review

“…Mobility was reported in four cases; specifically, this was of grade II in the two cases described by Kumari et al [28] and in the case of Liu et al [18]. Mobility was also highlighted by Brudza-Zwiech et al in their root fracture case, but this time without specifying the degree [29]. Regarding dental luxation trauma, Bonanato et al described a case with an extrusive vestibular luxation [14], Liu et al [18] described a 1 mm palatal extrusive luxation, and Di Giorgio et al noted a 3 mm one [30].…”

“…In the case reports, six fractures lines were in the apical third [14,18,[27][28][29][30], and three in the middle third [18,28,32]. As for the 53 teeth of the retrospective study, Cho et al did not specify the exact location of the fracture, but wrote that all were fractures affecting the apex or the middle third of the root [31].…”

“…On average, about three intraoral radiographs were taken for each case. The studies with the most (n = 5) were those of Liu [18] and Bruzda-Zwiech et al [29]. Most of the studies also evaluated the positivity of the percussion of the fractured primary teeth at the time of the trauma and the negativity during the check-ups.…”