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Incidental finding of a horizontal root fracture when considering a tooth for root canal treatment Nadine Amin Alison Qualtrough Dental Update 2024 51:2, 707-709.
Authors
NadineAmin
BDS (Lond)
Dental Core Trainee in Restorative Dentistry and Oral Surgery, Manchester University Dental Hospital
A 44-year-old female patient was referred to the restorative department at Manchester University Dental Hospital for root canal treatment of the maxillary right lateral incisor, which appeared to have a sclerosed root canal. The tooth had a history of trauma when the patient was 6 years old. A cone beam computed tomography scan of the tooth revealed an incidental finding of a transverse root fracture that was otherwise not visible on the peri-apical radiograph. This highlights the diagnostic challenge of peri-apical radiographs and emphasizes the value of three-dimensional imaging in endodontics. It also highlights the importance of timely referral and management of traumatic dental injuries to reduce the risk of complications in the future.
CPD/Clinical Relevance: This case report emphasizes the value of three-dimensional imaging in diagnosis.
Article
Traumatic dental injuries are common in adults and children. It has been reported that 25% of all school children experience dental trauma at some point, and 33% of adults have also experienced dental trauma to the permanent dentition.1 Root fractures are one of the potential outcomes of dental trauma. Transverse root fractures tend to be less commonly reported (0.5–7%) compared with other dental injuries, and most commonly involve the maxillary central and lateral incisors. Management of these root fractures depends on several factors including the location and angulation of the fracture, degree of displacement, tooth mobility and vitality. Typically, the more apical the fracture is, the better the prognosis. It is crucial to closely monitor teeth with root fractures to assess the healing and pulp survival status. Pulp necrosis and infection of the coronal fragment may occur as a direct response to the trauma around 3–4 months after the injury. Alternatively, necrosis and infection may occur years later and may be due to ingress of bacteria through cracks or fractures.2
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