Check Page Ranking

Dental tourism
New additions
Dental books
FREE journals
Bad breath
Kids caries
Smoking effects
Patient info
Dental Videos
Latest news
ROOTS cases
Wisdom tooth
Drugs of choice

Endo tips    Better Endo    Endo abstracts    Endo discussions

5 year recall of a horizontal root fracture - Courtesy ROOTS

The opinions and photographs within this web page are not ours. Authors have been
credited for the individual posts where they are -
From: Marga Ree
Sent: Tuesday, February 01, 2011 2:05 AM
Subject: [roots] 5 year recall of a horizontal root fracture

I have posted this case earlier and wanted to show the CBCT of the 5 year follow-up.

At the age of 13 this boy sustained a trauma on tooth 11. Unfortunately, 
the horizontal root fracture was treated by his dentist by performing an 
endo in the 2 segments. Because of persistent complaints, the coronal 
segment was retreated at a dental school, with gutta-percha and sealer. 
I questioned the choice of the root filling material, it's an illusion 
to think that this could have been sealed with gutta-percha and sealer. 
His symptoms never went away, tooth was sensitive to percussion and had a
grayish discoloration. He got the advice to have the tooth extracted.

I performed a conventional retreatment till the fracture level, filled 
the coronal segment with MTA, raised a flap and removed the apical 
fragment in 2 parts, all this was done in 1 treatment session.
We applied sodium perborate for a few days, and the access opening was 
filled was with composite.

Healing was amazing, after 2 months tooth was rock solid and patient 
was completely symptomfree, for the first time since the trauma took 
place. The last rad and CBCT shows a 5 year follow-up. When I posted 
this case for the first time, there was a lot of discussion about the 
poor crown/root ratio. He is 18 years old now, and he is doing fine, 
no complaints whatsoever. I thought it was cool to post the CBCT, 
you see only one slice, but when scrolling through the images, there 
is an intact PDL in every single slice! -  Marga

conventional retreatment

conventional retreatment

conventional retreatment

conventional retreatment Nice handling Marga: - you got the patient symptomfree after previous failed attempts - you performed surgical and non surgical retreatment on a 13 year old boy in single visit, avoiding patient management issues and multiple visits - you maintained an important tooth in the arch, maintaining bone level and esthetics - you got a healing 100 % not only on radiograph but also on CBCT level. - even if this will fail in the future, this lucky patient has now enough bone for proper implant placement Congratulations! - Roberto Great case and thanks for sharing. Now I know what to do next time I have a case like that --> leaving the extraction set in the closet and start the endo and surgery. It is amazing.- RafaŽl State of the art !!!! Thanks for sharing your cases!! - Chaniotis M. Antonis Dear Marga, I congratulate you great results in healing. I'm a big fan of your excellent work. My question is, what could be the reason that the tooth 11 is currently a little bit shorter than #21? - Alicja Dziedzicka, Warsaw, Poland Hi Alicja, Thanks for the kind words. I see what you mean, I have no idea, but I don't have the impression that the eruption of this tooth was disturbed at a certain point of time. What do you think? - Marga Great for your patient. I am sure he will enjoy this tooth for many years to come Wonderful as always. Great to see your posts again. - Thomas Shimco About the "short" appearance of tooth 11 in the 5 years period time, I guess it is very hard to comment something, as long as we are watching 2 different angulation of the pictures: one with closed mouth and one with the mouth open. To show exactely what I mean, I took my residency colleague Ricardo now in the clinic and in between 20 seconds I extruded his 11, than I luxated it with rotation of the axis, and than I felt pity for him and I intruded the tooth back. Only instrument I used was a Canon 350D taking pics from different angulations.- Roberto conventional retreatment

conventional retreatment

conventional retreatment

conventional retreatment

conventional retreatment Great explanation Roberto, I think you hit the nail on the head! - Marga Is this what they call photodontics??? - Peter Roberto, Thank you for explanation and very nice pictures? I think you are right, the long axis of this tooth is angulated. - Alicja Dziedzicka

Forked tongue cases
Advanced perio and MSD
Newsletter 18-07-2010
PCD preservation
Lower premolar
Single implant
Irreversible pulpitis
Upper premolar

Dental problems
Apico tooth #13
Root resorption
CBCT Tooth #5
Alveolar fracture
Surgical planning
Fracture/ Trauma

Autotransplantation case
Hero shaper files
Newsletter 11th July
Commercial or science?
Self adjusting file
Munce discovery burs
RCT Tooth #14
7 years failure

Molar anatomy
Orifice seals
Extraction socket
Fractured molar
Pulpo periodontitis
Lateral incisor
Large lesion

Pericemental dentin
Mesio distal crack
Newsletter 4-7-10
2 molars with AP
Vertical condensation
Big lesion
Re-splitting tooth

Bone blocks
Micro surgery
Endo pathology
Complex roots
3 D era in Endo
High pulp horn
Apical periodontitis

Retreatment tooth #22
RCT tooth #16
Cuspid palpation
CbCT case #2
Vertical percussion
Buccal mucosa
Cyst like lesion

Tooth #34, #36
Vertical fracture
Cantilever bridge
Enamel matrix
Missed DB canal
Immediate implant
Tough case