Root Fractures Flashcards
What percentage of dental injuries do root fractures account for?
7%
What teeth are most frequently affected by root fractures?
Upper central incisors
Who is typical patient affected by root fractures?
11 to 20-years-old
Why are root fractures less common in patients below this age?
Their bone is more elastic
What are 3 classifications of root fractures?
Hard tissue healing after root fracture, connective tissue healing after root fracture, and non-healing due to infection in line of fracture
What type of trauma usually results in a root fracture?
If coronal fragment is displaced in which direction has it usually gone?
Palatally and in a slightly extruded direction
What are 2 factors that determine healing?
Whether pulp is severed and whether bacteria has invaded fracture line
What happens if pulp is intact after injury?
A dentin callus is formed between two fragments after some weeks, whereafter peripheral aspect of fracture is healed by cementum deposition, a process which can take place over a period of several years
What happens if pulp has been ruptured?
Revascularization of coronal aspect of pulp has to take place prior to fracture healing
What happens if bacteria gain access to coronal pulp in its avascular condition?
Healing of pulp is impossible and an accumulation of granulation tissue between root fragments will result as a response to infected coronal aspect of pulp
What 2 factors does treatment depend on?
Level of fracture and degree of displacement of coronal fragment
What is required where mobility is greater than grade 1?
Splinting
What will a displaced fragment require?
Splinting once it has been repositioned to immobilise it in correct position and allow healing
What does more coronal fracture line mean?
More likely that mobility will be present
What 2 factors predict prognosis for pulpal healing?
Stage of root development at time of injury and dislocation of coronal fragment
From most to least likely, what 3 complications occur in root fractures?
Pulp necrosis, progressive root resorption, and loss of marginal bone support
What risk factors, if any, predict their likelihood?
What are common complications of root fractures?
Pulp death and pulp obliteration
What are mature dislocated root fractures most likely to undergo?
Pulp necrosis but root treatment can be undertaken, where coronal fragment only is prepared
What are 2 types of resorption?
One indicating healing (within canal) and other suggesting further treatment is required
What is need with some cervical (coronal) third fractures?
Permanent interproximal fixation usually in form of a bonded retainer/coronal fragment may be extracted, root portion root-filled and a post-crown placed
