Prognosis of root-fractured permanent incisors

Abstract

The prognosis of 56 root-fractured permanent incisors was evaluated clinically and radiographically for 2 to 31 years. Information about initial case histories, examination and treatment of root-fractured teeth were recorded retrospectively from patient cards. Most of the root fractures occurred in the 16-20 year age group (38%) followed by the 11-15 year age group (29%). Males were involved more often than females. Fifty-two percent of the patients visited the dental clinic within the first week, while 48% did so 1 month-31 years later after the injury. The leading cause of root fractured injuries was falls (46%) and mostly involved one tooth (71%). Maxillary central incisors were the most often affected teeth (95%). The most common type of root fracture was in the middle third of the root (57%) followed by apical part (34%). About 59% of untreated or splinted teeth maintained their vitality. Healing with connective tissue was observed in 19 teeth, with calcified tissue in 15 teeth and with osseous tissue in only one tooth. There was partial or complete obliteration of the pulp space in these healed cases (62.5%). The formation of pulpal hard tissue produced no additional clinical problems. Partial or total pulp necrosis were noted in 21 (37.5%) teeth. Endodontic treatment was successful in 12 cases. The remaining 9 teeth were extracted due to the loss of marginal alveolar bone and apical periodontitis.