Root-Fracture.ppt for dental student fr bds

endodontic

1. Root FractureRoot Fracture

2. Root FractureRoot Fracture
•Clinical findings: Coronal segment may be Clinical findings: Coronal segment may be
mobile/displaced. Percussion positive. Bleeding mobile/displaced. Percussion positive. Bleeding
from the sulcusfrom the sulcus
•Radiographic findings: horizontal fractures detected Radiographic findings: horizontal fractures detected
with 90 degree film. Oblique fracture ( often in apical with 90 degree film. Oblique fracture ( often in apical
third) require occlusal view or varying horizontal third) require occlusal view or varying horizontal
radiographs.radiographs.
•Treatment: Reposition coronal segment promptly. Treatment: Reposition coronal segment promptly.
Confirm reposition radiographically. Splint for 4 Confirm reposition radiographically. Splint for 4
weeks. Fractures in cervical third require stabilization weeks. Fractures in cervical third require stabilization
up to 4 months. Monitor pulpal status for one year. If up to 4 months. Monitor pulpal status for one year. If
necrotic endodontic therapy on the coronal segment necrotic endodontic therapy on the coronal segment
to the fracture line.to the fracture line.

3. Root Fracture follow upRoot Fracture follow up
•Follow up: 4 weeks remove splint, clinical and Follow up: 4 weeks remove splint, clinical and
radiographic exam. 8 weeks clinical and radiographic exam. 8 weeks clinical and
radiographic exam. 4 months remove splint on radiographic exam. 4 months remove splint on
fractures in the cervical third. Then clinical and fractures in the cervical third. Then clinical and
radiographic exam at 6 months, 1 year and 5 radiographic exam at 6 months, 1 year and 5
years.years.
•Favorable outcome: positive pulp test at 3 Favorable outcome: positive pulp test at 3
months. Signs of repair of the fractured months. Signs of repair of the fractured
segments.segments.
•Negative outcome: Symptomatic, negative pulp Negative outcome: Symptomatic, negative pulp
test, extrusion of coronal segment, radiolucency test, extrusion of coronal segment, radiolucency
at fracture line. Need for endodontic therapy. at fracture line. Need for endodontic therapy.

4. Alveolar FractureAlveolar Fracture

5. Alveolar FractureAlveolar Fracture
•Clinical findings: fracture involves the alveolar bone Clinical findings: fracture involves the alveolar bone
and may extend to adjacent bone. Segment mobility and may extend to adjacent bone. Segment mobility
and dislocation with several teeth moving together. and dislocation with several teeth moving together.
Drastic change in occlusion.Drastic change in occlusion.
•Radiographic findings: Several PA angulations, Radiographic findings: Several PA angulations,
occlusal film and panoramic radiograph needed to occlusal film and panoramic radiograph needed to
determine the course and position of fracture lines.determine the course and position of fracture lines.
•Treatment: Reposition segment and splint, suture Treatment: Reposition segment and splint, suture
gingival lacerations. Stabilize segment for 4 weeksgingival lacerations. Stabilize segment for 4 weeks

6. Alveolar Fracture: Alveolar Fracture: follow follow
upup
•Follow up: 4 weeks remove splint do clinical Follow up: 4 weeks remove splint do clinical
and radiographic exam. Follow closely with and radiographic exam. Follow closely with
clinical and radiographic exam at 8 weeks, 4 clinical and radiographic exam at 8 weeks, 4
months, 6 months, 1 year and 5 years.months, 6 months, 1 year and 5 years.
•Favorable outcome: positive pulp tests after 3 Favorable outcome: positive pulp tests after 3
months. No signs of PA pathologymonths. No signs of PA pathology
•Unfavorable outcome: Symptomatic negative Unfavorable outcome: Symptomatic negative
pulp test after 3 months. PA lesion or pulp test after 3 months. PA lesion or
external inflammatory root resorption. external inflammatory root resorption.
Endodontic therapy needed.Endodontic therapy needed.