horizontal root fracture
TRANSCRIPT
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Horizontal root fracture du jourDr. Christian Diegritz
Freitag, 25. Mai 12
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Anamnesis
• Patient 26 years old
• medical history: non contributory
• special anamnesis: „direct contact with a ellbow“
• referral slip from the omfs: horizontal root fracture tooth no. 8, TTS for 4 weeks, please NSRT
Freitag, 25. Mai 12
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PA from yesterday
• Perc: +, Vit: -
• TST wnl, mobility: 1-2 (TTS in place!)
• Diagnosis: pulp necrosis due to horizontal root fracture middle third
• double contour may mean 2 fracture linesor deep buccal and high palatal fracture line
Freitag, 25. Mai 12
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CBCT yesterday
Freitag, 25. Mai 12
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Freitag, 25. Mai 12
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Freitag, 25. Mai 12
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Freitag, 25. Mai 12
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Freitag, 25. Mai 12
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Reconstructionfacial lateral palatal
Freitag, 25. Mai 12
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Problems
• since the fracture line is very close to the cej palatal I decided to leave the splint for 3 months (Dental Trauma Guide: cervical root fractures 4 months, mid 4 weeks)
• how should this case be treated: mid root fracture or cervical fracture?
• are the double fracture lines compromising the prognosis of this tooth?
Freitag, 25. Mai 12
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Treatment plan 1
• splint for 4 months
• wait and control closely for 1 year (vitality)
Freitag, 25. Mai 12
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Treatment plan 2
• Access cavity
• clean and shape to the fracture line and leave the apical part „intact“
• placement of MTA
• follow up 2 months 6 months 1 year 2 years
Freitag, 25. Mai 12
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Treatment plan 3
• fracture line compromises the predictability of the case
• extraction and implantation
Freitag, 25. Mai 12
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Any advice is greatly appreciated
Freitag, 25. Mai 12