Management of Horizontal Root Fracture

DR. RODRIGO CUNHA, Endodontist, Winnipeg MB

In this latest episode of CDA Oasis Live, Dr. John O’Keefe invites Dr. Rodrigo Cunha, endodontist from Winnipeg MB, to discuss the management of a horizontal root fracture.

Dr. Cunha explains that it is frequently a case of “less is more” when it comes to treating horizontal root fractures, and backs up his assertion with a case study from his practice involving a paediatric patient who presented two weeks post trauma.

Here are the key takeaways from the conversation…

• Root canal treatment is not necessary in every case of horizontal root fracture. It is often a case of “less is more."
• There are a number of parameters to consider:
  • Age of patient – the younger the patient, the more likely the pulp will regenerate and heal on its own.
  • Open apices vs closed apices (usually goes along with patient age) – when the apices are open there is a higher chance of regeneration and healing.
  • Level of horizontal root fracture – the further the fracture is from the bone crest, the better the prognosis.
• Any case where there is a fracture can be unpredictable. It is always best to indicate this to the patient/patient caregiver.
• Long-term follow-up is imperative. That way if anything goes wrong it can be caught in time and treated accordingly.
• Gradually extend follow-up intervals out to every two years. If the colour of the tooth changes, if a blister shows up on the gum line, or if there are any other symptoms, the patient should be reviewed.

We hope you find the conversation useful. We welcome your thoughts, questions and/or suggestions about this post and other topics. Leave a comment in the box below or send us your feedback by email.

Until next time!
CDA Oasis Team