17/05/2024
Cervical root fracture, 5-year follow-up
A 28-year old female fell from her bike during her holiday in France, and went to a hospital the next day. She was diagnosed with a complicated crown fracture of 21, luxation of 11, and a complicated cervical root fracture of 22. The original fragment that snapped off from 21 was re-attached.
The tooth with the cervical root fracture showed mobility 3, the dentist in France applied a splint, and recommended extraction of 22.
I saw her 1 week after the accident, and took a CBCT. It looked pretty hopeless.....
Since we had nothing to loose, I decided to remove the splint from 14-11 and 24 after another week, and to leave the splint on 21-22-23 in place for 3 months. All teeth tested vital, also 22.
We removed the splint after 3 months, and the tooth was still slightly mobile, but no pain anymore. I told the patient that she had to overcome her fear to use the tooth again in daily life, and that is what she did, step by step.
At the 1-year follow-up, the tooth didn't show any mobility and the patient was asymptomatic. All teeth tested vital.
Then she came with complaints after 2 years. I expected the worst scenario for the tooth with the cervical root fracture, but it was rock solid, tested vital and didn't show any probing depths. The pulp of 21 had become necrotic, and we did root canal treatment on this one.
At the 5 year follow-up, 22 was still stable, no complaints, fully asymptomatic.
A nice example of the healing capacity of an intra-alveolar root fracture in the cervical one-third of the root!
If you want to learn more about root and crows-root fractures, come to Deventer on May 30, where I will give a presentation on this topic, admission is free of charge!
See: https://www.colosseumdental.nl/academy/colosseum-dental-talks/ #/aanmeldformulier