Endodontic Healing of Horizontal Root Fractures: A Case Report

Abstract

Traumatic injuries of teeth are more frequently observed in the maxillary anterior region. Root fractures in permanent teeth are quite uncommon with frequency between 0.5% and 7% among all cases of dental trauma. Horizontal root fracture are most commanly seen in the middle third, followed by apical, and coronal third. Treatment choices vary depending on pulp vitality and root development stage. When pulp remains vital spontaneous healing can be observed but if pulp looses its vitality endodontic treatment is indicated. This case report describes horizontal root fracture of the maxillar right central incisor of a 10 year-old boy and its healing after root canal treatment. On clinical examination both of maxillar central incisors were slightly mobile and the gingival tissues around the teeth were severaly injured and edematous. Teeth were splinted for 3 weeks after the traumatic injury and endodontic treatment was applied at the and of this period due to the loss of vitality of both teeth. Root apex of left central incisor was open and the tooth was treated with apexification using Ca OH 2 for 10 months. The coronal part of the right central incisor was also treated by using Ca OH 2 for 8 months and the apical part remaind vital

Keywords

• horizontal root fracture, Kalsiyum Hidroksit

Horizontal kök kırığının endodontik tedaviyle iyileşmesi: bir olgu sunumu

Abstract

Travma sonucu meydana gelen yaralanmalar ön grup dişlerde sıklıkla görülmektedir. Daimi dentisyondaki yaralanmaların % 0,5-7’sini oluşturan kök kırıkları ise oldukça nadir görülmektedir. Travma sonucunda dişin kökünde meydana gelen kırıklar kökün anatomik yapısına göre; koronal, orta veya apikal üçlüde görülebilmektedir. Kök kırıklarının tedavisi pulpanın vital veya nekrotik olmasına ve kök gelişim aşamasına bağlı olarak değişmektedir. Kırık dişte pulpanın vitalitesinin korunduğu durumlarda herhangi bir tedavi uygulanmadan iyileşme beklenirken pulpanın nekrotik olduğu durumlarda ise kök kanal tedavisi yapılmalıdır. Bu vaka raporunda, apikal üçlüsünde horizontal kök kırığı bulunan 10 yaşında erkek hastanın daimi sağ santral 11 dişinin endodontik tedavisi anlatılmaktadır. Hastanın intraoral muayenesinde üst santral dişlerinde lüksasyon olduğu ve diş etlerinde ödem ve harabiyetin bulunduğu gözlenmiş, radyolojik muayene sonucunda ise üst çene sağ santral dişinin apikal üçlüsünde horizontal kök kırığı olduğu tespit edilmiştir. Tedavi başlangıcında dişlerin splintlenerek takip edilmesine karar verilmiş ancak 3 hafta süren takibin ardından yapılan vitalite testinde santral dişlerin devital olduğu tespit edilmiş ve o seansta dişlere kanal tedavisi başlanmıştır. Fragmanları ayrılmış horizontal kök kırığı bulunan 11 numaralı dişin koronal kısmı 8 ay boyunca, apeksi açık 21 numaralı diş ise 10 ay boyunca Ca OH 2 ile apeksifikasyon tedavisi uygulandıktan sonra kök kanal dolguları tamamlanmış ve 12 ay süreyle takip edilmiştir.

Keywords

• horizontal kök kırığı, kalsiyum hidroksit

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