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Root Fracture. Clinical findings: Coronal segment may be mobile/displaced. Percussion positive. Bleeding from the sulcus Clinical findings: Coronal segment.

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Presentation on theme: "Root Fracture. Clinical findings: Coronal segment may be mobile/displaced. Percussion positive. Bleeding from the sulcus Clinical findings: Coronal segment."— Presentation transcript:

1 Root Fracture

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

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

4 Alveolar Fracture

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

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


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