TRAUMA FRACTURE CBCT – see images below
I suggest extract the tooth place an implant and save the patient from a bunch of speculation and conjecture. The patient only wants a tooth and an implant will give them that predictably.
Andrew W Kelly -IMPLANTOLOGIST
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I have posted this case earlier and wanted to show the CBCT of the 5 year follow-up.
At the age of 13 this boy sustained a trauma on tooth 11. Unfortunately, the horizontal root fracture was treated by his dentist by performing an endo in the 2 segments. Because of persistent complaints, the coronal segment was retreated by a resident of an endo program, with gutta-percha and sealer. I questioned the choice of the root filling material, it’s an illusion to think that this could have been sealed with gutta-percha and sealer. His symptoms never went away, tooth was sensitive to percussion and had a grayish discoloration. He got the advice to have the tooth extracted.
I performed a conventional retreatment till the fracture level, filled the coronal segment with MTA, raised a flap and removed the apical fragment in 2 parts, all this was done in 1 treatment session. We applied sodium perborate for a few days, and the access opening was filled was with composite.
Healing was amazing, after 2 months tooth was rock solid and patient was completely symptomfree, for the first time since the trauma took place. The last rad and CBCT shows a 5 year follow-up. When I posted this case for the first time, there was a lot of discussion about the poor crown/root ratio. He is 18 years old now, and he is doing fine, no complaints whatsoever. I thought it was cool to post the CBCT, you see only one slice, but when scrolling through the images, there is an intact PDL in every single slice!
Marga Ree – ENDODONTIST EXTRAORDINAIRE
