Oral Health Group

Of tulips and horizontal root fractures


February 1, 2011
by ken

Marga Ree is one of the most stellar endodontists in the world.  She works in the Netherlands and shares cases like these online and a courses throughout the globe.  She will be in Toronto at the George Hare Endodontic Study Club in March.

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 at a dental
school,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. H
is 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. W
e
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

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