Treatments of horizontal root fractures: four case reports

Horizontal root fractures are rare in comparison to other types of injuries and the reported
prevalence in the literature is between 0.5% and 7%. The treatment and prognosis of root
fractures depend on many variables, the most important being the length of time between trauma
and treatment, degree of dislocation and mobility, site of fracture, fixation period, stage of root
development, age of patient, and quality of treatment. The ideal healing type is hard tissue healing.
The aim of these case reports is to present four different patients who had horizontal root fractures
of immature permanent teeth treated by repositioning and fixation with good healing. Patients were
referred to our clinic with a complaint of mobility and tenderness in their upper central incisors
as a result of an orofacial injury. As a result of radiographical examination, horizontal fractures
were diagnosed on the roots. Teeth were repositioned and rigid fixation was applied. Splints were
retained for about 12 weeks. After splints were removed, patients were scheduled for follow‑up
visits at 3 month intervals. After long‑term clinical and radiographical follow‑up, all teeth presented
positive response to electrical pulp tests, suggesting a repair of root fractures. These immature teeth
showed radiographic evidence of continued root development and normal color and mobility, and
no pain was observed in horizontal and vertical percussion tests. Patients reported no discomfort
with their teeth. Using splints without any further treatment was found to be successful in the
presence of suitable conditions for the treatment of horizontal root fractures.