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International Poster Journal of Dentistry and Oral Medicine



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Int Poster J Dent Oral Med 20 (2018), OMD/PDA     15. Jan. 2019
Int Poster J Dent Oral Med 20 (2018), OMD/PDA  (15.01.2019)

Supplement, Poster 2024, Language: English

Root Fractures
Clinical Approaches
Santos, Filipa Barros dos / Morais, Catarina / Fernandes, Ricardo / Bernardino, Pedro / Freitas, Vítor
Introduction: Dental fractures are the third most common cause of tooth lost and they can be coronal or radicular fractures. They can also be classified according to fracture direction: horizontal or vertical. The first ones are the most common. The main cause for this type of fractures are direct traumas on anterior teeth, mostly on upper central incisors. Vertical fractures extend along the long axis of the root towards the apex, and they can be complete or incomplete, supra-osseous or infra-osseous, involving only one or both sides of the root.
Objectives: Understand the different types of root fractures, as the prognosis of the tooth can be different according to the type and location of the fracture and the different treatments which patients are submitted these days.
Methods: The research included the term "root fractures", "vertical root fractures", "horizontal root fractures", "prognosis of root fractures" and "treatment of root fractures". Articles were included in Portuguese, English and Spanish. 20 articles were selected: 7 review articles, 6 research articles and 7 clinical cases.
Results: Horizontal fractures can be classified according to their localization: apical one third, middle one third and cervical one third. Physiological repair of FRH it's a combination of pulp and periodontal ligament responses. Depending on the fracture site, the clinical approach is different. It can be just evaluation of tooth response and endodontic treatment to, in more extreme cases, extraction of the tooth. Vertical root fractures represent approximately 2 to 5% of crown / root fractures, most frequently in endodontically treated teeth. They are a constant problem in dentistry because they are difficult to diagnose in their initial states. In most cases, tooth extraction is the only reasonable treatment when the fracture is finally diagnosed. However, there are other treatment options that should be evaluated.
Conclusions: Fractures are a constant problem in dentistry because they are difficult to diagnose in their initial states. Diagnosis can be problematic and regularly requires only a prediction. Knowing how to identify, make a reasonable prognosis and know how to act according to the clinical implications of each case requires a correct diagnosis and an identification of the different locations and extent of fractures.
Clinical Implications: In the daily practice of the dentist, root fractures are a frequent problem. There are several therapeutic approaches that vary depending on the region that fractured, the patient's age, mobility, and root development / formation. As such, it is crucial that the dentist can make a correct differential diagnosis of this condition, in order to be able to act in the most effective way.

Keywords: Fractures, root, trauma, horizontal, vertical

27th Annual Meeting of the Portuguese Dental Association 2018 (OMD)
08.-10. November 2018
Exponor, Porto, Portugal