1. Horizontal Root Fracture IN THE NAME OF GOD By:Dr. Roohi Endodontics department

2. description

3. Etiology

4. Root fracture - diagnostic signs Visual signs The coronal segment may be mobile and in some cases displaced. Transient crown discoloration (red or grey) may occur. Bleeding from the gingival sulcus may be noted.

5. Root fracture - diagnostic signs Percussion test Mobility test Sensibility pulp test

6. Radiographic findings Radiographs recommended Root fracture - diagnostic signs

7. treatment

8. Treatment Localization of fracture line Treatment Patient instructions Follow-up

9. Healing patterns

10. Prognosis No events recorded during 10-year follow-up Pul necrosis Infection related resorption Ankylosis resorption Tooth loss Only pulp canal obliteration was seen

11. Prognosis

13. Results, ten years after the injury Number of diagnosed events Estimated risk (%) 95% confidence interval Tooth loss19.1[ 0 - 24.7 ] Pulp necrosis323.1[ 1.6 - 44.5 ] Pulp canal obliteration9> 76.9not available Ankylosis00not available Inflammatory root resorption 00not available Surface resorption00not available Bone loss00not available

14. Prognosis Results, ten years after the injury Number of diagnosed events Estimated risk (%)95% confidence interval Tooth loss411[ 0.8 - 21.2 ] Pulp necrosis1433.2[ 18.4 - 48 ] Pulp canal obliteration25> 67.4not available Ankylosis12.5[ 0 - 7.4 ] Inflammatory root resorption 00not available Surface resorption00not available Bone loss26[ 0 - 14.3 ]

15. Prognosis Results, ten years after the injury Number of diagnosed events Estimated risk (%) 95% confidence interval Tooth loss554[ 27.2 - 80.8 ] Pulp necrosis5> 31.2not available Pulp canal obliteration9> 68.8not available Ankylosis00not available Inflammatory root resorption 00not available Surface resorption00not available Bone loss318.8[ 0 - 37.9 ]

16. Prognosis Results, ten years after the injury Number of diagnosed events Estimated risk (%) 95% confidence interval Tooth loss1021.5[ 6.4 - 36.6 ] Pulp necrosis2230.9[ 19.9 - 41.9 ] Pulp canal obliteration43> 69.8not available Ankylosis11.5[ 0 - 4.3 ] Inflammatory root resorption 00not available Surface resorption00not available Bone loss57.6[ 1.1 - 14.2 ]

17. References Andreasen FM, Andreasen JO, Bayer T. Prognosis of root fractured permanent incisors – prediction of healing modalities. Endod Dent Traumatol 1989; 5: 11–22.Andreasen FM, Andreasen JO, Bayer T. Prognosis of root fractured permanent incisors – prediction of healing modalities. Endod Dent Traumatol 1989; 5: 11–22. Andreasen FM, Andreasen JO. Resorption and mineralization processes following root fracture of permanent incisors. Endod Dent Traumatol 1988; 4: 202–214.Andreasen FM, Andreasen JO. Resorption and mineralization processes following root fracture of permanent incisors. Endod Dent Traumatol 1988; 4: 202–214. Andreasen JO, Andreasen FM, Mejàre I, Cvek M. Healing of 400 intra-alveolar root fractures. 1. Effect pre-injury and injury factors such as sex, age, stage of root development, fracture type, location of fracture and severity of disclocation. Dent Traumatol 2004; 20: 192-202.Andreasen JO, Andreasen FM, Mejàre I, Cvek M. Healing of 400 intra-alveolar root fractures. 1. Effect pre-injury and injury factors such as sex, age, stage of root development, fracture type, location of fracture and severity of disclocation. Dent Traumatol 2004; 20: 192-202. Andreasen JO, Andreasen FM, Mèjare I, Cvek M. Healing of 400 intra-alveolar root fractures. 2. Effect of treatment factors such as treatment delay, repositioning, splinting type and period antibiotics. Dent Traumatol 2004; 20: 203-211.Andreasen JO, Andreasen FM, Mèjare I, Cvek M. Healing of 400 intra-alveolar root fractures. 2. Effect of treatment factors such as treatment delay, repositioning, splinting type and period antibiotics. Dent Traumatol 2004; 20: 203-211. Cvek M, Tsilingaridis G, Andreasen JO. Survival of 534 incisors after intra-alveolar root fracture in patients aged 7-17 years. Dent Traumatol 2008; 24: 379-87.Cvek M, Tsilingaridis G, Andreasen JO. Survival of 534 incisors after intra-alveolar root fracture in patients aged 7-17 years. 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Oxford: Blackwell/Munksgaard Publishing Company. 2003, 34-35. Andreasen FM, Andreasen JO, Cvek M. Root fractures. In: Andreasen JO, Andreasen FM, Andersson L, (eds.). Textbook and Color Atlas of Traumatic Injuries to the Teeth (4 th ed.). Oxford, Blackwell 2007. 337-371 Andreasen JO, Ahrensburg SS, Tsilingaridis G. Root fractures: the influence of type of healing and location of fracture on tooth survival rates -an analysis of 492 cases. Dent Traumatol. 2012, 28: 404-409Andreasen JO, Ahrensburg SS, Tsilingaridis G. Root fractures: the influence of type of healing and location of fracture on tooth survival rates -an analysis of 492 cases. Dent Traumatol. 2012, 28: 404-409 Andreasen JO, Ahrensburg SS, Tsilingaridis G. Tooth mobility changes subsequent to root fractures: a longitudinal clinical study of 44 permanent teeth. Dent Traumatol.2012, 28: 410-414Andreasen JO, Ahrensburg SS, Tsilingaridis G. Tooth mobility changes subsequent to root fractures: a longitudinal clinical study of 44 permanent teeth. Dent Traumatol.2012, 28: 410-414 Hermann NV, Lauridsen E, Ahrensburg SS, Gerds TA, Andreasen JO. Periodontal healing complications following concussion and subluxation injuries in the permanent dentition. A longitudinal cohort study. Dent Traumatol. 2012, 28: 386-393Hermann NV, Lauridsen E, Ahrensburg SS, Gerds TA, Andreasen JO. Periodontal healing complications following concussion and subluxation injuries in the permanent dentition. A longitudinal cohort study. Dent Traumatol. 2012, 28: 386-393 DiAngelis AJ, Andreasen JO, Ebeleseder KA, Kenny DJ, Trope M.International Association of Dental Traumatology guidelines for the management of traumatic dental injuries: 1. Fractures and luxations of permanent teeth. Dent Traumatol. 2012, 28:2-12DiAngelis AJ, Andreasen JO, Ebeleseder KA, Kenny DJ, Trope M.International Association of Dental Traumatology guidelines for the management of traumatic dental injuries: 1. Fractures and luxations of permanent teeth. Dent Traumatol. 2012, 28:2-12

19. etiology

20. Treatment