Fratura radicular horizontal de terço médio pós-traumatismo dental: relato de caso

Abstract

Root fractures in permanent teeth are uncommon injuries, occurring in approximately 0.5 to 7% of cases of dental trauma. They are characterized by a discontinuity in the root tissue, often caused by horizontal or oblique traumatic forces, resulting from sports accidents, falls, or assaults. Furthermore, the most common location described for these fractures is in the middle third of the root rather than in the apical or cervical thirds. The classification of root fractures can be done according to their orientation in horizontal, oblique or vertical, as well as according to the extent of the lesion, and may involve enamel, dentin, cementum and even alveolar bone. Fractures are more common among adults, as in children the bone is more malleable. In addition, they have an uncertain prognosis and can lead to several complications, from pulp necrosis, root resorption to cases of bone loss or loss of the dental element, compromising aesthetics and can lead to psychological burdens to the victim and dental function. The treatment of root fractures varies according to the complexity of the lesion and may include orthodontic containment, endodontic treatment, tooth extraction, among others. The objective of this paper is to describe a case report of an upper central incisor with horizontal fracture in the middle third of the root. The tooth was treated by the conservative approach of rigid containment for 3 months and follow-up. In the initial evaluation, the upper central incisor, tooth 11, presented mobility and a positive result to the pulp sensitivity test. After performing the repositioning and rigid containment and periodic clinical and radiographic follow-up, tooth 11, with horizontal root fracture in the middle third, showed complete healing and normality to the pulp sensitivity test. After 5 years of follow-up, there were no signs of pulp necrosis, root resorption or mobility, thus characterizing success in conservative treatment.