Resident Albert Einstein Medical Center Willow Grove, Pennsylvania, United States
Traumatic dental injuries (TDIs) can be complex and complicated to manage. Approximately 25% of all school-aged children experience dental trauma, and 33% of all adults will have experienced a traumatic dental injury before age 19. TDIs that involve a root fracture can range in prognosis depending on the location of the fracture. Root fractures can be localized at the apical, middle, or cervical third. However, oblique fractures can also involve the cervical third in the labiolingual dimension. Proper diagnosis, treatment planning, and follow-up are imperative to help ensure a favorable outcome. The current guidelines from the International Association of Dental Traumatology (IADT) recommend stabilizing a tooth with a fractured root with a flexible splint for up to four weeks. Should the fracture occur in the cervical area, the recommendations state that you may splint for an extended period, up to four months, to avoid any long-term adverse outcomes, such as ankylosis. However, no definitive research has ever substantiated those claims and ankylosis and resorption are not typically observed in these case types. The purpose of this table clinic is to review the current guidelines for splinting times for teeth with transverse root fractures and propose an extended splinting time for these case types. We present a case of a mid-root fracture with prolonged splinting without any adverse effects. Clinicians should not fear longer-term splinting, and the splinting time should be based on the individual needs of the patient to achieve better long-term success and survival for TDIs involving root fractures.
