This 13 year old boy has sustained a trauma on tooth 11. The horizontal root fracture has unfortunately been treated by his dentist by performing an endo in the 2 segments. After a while the coronal segment has been retreated by another dentist, with gutta-percha and sealer.
His symptoms never went away, tooth was sensitive to percussion and showed a greyish discoloration. He has been adviced to have the tooth extracted, because everything possible had been done.
But later on by endodontist submitting this article did a conventional retreatment till the fracture level, and filling the coronal segment with MTA. Then, in the same session, he raised a flap and removed the apical fragment in 2 parts. The fracture line is usually not horizontal, but oblique, and left a reverse bevel to the palatal aspect of the root. You can see the apical fractured segment in two parts on the clinical pic. After removing the sutures, he placed sodium perborate for a few days, and finally filled the access opening with composite. The boy is doing well, and in my opinion there is a reasonable chance for tooth to be retained, at least till he is old enough to have an implant.
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