Timely diagnosis and treatment of horizontal root fractures tied to favorable outcomes, suggests study

Horizontal root fracture (HRF) is a complex traumatic dental injury that affects the pulp, dentin, cementum, and periodontal ligament. This retrospective cohort study evaluated treatment outcomes in permanent teeth with Horizontal root fracture. They analyzed clinical and radiographic data from a dental trauma centre (2006–2022). Permanent teeth with HRF with a follow-up of ≥12 weeks were considered for outcome assessment (defined as clinical normalcy and radiographic healing at the fracture line). Prognostic factors were identified through multivariable logistic regression analyses (P value ≤ .05). Results: 125 teeth from 103 patients were included. After a median follow-up of 79 weeks, the overall favourable outcome was 92%. This includes teeth that received emergency splinting/repositioning at baseline (62.2%) and those that received subsequent endodontic intervention for the coronal fragment (baseline: 85%; subsequent follow-ups: 91.8%). Being male and incomplete root development were both significantly associated with a better outcome of splinting/repositioning and a reduced likelihood of requiring endodontic treatment. Treatment delays surpassing one week were significantly associated with an increased likelihood of requiring endodontic treatment compared to timely presentations within 24 hours.

With timely diagnosis and treatment, and close monitoring, Horizontal root fracture cases can achieve a 92% favourable outcome. Male sex and incomplete root development correlate with improved baseline outcomes and a reduced need for endodontic treatment. Conversely, delayed presentation increases the likelihood of requiring endodontic intervention.

Reference:

Mahshid Sheikhnezami, Reza Shahmohammadi, Hamid Jafarzadeh, Amir Azarpazhooh. Long-Term Outcome of Horizontal Root Fractures in Permanent Teeth: A Retrospective Cohort Study. Journal of Endodontics. Open AccessPublished:February 12, 2024DOI:https://doi.org/10.1016/j.joen.2024.02.002

Keywords:

Timely diagnosis, treatment, horizontal root fractures, favorable outcomes, Endodontic treatment, healing, horizontal root fracture, outcome, pulp, traumatic dental injury, Mahshid Sheikhnezami, Reza Shahmohammadi, Hamid Jafarzadeh, Amir Azarpazhooh