Outcomes for root-fractured permanent incisors: a retrospective study.
OBJECTIVE
The objective of this study was to assess the outcomes for treated root-fractured permanent incisors with respect to pulp vitality, root tissue union, and tooth survival and to examine the effects of clinical and radiographic parameters and rigid splinting on the outcome.


METHODS
Eighty-four teeth were identified and data extracted from case notes prior to transfer to an SPSS data base for analysis. The odds ratios for each factor were calculated and the significance of differences was determined. Tooth loss and relevant risk variables were examined using Cox's regression model and Kaplan-Meyer survival curves.


RESULTS
Fourteen (17%) had fractures in the apical third, 47 (56%) in the middle third, and 23 (27%) in the coronal (gingival) third. Twenty-four (29%) also had crown fractures involving enamel and dentine. Crown fractures were identified as significant risk factors for pulp vitality. Loss of pulp vitality, horizontal displacement, and extrusive displacement of the coronal fragment were significant risk factors for hard root tissue union. Survival was poorest with gingival third fractures with 14 (61%) of these teeth being lost. Splinting rigidly had no significant effect on pulp vitality and type of root tissue healing.


CONCLUSIONS
Loss of pulp vitality was significantly associated with enamel-dentine crown fracture. Hard root tissue union was significantly affected by pulp necrosis and luxation of the coronal fragment. Survival was poorest for root fractures within the gingival third of the root. Splinting with rigid fixation had no significant effect on pulp vitality and type of root tissue union.
Welbury
R
R
Department of Child Dental Health, Glasgow Dental Hospital and School, Scotland, UK. Welbury@dental.gla.ac.uk
Kinirons
M J
MJ
Day
P
P
Humphreys
K
K
Gregg
T A
TA
D000293:Adolescent; D000328:Adult; D002648:Child; D003743:Dental Enamel / Q000293:injuries; D003782:Dental Pulp / Q000293:injuries; D003788:Dental Pulp Diseases / Q000209:etiology; D003790:Dental Pulp Necrosis / Q000209:etiology; D003804:Dentin / Q000293:injuries; D005500:Follow-Up Studies; D006801:Humans; D007180:Incisor / Q000293:injuries*; D016017:Odds Ratio; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D012307:Risk Factors; D013165:Splints; D013223:Statistics as Topic; D016019:Survival Analysis; D019227:Tooth Apex / Q000293:injuries; D014084:Tooth Avulsion / Q000209:etiology; D019228:Tooth Crown / Q000293:injuries; D014082:Tooth Fractures / Q000628:therapy*; D016388:Tooth Loss / Q000209:etiology; D014092:Tooth Root / Q000293:injuries*; D016896:Treatment Outcome; D014945:Wound Healing