Fractured Root: Symptoms and Treatments
Fractures in dental roots do not always cause severe pain. You may have a fractured root and not know it. Therefore, it is important to understand the symptoms of fractured roots, as the problem is serious and needs treated by a dental professional, as X-rays are one of the few ways to accurately detect cracks and fractures in the root and dental crown.
Symptoms of fractured roots
Painful sensitivity when chewing or feeling the roots.
The most common symptom present in dental root fractures may not appear immediately after the installation of the problem. In some situations, for example, these symptoms may be present months after the root fracture.
Clinical mobility of the tooth.
Teeth that move at the touch of fingers or dental instruments deserve double attention. This is because the problem can be confused with the natural mobility present in teeth with bone loss due to periodontal problems. Furthermore, the increased mobility of the tooth may not be noticed by the patient. The radiographic examination, as well as for any clinical sign found, is fundamental in aiding the diagnosis of the fracture.
Gum swelling.
Gums that swell from time to time can be the cause of many problems, such as gingivitis itself. But for many cases of fractures, the situation may be indicative of fractures in the roots of teeth. The problem is more common in anterior teeth.
The treatment and prognosis of a fractured anterior tooth root depends on several factors. Among them are the time between the fracture and treatment, the degree of mobility of the tooth, the location of the fracture (the closer to the gum, the worse the recovery prognosis), the degree of tooth development (children have a worse prognosis for fractures in permanent teeth), age and quality of care provided. And among all these factors, the location of the root fracture and the extent of the fracture to the dental pulp (where nerves and blood vessels are located) are the ones that most influence the prognosis and treatment of a fractured root.
1. Temporary immobilization
The treatment consists of immobilizing the tooth until the fracture consolidates – the treatment idea is the same for fractures in long bones such as the radius or the femur. The difference is the way the tooth is immobilized: orthodontic wire joined by resins is the most common technique; tapes with fibers impregnated with resin are more aesthetic alternatives for the treatment. The period of immobilization can range from 45 to 90 days, depending on the degree of mobility or other technical considerations.
2. Apicectomy
When the fracture occurs very close to the apex of the root (almost at the end), surgery to remove the tip of the root (apicectomy) is a very interesting possibility – not to mention essential. And for these procedures, root canal treatment prior to or during the surgical procedure is mandatory.
3. Orthodontic traction
The best prognosis for a fractured tooth root occurs in situations where the problem occurs close to the gums. In these cases, the objective of the treatment is to expose the fractured area above the gums, thus allowing repair techniques either with fixed dental prosthesis in porcelain or dental restoration in resin or porcelain.
4. Surgery to increase the clinical crown
An alternative to orthodontic traction is surgery to lengthen the clinical crown. Similar to techniques such as gingivoplasty and gingivectomy, the technique exposes fractures located close to the gingival margins, thus allowing recovery with dental prostheses or resin or porcelain restorations.
5. Extraction
Extraction (tooth removal) is common in several situations, mainly for fractures located in certain specific parts of the root. In these cases, the treatment of the fractured tooth root ranges from dental implants to fixed dental prostheses such as bridges.