The Endo Fix
Serial periapicals of maxillary central horizontal root fracture showing pulp canal obliteration

Horizontal Root Fracture

This seems to be fairly predictable of this case type. Stabilize it. Monitor it. Watch it pulp canal obliterate (PCO). And the root tip kinda sails off into the sunset. Based on those that I’ve seen, a horizontal root fracture like this doesn’t have a terrible prognosis as long as it’s managed correctly. Meaning the doc keeps his handpiece holstered.

Serial periapicals of maxillary central horizontal root fracture showing pulp canal obliteration

Here’s a couple other older cases with the same progression. The increased density caused by PCO can cause some color changes, not to be confused with a necrotic tooth. No intervention is necessary. If desired, internal bleaching without endodontic therapy can be offered, which of course carries its own risks, benefits, and alternatives.

Older horizontal root fracture case: serial periapicals of maxillary incisors and smile photo
Horizontal root fracture case: serial periapicals of maxillary central and clinical photo

Some of these can be observed in the wild 30 years after the fact.

Periapical and CBCT sagittal of a long-standing horizontal root fracture in a maxillary incisor

If a patient of yours has a traumatic dental injury, here is what we tell families.