Contribution of cone beam computed tomography in the diagnosis of root fracture

case report

Abstract

Aim: Root fractures are a type of trauma that can compromise the dental element, and if not properly diagnosed and treated, can lead to the loss of the fractured teeth. This paper aims to present a case of application of CBCT in the diagnosis of root fracture. Case Report: Patient 50 years old, female, attended the dental office with complaint of painful symptomatology on tooth 36, and had been perceived for 3 months, with mild worsening during the reported period. It was reported a history of endodontic treatment in tooth 36, 1 year ago. Intraoral examination revealed pain to percussion. After a clinical examination, a periapical radiograph revealed periapical bone rarefaction in the lateral periodontium and furcation region of the tooth 36, vertical loss of the alveolar bone crest on the distal face. A CBCT of the tooth 36 was performed to evaluate the possibility of cracking or root fracture and this revealed a hyperdense image inside the mesiobuccal, mesio-lingual and distal root conduits compatible with endodontic filling material and longitudinal hypodense line, extending from the cervical to the apical third, at the distal root, compatible with fracture and associated bone loss, with furcation. Considering the diagnosis, tooth extraction and planning for implant rehabilitation were performed. A periapical radiography was performed 4 months after the extraction and signs compatible with bone repair were noted. Final Considerations: CBCT contributed to the diagnosis of root fracture, and established the correct treatment plan for the case.