Q: What should be the immediate treatment of an anterior tooth that has a fracture in the middle portion of the root?
A. Pulpectomy to the coronal portion and apicoectomy of the root portion
B. Pulpectomy to both portions of the tooth
D. No treatment required
We can perform pulpectomy of the coronal portion, but performing apicoectomy of the almost half of the root of an anterior tooth will result in large amount of bone cutting and damage. Therefore, this is not a feasible practical treatment plan.
We can perform pulpectomy of both coronal and apical portion of the roots immediately. For the time being, we can fill the entire root canal with non-setting calcium hydroxide and seal it temporarily. This non-setting calcium hydroxide will stimulate the Cementoblast cells to repair the root fracture. We can perform complete root canal treatment later on, if the tooth concerned remains asymptomatic.
Root fracture in the middle of the root will most probably not cause mobility in the anterior tooth. Therefore, we are not supposed to splint it.
No treatment is the last option, if patient or the guardians of the patient do not agree for the proposed treatment. But in examination we have to assume that they will agree.
Considering all the above-mentioned factors, the option B seems to be the logical option.
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