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Save a tooth - horizontal root fracture?



Junior member
Jan 1, 2016
After hearing a crack and suddenly feeling my second upper right incisor become very loose, I managed to get an emergency appointment with a locum dentist the next day. They xrayed and diagnosed horizontal root fracture. It's within the gum and about level with the bone end. To date I have very healthy teeth, no fillings and slight bone loss, prob due to a previous Vit D deficiency. I am female in my mid forties. The dentist I saw just wanted to do an extraction and replace tooth with a false tooth on a plate or that I should have an implant in 6 mths after bone has filled in.

I just really wanted to check with dentists on here please if there really is nothing that can be done with a tooth like this to save it. The tooth has stayed in situ, no pain, no blood when it happened and the X-ray shows a very thin line across. I have been eating soft food for last few days, cleaning round it gently and not biting in that area at all. It already feels a little more stable but not much.

I have read of splinting and root fractures healing - is this possible? I'd love to know one way or the other please. (I am usually a very quick and good healer for cuts, sprains, etc usually) If there's a chance of it healing shouldn't I give this a go?

If it can't heal - is there a reason why the tooth could not be removed at the fracture and the remaining root be used to make a natural implant rather than to pull a healthy root and nerve to replace it with a metal implant post? I'm having trouble accepting that pulling my tooth, in this day and age of clever and innovative break throughs, is the only solution. I do a lot of singing and play wind instruments so the idea of a plate scares me and is making me feel very old - I've always looked after my teeth and visit dentist every 6 months. I will see regular dentist in a few days but have only seen once before too as she's new. Looking for words of wisdom from experienced, innovative expert please!
hello goodteeth! happy new year!

I'm not a dentist nor an expert; I've had more than my fair share of many, many dental treatments over the years (I too am a 40 something female and have recently had several dental concerns happen all at once!). So feel free to ignore my ramblings if you're seeking expert opinions only. :)

A horizontal fracture must be a difficult tooth to treat, based on what your dentist has advised. I understand that a *vertical* root fracture is generally viewed as a lost cause the majority of the time, unless only one root of several is affected and there's a possibility the tooth can be saved by only removing the damaged root tip. Horizontal fracture - I would imagine that treatment would depend on where exactly the fracture is located. Is it at the very tip of the single root? If it is, I would ask if an Apicoectomy has any chance of success in your case. Does your dentist have *any* hesitation about diagnosing the fracture based on imaging? Is he/she seeing any indication of root resporption or infection on the imaging?

If Apico is not a viable solution, I would ask about the idea of splinting it. I've read that this can be successful, but it depends on several factors such as age, exact extent of fracture and symptoms (among others).

Personally, given my own experience with tooth roots and RCT and Apico surgeries, I'd recommend you consult a respected Endodontist. An Endo will tell you if the tooth is worth investing for further treatment or if it's a lost cause. If you're still not satisfied, seek a third opinion from another General Dentist or Oral Surgeon (<<OS would be my next step after Endo).

It is very expensive where I live (America, west coast) to get an Implant and generally, most oral surgeons want payment up front. However, the implant process for many of us is 3-4 different stages spaced out by several months each. Which can really help - it's not as if I have to fork out $5-6 grand in one sitting.

I recently lost a front adult tooth, #8 (front and center!!). I have a partial denture (what you termed as "false tooth on a plate"), and it has been a big adjustment, but like anything, you *do* eventually adjust. So, I fully understand your hesitation to lose this tooth. It's a very difficult thing to hear that a tooth is going to be lost, much less a front tooth. If I were you, I wouldn't hesitate to get at least a second (or third or fourth) opinion before you jump. I had 6 opinions before I agreed to lose mine! Ask your dentist why you must have extraction, and ask him to explain to you why this tooth can't be saved (or if there's *anything* he can suggest that has even a slight chance of saving it). But if several dental professionals agree the root is fractured and can not be saved, do remember that a fractured tooth can invite infection.

Best of luck.