Surgical and Nonsurgical Endodontic Management of Horizontal Root Fracture and Cervical Root Perforation

Abstract Horizontal root fractures in anterior teeth present a complex treatment challenge, with prognosis influenced by fracture location and associated complications. This case report describes the successful management of horizontal root fractures in maxillary central incisors, complicated by an iatrogenic cervical root perforation. A combined approach using nonsurgical endodontic therapy, splinting, and surgical intervention, supported by cone beam imaging, facilitated healing. The use of biocompatible materials such as MTA and calcium hydroxide contributed to long-term tooth preservation while the application of magnification tools and ultrasonic tips improved the precision of the surgical approach. Follow-up at 12 months demonstrated clinical stability and radiographic evidence of healing, emphasizing the importance of a multidisciplinary approach to such cases. Long-term follow-up is essential to monitor the healing process and ensure the continued stability and function of the treated teeth.