Multidisciplinary Management of Cervical Horizontal Root Fracture: A Case Report and Literature Review

Cervical horizontal root fractures (CHRFs), although less common than mid-root fractures, present a significant clinical challenge due to their location near the alveolar crest, compromising tooth stability and complicating treatment. This paper reviews the etiology, classification, diagnosis, and current evidence-based management strategies for horizontal root fractures, and a case report on the management of CHRF is presented. Emphasis is placed on decision-making between conservative, prosthetic, orthodontic, or surgical treatment, and prognosis factors that influence long-term outcomes. Management of CHRF requires accurate diagnosis and a multidisciplinary strategy tailored to the specific fracture type and patient needs. Collaboration among dental specialties enhances prognosis and patient outcomes. Though CHRF cases are considered to have a poor prognosis, a carefully, well-planned interdisciplinary treatment procedure and various therapeutic techniques and approaches can be employed to promote healing and preserve the teeth with CHRF without undergoing extraction. This case report presents the successful management of a tooth with CHRF through a well-planned endodontic and prosthetic approach. The two fractured fragments were approximated, stabilized, and supported using a resin-bonded fiber post. Owing to its modulus of elasticity similar to that of dentin, along with superior flexural, tensile, and fatigue strength, the fiber post offers enhanced resistance to root fracture. Following root canal therapy and tooth preparation, the tooth was restored and splinted with an all-ceramic bridge involving the adjacent teeth. In a diabetic patient with well-controlled blood glucose on medication, healing is anticipated to be fair. Moreover, post-cementation, the restored tooth was kept out of occlusion during functional movements to minimize mechanical stress on the tooth and restoration, thereby promoting healing and optimal biomechanical stability.