Treatment Strategies for Primary Root Fractures: A Case Series

Traumatic dental injuries (TDIs) constitute a clinically significant concern in pediatric dentistry, necessitating special attention to the trauma affecting primary dentition due to their potential to cause damage to the underlying permanent successors. The anatomical proximity of primary tooth roots to developing permanent tooth germs increases the risk of sequelae, making root fractures in primary teeth more challenging to diagnose and manage. This case series highlights the diagnosis and management of TDIs in three pediatric patients aged 4-7 years, each presenting with varying severities of horizontal root fractures and associated symptoms in the primary maxillary incisors. Among traumatic dental injuries in children, root fractures of primary teeth are clinically significant, with horizontal root fractures being the most commonly reported type, and their prognosis is largely determined by the fracture location and extent. Clinical presentations in this case series ranged from no mobility and the displacement of the teeth to severe luxation injuries. Management strategies were modified according to each case to have a favorable prognosis followed by esthetic rehabilitation. All patients were monitored through clinical and radiographic follow-ups, demonstrating favorable healing outcomes with no evidence of any adverse sequelae. The management of horizontal root fractures in primary teeth requires a case-specific approach based on the fracture level, tooth mobility, the root status of the primary tooth, and potential impact on the permanent successors. Each case is unique; hence, early diagnosis, appropriate intervention, and regular follow-ups are essential to achieve favorable outcomes in root fractures of primary teeth and to safeguard the developing permanent dentition.