EMERGENCY : Managing Patients With Primary Incisor Root Fracture

Injury to a primary incisor following a traumatic injury. Diagnosis of a root fracture may be suspected but must be confirmed radiographically. 

Presentation 

Population 

Incidence of primary tooth trauma is greatest when motor coordination is developing, around 2–3 years of age. 

More Likely to Occur 

° Protrusive incisors are more susceptible to dentoalveolar trauma. 
° Root fractures are uncommon in the primary dentition. Due to the plasticity of alveolar bone, luxation injuries are more common in the primary dentition. 

emergency-children

Signs 

The coronal tooth fragment may be absent, mobile, displaced or display normal physiologic mobility. 


Symptoms 

° Pain may or may not be reported. 
° Inability to occlude or discomfort with occluding if the coronal fragment is displaced or mobile. 

Diagnosis 

Based upon radiographic findings, a root fracture diagnosis is confirmed. 
° Occlusal film(s): root fracture visualized, most commonly seen in the middle or apical third 

Differential Diagnosis 

° Avulsion or complete intrusion, if the coronal fragment is not visible clinically 
° Luxation, if the coronal fragment is displaced 
° Subluxation, if the coronal fragment is mobile but not displaced 
° Concussion, if the coronal fragment is neither mobile nor displaced 




°jcda.ca 
°Canadian Dental Association 
°Jennifer MacLellan, DDS, MSc, Cert Ped, FRCD(C)